Congestive heart failure

Heart failure can be identified in several ways, including:

• Patient exam, including visual signs of heart failure such as swelling, a cough, pulse changes, shortness of breath, or cyanosis, and a discussion of your symptoms and medical history
• Electrocardiogram (EKG or ECG), which analyzes your heart’s rhythm
• Echocardiogram, which uses sound waves to record the heart’s structure and motion
• MRI imaging
• Stress testing to evaluate your symptoms when you are exercising
• Blood testing to look for signs of infection or elevated heart enzymes that can indicate issues with your heart muscle or a heart attack
• Cardiac catheterization to look for any restriction in your coronary arteries, such as a blockage

After completing this process, your doctor may refer you to a cardiology specialist for treatment.

Treatment

Treatment and prevention of congestive heart failure focuses on reducing risk factors and slowing the progression of existing disease. Heart failure itself cannot be reversed or cured.

The goal of congestive heart failure treatment is to ease symptoms and slow the progression of the disease. Early-stage heart failure can be managed with lifestyle modifications such as diet and exercise, as well as reducing pressure on the heart by losing weight. At home, supplies of oxygen can also ease the shortness of breath and fatigue caused by heart failure symptoms.

Your doctor may recommend medications to reduce the work your heart has to do and eliminate excess fluids from your body to help your heart pump more efficiently:

• ACE inhibitors (angiotensin-converting enzyme inhibitors), which open blood vessels to improve blood flow
• Vasodilators, which perform similarly to ACE inhibitors and may be an option if you cannot tolerate ACE inhibitors or are taking another medication that can’t be combined with an ACE inhibitor
• Beta-blockers, which reduce anxiety and blood pressure, slowing rapid heart rhythms
• Diuretics to reduce the amount of fluid in your body and reduce fluid retention caused by heart failure

Additional therapies for heart failure include:

• Specialized physical therapy
• Surgery to repair issues contributing to your heart failure, such as valve abnormalities, or to implant a ventricular assist device that will enable your heart to pump better
• Heart transplant

Make your heart health a priority by receiving the care and treatment you need right in your community. Dignity Health offers many services for the diagnosis and treatment of congestive heart failure.

Who is a candidate for heart replacement surgery?

The prognosis for heart failure depends on how early it is diagnosed, as well as other health conditions, like diabetes or high blood pressure. Once it begins, heart failure cannot be cured, though the progression can often be dramatically slowed. A heart transplant is the only definitive solution for heart failure.

Using the latest surgical techniques, a growing number of people with heart failure are candidates for a heart transplant. However, heart transplants have strict eligibility criteria in order to make sure that patients who have the greatest need and are most likely to have good outcomes are prioritized. To qualify, candidates usually need to demonstrate the following:

• Age younger than 69
• Diagnosis of end-stage, life-threatening heart failure with a prognosis of less than one year without a transplant
• No active infections or cancer diagnoses
• Healthy weight
• Willing to abstain from alcohol, smoking, and drugs for at least three months before and throughout the process
• Access to sufficient emotional, social, practical, and financial support to recover after surgery

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.