Heart Failure

Heart Failure

What is heart failure?

Heart failure, also called congestive heart failure, is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the heart's diminshed capacity to pump reflects a progressive, underlying condition. Nearly 5 million Americans are living with heart failure, and 400,000 to 700,000 new cases are diagnosed each year.

What causes heart failure?

Heart failure may result from any or all of the following:

How does heart failure affect the body?

Heart failure interferes with the kidney's normal function of eliminating excess sodium and waste products from the body. In congestive heart failure, the body retains more fluid, resulting in swelling of the ankles and legs. Fluid also collects in the lungs, which can cause profound shortness of breath.

What are the symptoms of heart failure?

The following are the most common symptoms of heart failure. However, each individual may experience symptoms differently. Symptoms may include:

The severity of the condition and symptoms depends on how much of the heart's pumping capacity has been compromised.

The symptoms of heart failure may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

How is heart failure diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for heart failure may include any, or a combination of, the following:

Treatment for heart failure

Specific treatment for heart failure will be determined by your health care provider based on:

The cause of the heart failure will dictate the treatment protocol established. If the heart failure is caused by a valve disorder, then surgery may be performed. If the heart failure is caused by a disease, such as anemia, then the underlying disease will be treated. Although there is no cure for heart failure due to damaged heart muscle, many forms of treatment have been used to treat symptoms very effectively.

The goal of treatment is to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy.

Treatment of heart failure may include:

Ventricular assist devices (VADs)

A ventricular assist device (VAD) is a mechanical device that is used to take over the pumping function for one or both of the heart’s ventricles, or pumping chambers. A VAD may be necessary when heart failure progresses to the point that medications and other treatments are no longer effective.

For persons with severe or end-stage heart failure, ventricular assist devices (VADs) may be required to support the heart in order to ensure an adequate cardiac output (amount of blood pumped out by the heart per minute) to meet the body’s needs.

Heart transplantation is an option for some patients with severe heart failure (HF), but during this late stage of HF, over 50 percent of persons on a waiting list for heart transplantation will die before receiving a donor heart. Organ donors are in short supply and do not meet the demand for patients waiting for heart transplant. The wait time for heart transplantation varies from days to months.

Long wait times and decreased availability of donors has led doctors and researchers to seek other methods to support the failing heart. Patients may die waiting for a transplant or other important organs such as the liver and kidney may become permanently damaged before a donor heart is available. VADs have shown great promise in maintaining adequate blood circulation in cases of severe HF.

VADs may be used in the following situations:

The two basic types of VAD's are left ventricular assist (LVAD) which is the most common, or the right ventricular assist (RVAD). If both are used at the same time it is called biventricular assist (BIVAD). However a BIVAD is not a separate type of VAD.

VADs are most commonly implanted during a process similar to other types of open heart surgery.

All types of VADs have similar complications postoperatively and during prolonged therapy:

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