The good, the bad and the ugly of heart disease risk factors
Congestive Heart Failure: Stages And Types
Systolic congestive heart failure occurs when the heart does not pump blood effectively. There are 4 stages of congestive heart failure. As the stages progress, the symptoms become more severe.
Congestive heart failure may happen when the heart muscle is too weak or when another health problem prevents it from circulating blood efficiently. Over time, systolic congestive heart failure, or heart failure (HF), can lead to dysfunction of other organs due to inefficient pumping.
This article discusses how HF progresses over time and explains the outlook for people with this condition. It also examine the causes, symptoms, treatment options, and stages.
There are four different stages of systolic heart failure: A, B, C, and D.
When the condition progresses to the next stage, a person's chance of surviving decreases.
People with stage A HF do not yet have dysfunction of the pumping activity of the heart but have a high risk of developing HF due to related conditions, such as chronic high blood pressure, diabetes, and coronary artery disease.
SymptomsA person usually has no symptoms of HF at this stage but may experience symptoms of their chronic conditions, including:
People with this stage HF have no problems with the structure of the heart or how their heart works. Treatment should focus on managing risk factors.
Structural heart disease develops at this stage, such as reduced pumping function of the heart, which can lead to an enlarged left ventricle. It can also result from a previous heart attack.
SymptomsMost people at stage B still do not show symptoms of HF.
OutlookA doctor may prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe ACE inhibitors/ARB or ARNI and beta blockers at this stage.
People at this stage will show symptoms of HF linked to underlying structural heart disease, including fatigue or breathlessness. These symptoms usually occur due to problems with the squeezing function of the left ventricle, or the pumping chamber of the heart.
Stage C HF also includes people who no longer show symptoms but are currently undergoing treatment for previous symptoms, such as those who spent time in the hospital with heart failure exacerbation.
SymptomsCommon symptoms include:
A doctor will definitely prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe diuretics, ACE inhibitors/ARB/ARNI and beta blockers, mineralocorticoid receptor blockers, or SGLT2 inhibitors at this stage.
A doctor also may consider implantable cardioverter-defibrillators and cardiac resynchronization therapy at this stage.
At stage D, people will have advanced structural heart disease and display significant symptoms, even when they are at rest.
SymptomsSymptoms may include:
This stage is severe and may require advanced specialized treatment. Such as mechanical circulatory support, continuous inotropic infusion to make the heart squeeze harder, cardiac transplant, or hospice care.
The most common type of HF is left-sided HF. The left side of the heart must work harder to move the same volume of blood around the body. This may cause a fluid buildup in the lungs and make breathing difficult as it progresses.
These fluids give congestive heart failure its name.
There are two kinds of left-sided HF.
With systolic heart failure, the left ventricle cannot contract normally, limiting the heart's pumping ability. The stages of HF only refer to systolic heart failure and not the other types.
With diastolic heart failure, the muscle in the left ventricle stiffens. If the muscle cannot relax, the pressure in the ventricle increases, causing symptoms.
Right-sided HF is less common. It occurs when the right ventricle cannot pump blood to the lungs. This can lead to blood backing up in the blood vessels, which may cause fluid retention in the lower legs and arms, abdomen, and other organs.
A person can have left-sided and right-sided HF at the same time. However, HF usually begins on the left side and can affect the right side if a person does not receive effective treatment.
Symptoms of HF range from mild to severe but may get worse over time if not managed medically.
Lifestyle strategies can reduce the risk of developing HF and can also slow its progress.
To prevent or slow the progression of HF, people should take the following steps:
People who already have HF should take the following steps to prevent further progression:
Without treatment, HF can be fatal. Even with adequate treatment, HF may get worse over time, triggering dysfunction of other organs throughout the body.
HF is more likely to occur in people with other conditions or lifestyle factors that weaken the heart.
Risk factors for HF include:
A doctor or cardiologist will perform a physical exam. This involves listening to the heart, checking for fluid retention, and looking at the veins in the neck to see if there is extra fluid present in the heart. They may order other diagnostic tests, including:
Different medications can help symptoms of and prognosis in HF. These include:
People with advanced HF might need more intensive treatment. Medical procedures that may help include:
Implantable devicesA surgeon might implant a medical device, such as:
A doctor may recommend other procedures for treating HF, including:
Not everyone with HF is an appropriate candidate for a transplant, and people often have to wait a long time before having one.
Heart surgery can be dangerous and invasive but is sometimes necessary, in combination with medications, to help treat HF in the best possible way.
Systolic congestive heart failure occurs when the heart does not pump blood effectively. It may happen for a variety of reasons such as a weak heart muscle or underlining health problems.
There are several stages of systolic congestive heart failure and each stage requires a different treatment. Lifestyle changes, medication, and surgery are typical methods of treatment.
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YOUR HEALTH: Diastolic Heart Failure; Trial Puts Novel Device To The Test
© Provided by Baton Rouge WAFB YOUR HEALTH: Diastolic heart failure; trial puts novel device to the test COLUMBUS, Ohio (Ivanhoe Newswire) - Diastolic heart failure happens when the left ventricle, or the pumping chamber of a person's heart becomes stiff, and blood can't flow from the heart into the lungs. Now, for the first time, doctors are testing a tiny device designed to relieve the pressure and give patients back their lives.
Yardwork makes Cecil Hamilton happy because until very recently, it was impossible - his legs would hurt and he was constantly out of breath.
Hamilton had diastolic heart failure, or DHF. The pumping chamber of his heart was stiff.
"You can imagine it as the heart becomes more of a copper pipe than a water balloon, interventional cardiologist at the Ohio State Wexner Medical Center, Scott Lilly, MD says.
Hamilton was hospitalized regularly for years, but a visit from the oldest of his eight grandchildren strengthened his resolve to get healthy.
"She was scared to death. I said, ÔThen, I gotta do something. I don't know what, but something. I don't want to see that look in my granddaughter's eyes again," Hamilton expresses.
That something was a small device. Hamilton's doctors asked him to take part in a randomized trial of a new device. In some patients, doctors threaded a catheter through the leg into the heart to create a small path between the upper chambers. Then doctors implanted the dime-sized device called an inter-atrial shunt.
Dr. Lilly explains, "That valve allows the blood to go from the left side to the right side. Presumptively reduces the amount of congestion in the lungs."
While Hamilton didn't know for sure that he received the device, he could breathe better as soon as he woke up.
"Three, four days afterwards, I knew that I had it because I could tell a difference," Hamilton exclaims.
He's now back to driving a bus for Ohio State's sports teams, bowling with his grandchildren, and getting his yard ready for another spring season.
Cecil Hamilton's doctors have since confirmed that he did receive the interatrial shunt device, which is designed to stay in place in a patient's heart permanently. A phase three clinical trial is underway to confirm earlier findings that showed patients improved with the device, and then the FDA will consider it for approval.
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Here's What To Do If You Have Pain On The Right Side Of Your Chest
Have Pain on the Right Side of Your Chest? Shutterstock
CHEST PAIN CAN feel like your body is setting off an alarm.
Your chest holds tons of vital organs, including your heart and lungs, of course. Medical issues that can arise with these organs can be life-threatening. So, of course, having pain in your chest can feel scary.
Left-sided chest pain is commonly associated with a heart attack. But what about right sided pain? Is it as serious as left-sided pain? What should you do when you feel that kind of pain?
"Chest pain can range from mild in severity to excruciating, innocent to life-threatening, and anywhere in between," says says Joseph Behn, M.D., family medicine physician at Mayo Clinic Health System.
We asked experts when to worry, and when to get help. All your chest pain questions answered, below.
What Can Cause Right-Sided Chest Pain?Unfortunately, the answer is quite broad—there are so many medical conditions that can cause pain in the chest.
It can be as simple as a pulled muscle or as complicated as pulmonary embolism, says Behn. Digestive issues such as acid reflux can radiate pain into the right side of the chest. Several musculoskeletal problems, such as broken ribs and pulled chest or back muscles can also result in pain. Even shingles can cause discomfort in that area.
More serious issues that deal with the heart and lungs are possible, too. Some can be life threatening, but most of them are treatable if help is sought out quickly. These can include esophagus spasms, pneumonia, aortic dissection, atrial fibrillation, and heart failure.
"While many of these conditions are not life threatening, chest pain should always be taken seriously, regardless of which side is affected," says Jonathan Koppel, M.D., assistant professor and general internist at Mount Sinai Hospital.
It's worth noting that it is possible to feel a heart attack on the right side of your chest. Though it's typically noticed on the left side, heart attack pain can be difficult to localize, or the pain can radiate to the other side of the chest. Pain pathways vary widely from person to person, says John Elefteriades, M.D., cardiologist and Men's Health advisor. This means that how the pain surfaces differs for every individual.
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How Do You Know if Chest Pain Is Serious?Even though it's possible that heart attack pain can show up on the right side of the chest, if it's only on the right and is very distinct in its location, it's unlikely to be from a heart attack, Koppel says.
How the pain materializes may be a signal of its severity. If you feel it gets worse with exertion, or comes with a shortness of breath, get it checked.
Behn says that new-onset pain that has new symptoms may be a sign that there's something more serious going on. If the new pain comes with sweating, nausea, lightheadedness, it's worth getting checked promptly.
Knowing your family health history and your personal risk factors can help you better evaluate pains like this. "It's best not to simply judge chest pain by the physical location of the pain itself but by a patient's clinical risk factors, the behavior and progression of the pain, and by other associated symptoms," Behn says.
For example, if your family has a history of heart attacks, it's best for you to get help right away if you experience any kind of chest pain. Have a conversation with your doctor about what you are predisposed to so you can be prepared.
When Should I Contact A Doctor About Right-Sided Chest Pain?If the pain feels muscular and doesn't come with any other symptoms, call your doctor to make an appointment to double check. If you're unsure, head to an emergency healthcare facility. It may save your life.
"Oftentimes people might create a story in their mind which allows them to brush off the symptoms such as 'I must have pulled a muscle' or 'I must have eaten something that didn't agree with me'," Behn says. "They may be right. They may be fatally wrong."
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