Heart Failure - Topic Overview

If your symptoms suddenly get worse, you will need emergency care.

How is heart failure diagnosed?

Your doctor may diagnose heart failure based on your symptoms and a physical exam. But you will need tests to find the cause and type of heart failure so that you can get the right treatment. These tests may include:

• Blood tests.
• A chest X-ray.
• An electrocardiogram (EKG or ECG) to check your heart’s electrical system.
• An echocardiogram to see the size and shape of your heart and how well it is pumping.
• Cardiac catheterization to check your heart and its blood vessels (coronary arteries).
• A stress test to look for coronary artery disease.

An echocardiogram is the best and simplest way to find out if you have heart failure, what type it is, and what is causing it. Your doctor can also use it to see if your heart failure is getting worse. It can measure how much blood your heart pumps to your body. This measurement is called the ejection fraction. If your ejection fraction gets lower and you are having more symptoms, it means that your heart failure is getting worse.

How is it treated?

Most people with heart failure need to take several medicines. Your doctor may prescribe medicines to:

• Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and vasodilators like hydralazine and nitroglycerin.
• Reduce symptoms so you feel better. These drugs include diuretics (water pills), digoxin, and potassium.
• Treat the cause of your heart failure.

It is very important to take your medicines exactly as your doctor tells you to. If you don't, your heart failure could get worse.

Depending on the cause of your heart failure, you might need surgery to help your heart work better. For example:

• You might havebypass surgery orangioplasty to open clogged arteries, or you may need surgery to repair or replace a heart valve.
• You might need to have apacemaker or adefibrillator if you have a problem with your heart rhythm. These help your heart keep a steady rhythm.

Lifestyle changes are an important part of treatment. They can help slow down heart failure. They may also help control other diseases that make heart failure worse, such as high blood pressure, diabetes, and coronary artery disease. The best steps you can take are to:

• Eat less salt (sodium). Sodium causes your body to retain water and makes it harder for your heart to pump. Your doctor may also ask you to limit how much fluid you drink.
• Get regular exercise. Your doctor can tell you what level of exercise is safe for you, how to check your pulse, and how to know if you are doing too much.
• Take rest breaks during the day.
• Lose weight if you are overweight. Even a few pounds can make a difference.
• Stop smoking. Smoking damages your heart and makes exercise harder to do.
• Limit alcohol. Ask your doctor how much, if any, is safe.