In my work as a cardiologist, I spend the majority of my time caring for people living with heart failure. Whether you’ve received a heart failure diagnosis or you’d like to know how to prevent it, it’s been my experience that knowing the right information at the right time is key to getting the right care for your heart.
That’s why it’s so important to talk with a doctor about your concerns. By voicing your concerns and asking questions, you help us make sure your heart care is as personalized and effective as it can be. Having these types of discussions is one of my favorite ways to help people live a more heart-healthy life. They’re also why I want to take a moment to answer some of the most important and commonly asked heart failure questions to help you get the conversation started.
What is heart failure? What does heart failure mean?
Heart failure is when your heart doesn’t work as well as it should. There are two types of heart failure: heart failure with reduced ejection fraction (also called systolic heart failure) and heart failure with preserved ejection fraction (also called diastolic heart failure).
If you have heart failure with reduced ejection fraction, your heart can’t pump blood very effectively, so less blood makes it out of the heart. If you have heart failure with preserved ejection fraction, your heart is stiff and can’t fully relax after pumping, so less blood enters the heart.
Heart failure isn’t the same as cardiac arrest, which is when your heart suddenly stops working. Instead, heart failure generally develops over time.
What causes heart failure? Can heart failure be reversed?
Several factors cause heart failure. Discovering what’s behind your heart failure also helps us determine how reversible it is.
Sometimes, heart failure can result from another cardiovascular condition, like coronary artery disease, valvular heart disease, or an irregular heartbeat (arrhythmia). When you get treatment for the underlying condition, your heart failure symptoms may improve as well. Other times, heart failure might occur because of built-up strain on the heart due to a combination of poor blood pressure control, dietary indiscretion, or lack of exercise. In these cases, lifestyle changes often help.
I always tell my patients that the best heart failure care starts with prevention. That means understanding if you’re at risk for heart failure, and if you are, taking steps to reduce your risk.
Am I at increased risk for heart failure?
Hypertension (high blood pressure), diabetes (high blood sugar), and high cholesterol levels all put stress on the heart. These conditions increase your risk for heart failure and many other forms of heart and vascular disease.
In addition, you’re more likely to develop heart failure if you or someone in your family has been diagnosed with a heart disease issue in the past, like a heart attack, cardiomyopathy or congenital heart disease.
How can I help prevent heart failure?
If your doctor has told you that you’re at risk of heart failure or other heart problems, it’s important to get your risk factors under control. Healthier eating, more exercise, eliminating smoking and abstaining from alcohol are likely to be some of the recommendations your doctor makes. These changes don’t just support your heart health – they also benefit your overall health, reducing your risk for a variety of potential medical problems. By making subtle lifestyle changes today, you may reduce your chance of needing to make more restrictive lifestyle changes later.
If you have a personal or family history of heart problems, be sure to discuss this with your primary care doctor, see your doctor regularly and stick to your doctor’s instructions for follow-up care. That way, potential heart failure signs and symptoms can be detected sooner, and your primary care doctor can bring in a cardiology specialist when it’s most appropriate.
What are the signs and symptoms of heart failure?
Usually, heart failure symptoms develop over time. Typical signs include decreased exercise tolerance, leg and/or abdominal swelling, a cough that doesn’t go away, shortness of breath, or unusual fatigue.
If you’ve noticed these symptoms, I recommend scheduling an appointment with a primary care doctor. They’ll be able to help determine if your symptoms could be due to a heart problem or something else, like bronchitis. If a heart condition is suspected, they’ll work closely with a cardiologist like me for additional expertise.
How is heart failure diagnosed?
We use a variety of techniques to diagnose heart failure and determine what kind of heart failure you have.
Blood tests help us measure different markers in your body that could point toward heart failure or some other condition. They help us understand how your thyroid, kidney and liver are functioning, in addition to your heart.
We may also use imaging tests, like echocardiograms, chest X-rays, and cardiac MRIs. These give us a direct look at your heart, helping us rule out other conditions. If we see fluid buildup and swelling in and around your heart, that’s often a telltale sign of heart failure. Here, your heart is enlarging to try to compensate for its weakened function.
During diagnosis, we not only try to determine whether you have heart failure but also what’s causing it. If tests show that another condition may be affecting your heart, like coronary artery disease or atrial fibrillation (AFib), that information helps determine how we treat your heart failure.
If I’ve received a heart failure diagnosis, what’s next?
Hearing you have heart failure can be a lot to process. But your doctor will go over all the test results with you and share what you can expect for managing and treating your heart failure. In some cases, we can model different scenarios for how your heart might respond to different therapies. My patients often tell me that these models help to boost their determination as they begin treatment.
Your doctor will tailor your treatment according to the type of heart failure you have. Here at HealthPartners and Park Nicollet, my colleagues and I take a team-based approach to heart failure care. As an integrated care group, we’ll have an expert team dedicated to conserving your heart’s strength to keep it at a stable, functioning level. Treatment from doctors and specialists across departments means that your primary care doctor, cardiologist, therapists and more work together to make sure you get well-rounded care no matter who your appointment’s with. Whenever possible, we’ll work with you to reverse heart failure.
What are some of the most common heart failure treatment options?
In addition to other personalized treatments, managing heart failure almost always involves adjustments to your lifestyle. Regular exercise according to your activity level will be key. Making changes to your diet to restrict your salt intake is also likely, as is cutting out tobacco and alcohol use. Weighing yourself every day also becomes crucial – sudden changes in weight can indicate fluid buildup in your body that needs a doctor’s attention.
After lifestyle changes, medication is typically the next line of treatment. Diuretics are often used because they help flush excess fluid from the body. Depending on what kind of heart failure you have, we may prescribe medications such as ACE inhibitors, ARBs, spironolactone and heart-failure-specific beta blockers to help control symptoms by reducing heart strain.
If additional therapies are needed, we might move onto cardiac resynchronization therapy (CRT) and/or use a device called an implantable cardioverter defibrillator (ICD). These help reduce heart failure symptoms by pacing your heart correctly and preventing sudden death. If you’ve had previous hospital admissions for heart failure, we may also use a CardioMEMS device to help monitor you for fluid retention and proactively adjust medication doses.
You may also benefit from other interventions directed toward your heart failure. When this is the case, cardiac rehabilitation is often used to help you recover more quickly and manage the lingering risk of heart failure.
These treatments have been shown to effectively manage symptoms and improve heart failure outcomes. If you ever have questions about your treatment plan or how to follow it, talk to your cardiologist so we can make sure you’re getting the best guidance.
Remember to stay in touch with your doctor
In the end, here’s what to keep in mind: If you’re at increased risk for heart failure, be sure to discuss with your primary care doctor how to stay heart-healthy and whether you would benefit from regular heart failure screening. Especially if one of your family members has been diagnosed with heart disease, letting your doctor know the details is essential to getting the right care yourself. And if you do have a heart failure diagnosis, be sure to follow your care team’s instructions for treatment to work best.
Heart failure is a serious cardiology condition. That’s why it’s so important to know where your heart health stands to help ensure your heart gets the care it needs. Whether you’re experiencing symptoms of heart failure, you’re at risk or you just want to make sure your heart is as healthy as it should be, scheduling an appointment with one of our primary care doctors is a great first step toward better heart wellness for life.