Heart & CV Heart Failure

 General Information

Heart failure occurs when, for whatever reason, the heart is unable to pump sufficient blood to meet the body’s needs. Heart failure has many possible causes, and it may occur at any age from infancy on, but the prevalence of heart failure clearly increases after age 60.

Careful diagnosis of the cause or causes of the heart failure offers the best opportunity for treatment. The signs and symptoms are much the same with any of the various causes of heart failure. Elderly patients may not have typical symptoms. Fatigue, sleeplessness, disorientation, and confusion are early signs of heart failure in elderly patients. Vascular changes may be noted in the legs and feet. Weakness is often present. The common symptoms of heart failure do occur in elderly patients, but often they are not the earliest signs and symptoms.

Important Points in Treatment
Specific treatment for heart failure depends on its cause. When your doctor can find a cause that can be treated directly, it will be treated. Anemia, high blood pressure, and hyperthyroidism are a few of these causes. A number of blood tests not directly related to the heart may be performed to search for causes. If a specific cause cannot be found or cannot be adequately treated, medications directed at the heart failure will be used. Five kinds of drugs are used to treat patients with heart failure: digitalis, diuretics, ACE inhibitors, beta blockers, and vasodilators.

  1. Digitalis, the traditional drug for the treatment of heart failure, improves the heart’s function as a pump. Careful control of the dosage is necessary to get a full effect without producing complicating side effects. Some patients’ problems do not warrant or require the use of digitalis.
  2. Diuretics are drugs that promote the output of excess fluid. Decreasing the fluid accumulation decreases the amount of work the heart must do as a pump, and thus lessens the severity of the heart failure. Often, potassium supplements are necessary to avoid losses that may accompany the use of diuretic drugs.
  3. Vasodilator drugs relax the blood vessels. These drugs, by decreasing muscular contraction of the blood vessels, may also decrease the work that the heart must perform as a pump. This may improve the circumstances of the heart failure.
  4. ACE inhibitors are drugs that modify the pressures within the blood vessels. These drugs can reduce the strain under which the heart is placed.
  5. Beta blockers are drugs that will slow the heart rate and thus will reduce the strain on the heart. These drugs have side effects and require careful dosing.

Besides these specific drugs, several measures that improve heart function do not involve medications. Adequate daily rest interspersed with mild exercise such as walking can help you prevent edema and retain physical fitness. Your physician will help you to find the limits of exercise that are appropriate in light of your heart disease. Limitation of dietary salt also may help control fluid accumulation and improve heart function. The stringency of salt restriction depends on the kind of drugs you are given and your customary salt intake. Generally, a dietitian tailors the amount of salt restriction to the needs of the individual patient, and your physician will help you with this determination. If you are overweight, a careful program of weight reduction also may help restore heart function. Avoid exposure to extremes of heat and cold, which call upon an extra measure of heart function to help you remain comfortable.

Notify Our Office If

  • You develop unusual fatigue or shortness of breath, or awaken at night short of breath, or notice persistent ankle swelling. These symptoms are often found with heart failure.
  • You experience minor changes in behavior, activity, or mentation. Elderly patients may have less typical symptoms, and often the symptoms are of a less specific character.