Take Shortness of Breath Seriously; It May Be a Symptom of Heart Failure
About 5.7 million Americans have heart failure, according to the Centers for Disease Control and Prevention. This number has been on the increase for years, because the average age of Americans is increasing, and the condition is more common in older adults. Another reason for the higher number is that, thanks to medical advances, more people are surviving heart attacks, and a history of heart attack increases the risk of heart failure. About 28 percent of men and 41 percent of women who survive a heart attack develop heart failure within five years.
Heart failure is a serious condition that can result in frequent hospitalizations and declining quality of life, and, if it’s untreated, it can be fatal.
“If you have heart failure, eating right, exercising regularly, and being compliant with your medications and your doctor appointments are keys to feeling good, reducing exacerbations of the condition, and living a longer, higher-quality life,” says Joy Gelbman, MD, a cardiologist at Weill Cornell Medicine.
What Is Heart Failure?
Heart failure is not a disease itself but a condition resulting from injury to the heart muscle. The term “heart failure” can be frightening, since it suggests that the heart is no longer working, but the term actually means that the heart is no longer able to effectively pump enough blood to meet your body’s needs. This results in less oxygenated blood reaching the brain, organs and muscles, fluid build-up, and an increased risk of blood clots forming in the heart.
Symptoms and Diagnosis
The most common symptom of heart failure is shortness of breath, which may be sudden and severe or may occur when you are lying flat or exercising. Other symptoms include swelling in the legs, feet, and/or abdomen, fatigue and leg weakness that occur when you are physically active, heart palpitations, coughing up pink phlegm or mucus, and lightheadedness or dizziness. Since these are symptoms that may be caused by a number of conditions, a medical evaluation is necessary to determine what is causing them.
An evaluation for heart failure will include a review of your medical history and symptoms and a physical examination. Blood and urine tests and other noninvasive tests, such as a stress test, echocardiogram, magnetic resonance imaging (MRI) test, or coronary computed tomography (CT) angiogram, also may be ordered.
Risk Factors and Causes
Heart failure is most common in people who have had a heart attack and suffered damage to part of the heart. Heart failure also can result from hypertension, diabetes, a malfunctioning heart valve, cardiomyopathy (a disease that causes the heart muscle to enlarge), myocarditis (inflammation of the heart) or heart defects that are present at birth (congenital heart disease).
Other conditions that raise the risk of heart failure include kidney disease, obesity, thyroid disorders, emphysema, and lupus. Some medications can raise the risk of heart failure, and severe infections and viruses that affect the heart may cause acute episodes of heart failure.
Treatment Options
A heart-healthy diet and regular exercise are key elements for treating heart failure. Your eating plan should consist mainly of fruits and vegetables, whole grains, lean proteins, and healthy fats. Limit red and processed meats and highly processed foods, especially those that are high in sodium.
Exercise is also important, although the shortness of breath that’s a common symptom will probably make physical activity challenging. For guidance on exercise, ask your cardiologist for a referral to a cardiac exercise program, where the staff can create an exercise regimen that is both safe and effective. In addition to benefiting your entire circulatory system, exercise can help you lose weight—an important treatment target since a majority of patients with heart failure are obese.
Some of the medications that may relieve your symptoms and help your heart pump more effectively include beta blockers (Lopressor, Inderal) and ACE inhibitors (Lotensin, Vasotec), angiotensin II receptor blockers (Cozaar, Diovan), and aldosterone antagonists (Aldactone, Inspra). Many patients need to take more than one medication to manage their heart disease.
Advanced heart failure therapies include intravenous medications, implantable cardioverter-defibrillators, pacemakers, and ventricular assist devices that help the heart pump more blood. If all other treatments fail and heart failure is severe, a heart transplant may be the final option.
It is also important to adhere to your doctor’s instructions for managing other conditions that contribute to heart disease, such as high blood pressure, high cholesterol, and high blood glucose levels. And, be sure to tell your doctor about any other over-the-counter or prescription medications you take, as well as any nutrition or herbal supplements, since some can slow your heart rate, worsen high blood pressure, or interact with heart failure medications.
While lifestyle strategies and medications cannot cure heart failure, they can reduce symptoms and prevent the heart from becoming weaker, giving you a longer, more enjoyable life.
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