What are the key symptoms of congestive heart failure. How is congestive heart failure diagnosed and treated. What are the stages of congestive heart failure and their prognosis. How can you prevent congestive heart failure and improve survival rates.

Understanding Congestive Heart Failure: An Overview

Congestive heart failure (CHF) is a chronic condition where the heart struggles to pump blood efficiently to meet the body’s needs. This serious cardiovascular disorder affects millions worldwide and can significantly impact quality of life. While often associated with older adults, CHF can occur at any age due to various underlying heart conditions.

The term “congestive” refers to the buildup of fluid in various parts of the body, particularly the lungs, which leads to one of the most common and distressing symptoms: difficulty breathing. Understanding CHF is crucial for early detection, proper management, and improving outcomes for those affected.

Recognizing the Symptoms of Congestive Heart Failure

Identifying the symptoms of CHF early can lead to timely intervention and better management of the condition. The most common signs include:

• Shortness of breath (dyspnea), especially during physical activity or when lying down
• Persistent coughing or wheezing
• Buildup of excess fluid in body tissues (edema)
• Fatigue and weakness
• Rapid or irregular heartbeat
• Reduced ability to exercise
• Lack of appetite and nausea
• Difficulty concentrating or decreased alertness

Is shortness of breath always a sign of heart failure? While breathlessness is a hallmark symptom of CHF, it can also be caused by various other conditions. However, when coupled with other symptoms like swelling in the legs or persistent fatigue, it warrants immediate medical attention.

The Link Between Breathing Difficulty and Heart Failure

Breathing difficulty in CHF occurs due to fluid accumulation in the lungs, a condition known as pulmonary edema. As the heart’s pumping efficiency decreases, blood can back up in the pulmonary veins, leading to fluid leakage into the lung tissues. This makes it harder for oxygen to move from the lungs into the bloodstream, resulting in shortness of breath.

Diagnosing Congestive Heart Failure

Accurate diagnosis of CHF involves a combination of clinical evaluation, physical examination, and various diagnostic tests. Healthcare providers typically follow these steps:

1. Medical history review and physical examination
2. Blood tests to check for biomarkers like BNP (B-type natriuretic peptide)
3. Chest X-ray to assess heart size and fluid in the lungs
4. Electrocardiogram (ECG) to detect heart rhythm abnormalities
5. Echocardiogram to evaluate heart structure and function
6. Stress tests to assess heart function during physical activity
7. Coronary angiogram in cases where coronary artery disease is suspected

How is the severity of heart failure determined? The New York Heart Association (NYHA) Functional Classification system is commonly used to categorize the severity of heart failure based on the degree of limitation in physical activity.

Treatment Options for Congestive Heart Failure

Treatment for CHF aims to improve symptoms, slow disease progression, and enhance quality of life. The approach is multifaceted and may include:

Medications

Several classes of medications are used to manage CHF:

• ACE inhibitors or ARBs to relax blood vessels
• Beta-blockers to reduce heart rate and blood pressure
• Diuretics to reduce fluid retention
• Aldosterone antagonists to help the body eliminate excess fluid
• Digoxin to strengthen heart contractions
• SGLT2 inhibitors, a newer class of drugs shown to reduce hospitalizations and mortality in CHF patients

Lifestyle Modifications

Patients with CHF are often advised to:

• Restrict sodium intake
• Monitor fluid intake
• Engage in regular, appropriate physical activity
• Quit smoking
• Limit alcohol consumption
• Manage stress

Devices and Surgical Interventions

In some cases, additional interventions may be necessary:

• Implantable cardioverter-defibrillators (ICDs)
• Cardiac resynchronization therapy (CRT)
• Ventricular assist devices (VADs)
• Heart transplantation in severe cases

Can congestive heart failure be reversed? While CHF is generally a chronic condition, in some cases, especially when caught early or caused by treatable conditions like valve abnormalities, it may be possible to reverse or significantly improve heart function.

Stages of Congestive Heart Failure and Prognosis

CHF is typically classified into four stages, as defined by the American College of Cardiology and American Heart Association:

Stage A: High Risk for Developing Heart Failure

Individuals with risk factors such as hypertension, diabetes, or coronary artery disease, but without structural heart disease or symptoms of heart failure.

Stage B: Structural Heart Disease without Symptoms

Patients with structural heart abnormalities (e.g., left ventricular hypertrophy) but no signs or symptoms of heart failure.

Stage C: Structural Heart Disease with Prior or Current Symptoms

Individuals with known structural heart disease and symptoms of heart failure.

Stage D: Refractory Heart Failure

Advanced heart failure requiring specialized interventions.

What factors influence the prognosis of congestive heart failure? Prognosis depends on various factors including the stage of heart failure, underlying cause, comorbidities, adherence to treatment, and response to therapy. While CHF is a serious condition, many patients can lead fulfilling lives with proper management.

Prevention Strategies for Congestive Heart Failure

Preventing CHF involves managing risk factors and adopting heart-healthy lifestyle choices:

• Control high blood pressure
• Manage diabetes effectively
• Maintain a healthy weight
• Exercise regularly
• Eat a heart-healthy diet
• Avoid tobacco use
• Limit alcohol consumption
• Manage stress
• Get regular health check-ups

How effective are preventive measures in reducing heart failure risk? Studies have shown that controlling risk factors can significantly reduce the likelihood of developing heart failure. For instance, maintaining optimal blood pressure can lower the risk by up to 50%.

Improving Survival Rates in Congestive Heart Failure

Enhancing survival rates in CHF involves a comprehensive approach:

1. Early diagnosis and treatment
2. Adherence to prescribed medications and lifestyle changes
3. Regular follow-ups with healthcare providers
4. Participation in cardiac rehabilitation programs
5. Monitoring for and managing comorbidities
6. Staying informed about new treatment options
7. Joining support groups for emotional and practical support

What role does patient education play in improving outcomes? Patient education is crucial in CHF management. Well-informed patients are more likely to recognize worsening symptoms early, adhere to treatment plans, and make necessary lifestyle changes, all of which contribute to better outcomes.

Living with Congestive Heart Failure: Coping Strategies and Quality of Life

While CHF is a chronic condition, many patients can maintain a good quality of life with proper management:

• Develop a support system of family, friends, and healthcare providers
• Engage in activities that bring joy and relaxation
• Consider counseling or therapy to manage emotional challenges
• Explore adaptive techniques for daily activities to conserve energy
• Stay socially connected to combat feelings of isolation
• Set realistic goals and celebrate small achievements
• Stay informed about your condition and treatment options

How can patients balance activity and rest with CHF? Finding the right balance is crucial. While rest is important, regular, appropriate physical activity can improve heart function and overall well-being. Working with a healthcare provider or cardiac rehabilitation specialist can help develop a tailored activity plan.

The Importance of Emotional Well-being

Living with CHF can be emotionally challenging. Depression and anxiety are common among CHF patients and can impact overall health outcomes. Recognizing and addressing mental health concerns is an integral part of comprehensive CHF management.

Advances in Congestive Heart Failure Research and Treatment

The field of CHF management is continuously evolving, with ongoing research focusing on:

• Novel drug therapies targeting specific pathways in heart failure
• Gene therapy approaches to repair damaged heart tissue
• Stem cell treatments to regenerate heart muscle
• Improved mechanical assist devices
• Personalized medicine approaches based on genetic profiles
• Telemedicine and remote monitoring technologies

What promising treatments are on the horizon for CHF? Recent advancements include the development of SGLT2 inhibitors, which have shown remarkable benefits in reducing hospitalizations and mortality in CHF patients. Additionally, research into regenerative medicine techniques, such as using stem cells to repair heart tissue, shows potential for future treatments.

The Role of Artificial Intelligence in CHF Management

Artificial intelligence (AI) is emerging as a powerful tool in CHF management. AI algorithms can analyze vast amounts of patient data to predict disease progression, optimize treatment plans, and identify patients at high risk of complications. This technology has the potential to revolutionize personalized care in CHF.

Global Impact and Public Health Implications of Congestive Heart Failure

CHF presents significant challenges to healthcare systems worldwide:

• High prevalence, especially in aging populations
• Substantial economic burden due to hospitalizations and long-term care
• Strain on healthcare resources
• Impact on workforce productivity
• Disparities in access to care and outcomes across different populations

How are healthcare systems adapting to the growing prevalence of CHF? Many healthcare systems are implementing integrated care models, focusing on prevention, early detection, and comprehensive management of CHF. These approaches aim to reduce hospitalizations, improve patient outcomes, and optimize resource utilization.

The Need for Global Strategies

Addressing the global burden of CHF requires coordinated efforts at local, national, and international levels. This includes:

• Improving public awareness about heart failure and its risk factors
• Implementing population-level prevention strategies
• Enhancing access to diagnostic tools and treatments in underserved areas
• Fostering international collaboration in research and best practices
• Developing policies to support heart-healthy environments

Congestive heart failure remains a significant challenge in cardiovascular health. However, with ongoing advancements in treatment, prevention strategies, and a growing understanding of the condition, there is hope for improved outcomes and quality of life for those affected. By combining medical interventions with lifestyle modifications and leveraging technological innovations, we can work towards reducing the burden of CHF on individuals and society as a whole.

When shortness of breath signals heart problems : Ayim Djamson, M.D.: Cardiology

Title: When Shortness of Breath Signals Heart Problems

Many different heart problems can lead to shortness of breath. It may happen suddenly or gradually over time. It may also occur only during physical activity or in stressful situations.

You should never ignore unexplained breathlessness, as it may be due to a serious underlying health condition. If you experience shortness of breath, please seek medical care.

Here at Metropolitan Cardiovascular Consultants, we partner with our patients to prevent and treat conditions and diseases that affect the heart while preserving and improving quality of life.

Dr. Djamson offers a wide range of cardiovascular services at our outpatient clinics. Patients can access advanced cardiac technology to diagnose and treat conditions that range from simple to complex.

If you have heart health concerns, a visit with a cardiologist is paramount. Symptoms of heart disease range widely, and a comprehensive evaluation is needed to identify and treat problems.

Unexplained shortness of breath may signal an underlying problem with the structure or function of your heart. Below is a list of potentially serious and frequently diagnosed heart conditions which may present with Shortness of Breath.

Coronary Artery Disease

Two main coronary arteries, the Left main and Right coronary arteries supply blood to the heart. These arteries may develop problems leading to serious and potentially life-threatening conditions

Coronary artery disease (CAD) is the most common type of heart disease in the US, it develops when there is a buildup of plaque in the walls of the coronary arteries leading to narrowing and eventually occlusion of these arteries.

These cholesterol rich fatty deposits (plaques) decrease blood flow to the heart muscle leading to a condition called Angina and raises the risk for a heart attack. Symptoms may not appear until there is a significant reduction of blood flow.

Shortness of breath, especially during exertion, may be an atypical presentation of Angina and may be due to underlying CAD.

Heart attack

A heart attack occurs when the heart muscle does not receive enough oxygenated blood and nutrients to function properly

Unfortunately, you might not have any symptoms of CAD until you suffer a heart attack. This makes it crucial to form a strong, collaborative relationship with your provider and schedule recommended checkups for prevention and early detection of heart disease. This is especially true if you have risk factors for CAD, these include Hypertension, Diabetes, High cholesterol, smoking and a family history of Coronary artery disease.

While chest pain is the most common symptom of a heart attack, patients especially women may present primarily with Shortness of breath and worsening fatigue.

You may notice a decrease in energy or breathlessness after minimal activity which you may attribute to ageing, a lack of physical activity or weight gain but these may represent early subtle signs of heart disease or a heart attack

Heart failure

Heart failure is a condition where the heart is unable to pump enough blood to satisfy the body’s need for blood, oxygen and other nutrients. This is caused by either diseased heart muscle which is too weak to pump enough blood to the body (heart failure with reduced ejection fraction) or a thick, stiff heart muscle which does not relax enough to be filled with blood (heart failure with preserved ejection fraction)

Shortness of breath is the most common symptom of heart failure. It is a distressing feeling that may cause you to feel smothered, Shortness of breath initially occurs with exertion but may get progressively worse and eventually occur at rest in severe cases. It typically is worse on lying flat on your back and patients sometimes wake up from sleep and sit up to catch their breath.

Causes of heart failure include CAD, long standing hypertension and a diseased Heart muscle termed Cardiomyopathy, this may be hereditary or may be secondary to diseases like Hypertension, CAD and sarcoidosis. A weakened heart muscle may also be caused by infections which directly damage the heart (myocarditis) most notably there have been multiple reports of Covid 19 causing myocarditis and eventually leading to cardiomyopathy and heart failure.

It is important that Heart failure is identified early and treated. Tests are available to help determine the cause of Heart Failure and treatments are available that have been shown to improve quality of life, reduce hospitalizations and death from heart failure

Cardiac arrhythmia

Heart rhythm abnormalities, conditions in which your heart either beats irregularly, out of step, too fast or too slow may present with shortness of breath, these conditions are usually easily identified and can be successfully treated and in some cases cured leading to a complete resolution of symptoms,

Your provider may first notice an arrhythmia during a routine physical exam. An arrhythmia may signal a harmless condition or something more serious. Common symptoms such as shortness of breath and dizziness require careful evaluation by a specialist.
Valvular Heart Disease
Heart valves work normally to perform 2 tasks 1. Open wide to let blood flow through 2. Keep blood flowing in one direction and preventing blood from leaking back in the opposite direction.
Conditions in which the heart valves do not open all the way lead to a narrowing of the valvular opening termed Stenosis if this is severe it may cause shortness of breath either due to the valve disease itself or because it leads to a cardiomyopathy and lung disease. When a valve is diseased and does not shut completely it allows blood to leak backwards this is termed regurgitation and when severe enough may also lead to shortness of breath. Valvular heart disease is easily diagnosed with a thorough physical exam and tests such as an Echocardiogram. Treatment of heart valve disease is more successful if instituted early, before patients develop cardiomyopathy and other irreversible effects of valvular heart disease like lung disease

Pericarditis

The pericardium has two thin layers of tissue that surround the heart, and inflammation of the tissue is called pericarditis. If you have pericarditis, you may experience chest pain and shortness of breath. Viral infections and autoimmune disorders can cause pericarditis.

Pericarditis typically resolves on its own, but may be severe or become chronic, it is important to identify and treat the underlying cause.

To learn more about how you can keep your heart healthy, please reach out to us by phone or request an appointment online at one of our three locations in Beltsville, Bowie, and Columbia, Maryland. You can also send a message to Dr. Djamson and his team

Shortness of Breath | Circulation

Difficulty in breathing (also known as shortness of breath, breathlessness, or dyspnea) is caused by various mechanisms related to different problems in the body. In one’s lifetime, one may experience rare episodes of shortness of breath as part of high levels of activity like exhaustive exertion, or during environmental conditions such as high altitude or very warm or cold temperatures. Other than these extreme conditions, shortness of breath is commonly a sign of a medical problem.

When Is Shortness of Breath a Sign of a Medical Problem?

If the shortness of breath is prolonged and persistent, it is likely to be related to a medical condition. If it is sudden and severe in intensity, even if it is of short duration, however, it may warrant medical evaluation. The following are other clues of existence of a medical problem.

• Shortness of breath at rest

• Shortness of breath with activity or exercise

• Shortness of breath when lying down

• Shortness of breath on exposure to allergens or provoking agents

• Shortness of breath accompanied with:

• Chest pain or chest discomfort

• Discomfort or pain in 1 or both arms, pain radiating to jaw, or pain in the neck

• Swelling in ankles and feet

• Fluid weight gain or unintentional weight loss with loss of appetite

• Unusual fatigue

• Sweating

• Yellow, green, or rusty colored sputum or phlegm or blood in the sputum

• Fever

• Wheezing or whistle-like sounds with breathing

• Persistent, chronic cough

• Blue discoloration of lips or fingertips

• Fainting, dizzy spells, lightheadedness

• Club-shaped deformation of fingertips

What Causes Shortness of Breath?

Symptom of shortness of breath can be caused by a variety of abnormalities in different organ systems in the body (Figure).

Organs that may be involved in development of shortness of breath. The X in the upper inset box indicates the location of the respiratory center.

Lung Problems

• Recent infections, such as bronchitis or pneumonia, or prolonged (chronic) infections, such as tuberculosis or chronic bronchitis. Shortness of breath may be accompanied by discolored phlegm and/or fever.

• Asthma, chronic obstructive lung disease (COPD), and emphysema: The airways are narrowed with increased resistance to exhaling air from the lung, resulting in air entrapment in the lung. Shortness of breath may be accompanied by wheezing. With asthma, there is usually an allergy history, whereas with COPD or emphysema, there is usually a smoking history.

• Lung cancer and other tumors: Shortness of breath is commonly accompanied by unintentional appetite and weight loss. There is usually a long history of heavy smoking.

• Scarring and damage of lung tissue by toxins (such as asbestosis) or by systemic illnesses (such as rheumatoid arthritis). There is usually a known history of these systemic illnesses or occupational exposures.

• Clot in the lung circulation (pulmonary embolus): Breathlessness is usually sudden and associated with rapid breathing and may be accompanied by chest pain. People with blood clots in the legs or pelvis (deep vein thrombosis, or DVT), debilitating medical conditions, immobility, or inherited tendency of forming clots may be prone to this condition (for more information about pulmonary embolism, see the Cardiology Patient Page by Goldhaber and Morrisson. Pulmonary embolism and deep vein thrombosis. Circulation. 2002;106:1436–1438).

• Diseases of the lung sac (pleura): If the pleura thickens, becomes scarred, or gets filled with fluid or blood because of infection (pleurisy), cancer, or toxins (asbestosis), or if it becomes filled with air (called pneumothorax) because of trauma, it will hinder expansion of the lung, resulting in shortness of breath.

• Diseases of the diaphragm and/or chest wall: The diaphragm is the muscle that expands the lung. It may become paralyzed after chest surgery. Obesity and spine or chest wall deformities also can produce difficulty in breathing.

Heart Problems

• Heart Failure: The shortness of breath in heart failure is caused by the decreased ability of the heart to fill and empty, producing elevated pressures in the blood vessels around the lung. Common symptoms of heart failure are difficulty in breathing when lying down (this is a specific symptom of heart failure), necessity of propping up the head of the bed with many pillows, wakefulness at night with shortness of breath, cough at night or when lying down, shortness of breath with activity, swelling of ankles or legs, unusual fatigue with activity, and fluid weight gain.

The cause of heart failure is usually damage to the heart muscle. In the majority of patients, this is caused by a heart attack (coronary artery disease). In some, it is caused by leakage or narrowing of the heart valves (in this condition, the doctor will report hearing a murmur), weakening of the heart muscle caused by toxins (such as alcohol or cocaine), viral infections, hereditary factors, or unknown factors.

Systemic Illness Problems

• Anemia, low red blood cell count: Because the red cells carry oxygen, when their number is extremely low, the oxygen demands of the body will not be met, resulting in shortness of breath.

• Increased metabolic states such as high thyroid level, shock (extremely low blood pressure), severe systemic infection (sepsis), or fever: The increased oxygen demands of the body will try to be met by breathing heavily and rapidly.

• Kidney or chronic liver problems: Because of increased fluid in the lungs and body and impaired oxygen exchange in the lungs, patients may experience shortness of breath in the advanced stages of both conditions.

Nervous System Problems

• Increased pressure in the brain caused by trauma, tumors, stroke, or bleeding. When the portion of the brain that regulates respiration is affected, these rare conditions may result in difficulty in breathing. Other neurological symptoms usually precede shortness of breath.

• Nerve and muscle disorders that affect the ability to coordinate and expand the chest and that affect movement of the diaphragm may produce difficulty in breathing.

• Anxiety disorder: Anxiety is sometimes accompanied by heavy and rapid breathing (hyperventilation). Shortness of breath usually resolves once the anxiety episode ends.

How Is Shortness of Breath Evaluated?

Your doctor will perform a thorough physical examination and obtain a chest x-ray. If heart disease is suspected, you may undergo an ECG, echocardiogram, or nuclear scan of the heart to measure its pumping function and/or a stress test to evaluate possible blockages in the vessels feeding the heart (coronary artery disease). If lung disease is suspected, you may undergo a lung function study (spirometry or PFT). Occasionally, an exercise test (cardiopulmonary exercise test) may be conducted on a treadmill or a bike to measure lung gas exchange, physical fitness, and heart function. Additional testing, such as a CT (computerized tomography) scan, may be required in some cases.

How Is Shortness of Breath Treated?

The type of treatment depends on the underlying cause. If you are diagnosed with heart failure, you may be treated with medications such as fluid pills (diuretics), angiotensin-converting enzyme inhibitors, digoxin, and beta-blockers. If asthma or chronic lung disease is the cause, you may be treated with medications that reduce the spasm or inflammation of the airways or with oxygen. For infection, you may be prescribed an antibiotic.

What Can I Do to Take Care of Myself?

• Quit smoking. Cessation of smoking will help to relieve some of your symptoms and to reduce your risk for lung cancer.

• Avoid exposure to allergens, dust, and toxic substances. If you are an asthmatic, avoid exposure to the allergens that cause shortness of breath.

• Avoid becoming overweight and exercise regularly. Always consult your physician before beginning a weight loss or exercise program.

• If you have heart failure, take your medications regularly, avoid salt intake, and weigh yourself daily to monitor fluid status.

• Learn about your medical condition. Talk with your healthcare provider to learn about methods to alleviate or resolve shortness of breath. Develop an action plan for worsening symptoms.

Footnotes

Correspondence to Biykem Bozkurt, MD, Medicine, 4C211, Houston VA Medical Center, 2002 Holocombe Blvd, Houston, TX 77030. E-mail [email protected]

Additional Resources

• American Thoracic Society. Consensus statement on dyspnea. Available at: http://www.olivija.com/dyspnea./ Accessed June 13, 2003.Google Scholar
• American Academy of Family Physicians. Diagnostic evaluation of dyspnea. Available at: http://www.aafp.org/afp/980215ap/morgan.html. Accessed June 13, 2003.Google Scholar

Heart Failure Symptoms | Michigan Medicine

Topic Overview

If you have heart failure, symptoms start to happen when your heart cannot pump enough blood to the rest of your body.

Shortness of breath

While shortness of breath is the most common symptom of heart failure, it may be difficult or impossible to distinguish it from shortness of breath caused by other health problems such as emphysema or severe anemia. Your doctor can help you determine why you have been feeling short of breath.

People with heart failure experience shortness of breath in many different ways. You might feel that:

• You can’t catch your breath.
• You feel tightness in your chest.
• You feel tired when you walk.
• You need to stop a lot when you walk.
• It gets worse when you lie flat, and it may wake you up at night.

Shortness of breath from exertion or exercise. If your shortness of breath isn’t severe, you may notice it only when you are exerting yourself, and sometimes only during more intense exertion. The medical term for this symptom is dyspnea (say “DISP-nee-uh”).

When heart failure develops gradually, your shortness of breath also may develop gradually, which can make it hard to notice. But people with more severe heart failure may have shortness of breath with minimal exertion.

Shortness of breath while lying down. People with more severe heart failure may experience shortness of breath when they lie down. The medical term for this symptom is orthopnea (say “or-THAWP-nee-uh”). The severity of this symptom usually depends on how flat you are lying—the flatter you lie, the more you feel short of breath.

To gauge the severity of this symptom, doctors often ask people how many pillows they need to lie on to avoid feeling short of breath in bed. For example, “three-pillow” orthopnea is worse than “two-pillow” orthopnea, because you have less tolerance for lying flat.

The reason you may have orthopnea is that when you lie flat, the blood that ordinarily pools in the veins of your legs is reentering your bloodstream. If you have heart failure, your heart may not be able to keep up with the increased amount of blood returning to the heart, so fluid builds up inside the lungs and causes shortness of breath.

Shortness of breath while sleeping. Some people with heart failure wake up in the middle of the night with severe shortness of breath. The medical term for this symptom is paroxysmal nocturnal dyspnea (PND). This may occur with waking up coughing and/or wheezing, having a rapid heart rate, and a feeling of being suffocated.

In general, people who experience PND don’t feel increased shortness of breath when they first lie down. But after several hours of lying down, they awake with shortness of breath, which often occurs suddenly. People who experience PND often have to sit up on the side of the bed, and they may feel a need to open a window to get more air. The shortness of breath generally goes away after a few minutes of sitting up.

Being very tired (fatigue)

You might feel that:

• You have less energy and feel more tired than usual.
• You can’t exert yourself like you could before.

You might also have low exercise capacity. This can be harder to describe. It is a symptom that people with heart failure often don’t even notice because they have gradually reduced the level at which they exert themselves.

For example, they may stop walking up the stairs, or they may drive to the store instead of walking. Some people at first deny that they have been experiencing this symptom. It is only after doctors ask them about changes in their activities that they realize they have been avoiding physical exertion. This decrease in your ability to exert yourself physically is what doctors call low exercise capacity.

Swelling in ankles or feet

People with heart failure often experience swelling in their ankles or feet. You might notice that:

• It gets worse at the end of the day or after you stand for long periods.
• It hurts.
• Pressure leaves impressions in your skin.
• Shoes no longer fit.

The degree of swelling you experience depends on how well your body is compensating for heart failure and how much sodium and water your body retains. In some cases the swelling is mild and merely bothersome, while in other cases it can be severe and painful if the skin becomes taut and sensitive.

The medical term for this swelling in the legs is pedal edema—”pedal” refers to the feet and “edema” refers to the buildup of excess fluid. Heart failure often causes what doctors call “pitting edema,” meaning that applying pressure to the swollen skin leaves an indentation in the skin. Doctors often test for edema by pressing their thumb to the skin and seeing whether it leaves an impression. You may see this yourself if you take off your shoes and socks and find that your socks have left an impression in the skin of your ankles and feet.

You may notice more severe swelling if you have been eating too much salt, which causes your body to retain fluid. Elevating your feet or wearing supportive stockings can help relieve the swelling.

Sudden weight gain

Weight gain may be the first noticeable sign that you have developed heart failure or that your heart failure is getting worse. The amount of weight gained varies greatly among people with heart failure, and it reflects the amount of sodium and water the body has retained.

A sudden weight gain may mean that excess fluid is building up in your body because your heart failure is getting worse. It is a symptom of sudden heart failure.

Your doctor will probably ask you to weigh yourself every day. Know when to call your doctor if you suddenly gain weight.

Your doctor likely will work with you to manage changes in weight caused by fluid retention. For example, if you have a weight increase of 2 lb (0.91 kg), your doctor may recommend taking an additional diuretic that day.

Heart Failure Signs and Symptoms

Heart failure is a condition in which the heart fails to function properly. The terms “heart failure” and “congestive heart failure (CHF)” don’t mean that the heart has actually “failed” or stopped but mean one or more chambers of the heart “fail” to keep up with the volume of blood flowing through them.

Heart failure is brought on by a variety of underlying diseases and health problems.

Your condition may involve the left side, the right side or both sides of the heart. Each side has two chambers:

• An atrium or upper chamber
• A ventricle or lower chamber

Any one of these four chambers may not be able to keep up with the volume of blood flowing through it.

Two types of heart dysfunction can lead to heart failure, including:

• Systolic Heart Failure This is the most common cause of heart failure and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs.
• Diastolic Failure The muscle becomes stiff and loses some of its ability to relax. As a result, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.

The left side of the heart is crucial for normal heart function and is usually where heart failure begins. The left atrium receives oxygen-rich blood from the lungs and pumps it into the left ventricle, the heart’s largest and strongest pump, which is responsible for supplying blood to the body.

After it has circulated through the body, blood returns to the right atrium and then travels to the right ventricle, which pumps it into the lungs to be replenished with oxygen. When the right side loses pumping power, blood can back up in the veins attempting to return blood to the heart.

Right heart failure may occur alone but is usually a result of left-sided failure. When the left ventricle fails, fluid backs up in the lungs. In turn, pressure from excess fluid can damage the heart’s right side as it works to pump blood into the lungs.

Heart failure usually is a chronic, or long-term, condition that gradually gets worse. By the time most people notice and see a doctor about their symptoms, the heart has been “failing,” little by little, for a long time.

This is a good reason to have regular health checkups. During a routine physical examination, your doctor may detect signs of heart failure long before you experience symptoms. Heart failure rarely occurs suddenly except after a major heart attack, severe heart valve problem or period of seriously high blood pressure.

Heart failure symptoms – HonorHealth Heart Care

Symptoms provide the key to detecting heart failure in its earliest stages. That’s why HonorHealth wants you to recognize heart failure symptoms and talk with your physician when they occur.

Heart failure symptoms depend on the area of the heart that’s damaged or weakened:

• Left-sided heart failure: This is most likely to involve edema (swelling) congestion in the lungs, accompanied by difficulty breathing.
• Right-sided heart failure: This typically results in edema in the feet, ankles, legs, fingers, abdomen and abdominal organs. Because a weakened heart cannot pump out enough blood, it has less room to accommodate blood returning from other parts of the body. Sudden weight gain resulting from this swelling is common.

While symptoms involving heart failure may be isolated to one area of the body, heart failure effects can be felt throughout the body and severely impair your quality of life.

Left-sided heart failure indications

Left-sided heart failure is related to pulmonary congestion. The left side of the heart receives oxygen-rich blood from the lungs. When the left side is not pumping correctly, blood backs up in the blood vessels of the lungs — pulmonary edema. As blood backs up in the lungs, pressure in the veins of the lungs increases. Fluids within the lungs are pushed into breathing spaces, interrupting the normal flow of oxygen.

Related symptoms include:

• Shortness of breath: Shortness of breath often becomes a problem during physical activity, but also can happen during rest. Difficulty breathing may occur suddenly at night, but may subside by moving around. Extra pillows to prop up your upper body can help you breathe more easily in bed.
• Persistent cough: A seemingly unexplained cough produces pink phlegm containing blood.
• Pulmonary crackles: Popping sounds occur when air is forced through lung passages narrowed by fluid build-up.
• Third heart sound: The normal heartbeat has two sounds made as the heart contracts (pumps blood) and expands (fills with blood). With heart failure, a third sound becomes apparent: The walls of the heart’s ventricles vibrate when blood fills the heart.
• Reduced urine output: With heart failure, the kidneys cannot function properly. Sodium remains in the body, causing water retention.
• Low oxygen saturation levels: This results from the heart’s inability to receive oxygen-rich blood from the lungs.
• Altered digestion.
• Dizziness, lightheadedness and confusion.
• Restlessness and anxiety.
• Fatigue and weakness.

Right-sided heart failure indications

Edema (persistent swelling) of the feet, ankles and legs is the most common symptom of heart failure in the right side of the heart. Edema also can occur in the fingers, abdomen and abdominal organs. Sudden weight gain resulting from swelling is common.

Other symptoms involving the right side of the heart include:

• Enlargement of the liver.
• Ascites: Excess fluid between the tissues lining the abdomen and abdominal organs.
• Severe loss of appetite, accompanied by abdominal pain and nausea.
• Weakness.

Shortness of Breath (Dyspnea) Treatment | Offering Specialized Care for Patients Experiencing Shortness of Breath near Cleveland, OH

For patients experiencing unexplained shortness of breath, also called dyspnea, University Hospitals Harrington Heart & Vascular Institute provides expert, collaborative care with advanced diagnostic testing to help determine the underlying causes of shortness of breath. We are considered a national leader in shortness of breath treatment because we are one of only a few major academic medical centers in the nation offering this specialized care for dyspnea.

We offer expanded testing services for patients who experience any of the following:

• Unexplained shortness of breath
• Diastolic dysfunction or diastolic heart failure
• Exercise-induced high blood pressure in the lungs (pulmonary hypertension)
• Exercise intolerance

In most cases, shortness of breath occurs with physical exertion. However, when it is chronic and not a direct result of physical exertion, it may be a symptom of a more serious underlying cause. Lung and heart conditions including chronic obstructive pulmonary disease (COPD), emphysema, pulmonary hypertension, heart disease and congestive heart failure may all lead to shortness of breath. At University Hospitals, our multi-disciplinary team of heart, lung, sleep and nervous system specialists will work together to pinpoint the cause of your dyspnea and design an individualized treatment plan for you.

Advanced Diagnostic Testing for Patients with Unexplained Shortness of Breath

There are a number of conventional diagnostic tests we may conduct to determine the cause of your shortness of breath. These tests can include:

• Blood tests: Blood tests will measure your blood oxygen saturation and blood gases.
• Chest X-rays: A chest X-ray will evaluate your lung condition.
• Electrocardiogram (ECG): In an ECG, the electrical activity of your heart will be recorded to pinpoint abnormal rhythms or arrhythmias.
• Physical exam: In a physical exam, your medical history and symptoms will be reviewed.

We are among a select few healthcare systems in the nation who offer more extensive exercise stress testing as a cornerstone of our dyspnea program. Exercise stress tests with imaging capabilities can identify stiffness in the heart or issues with lung circulation, including:

• Exercise echocardiogram (Stress Echocardiogram): An echo stress test will use ultrasound waves to create a moving picture of your heart and heart valves during exercise.
• Cardiopulmonary exercise testing (CPET): The test uses a breathing mask to measures oxygen and carbon dioxide gas exchange and more accurately determines a person’s exercise capacity.
• Invasive CPET (iCPET): A cutting-edge approach that uses an arterial catheter to monitor blood pressure and gas exchange to measure heart and lung function during exercise.

Treatments to Help Manage Shortness of Breath

Once the underlying disease or condition that is causing your shortness of breath is determined, our team of specialists will provide an individualized plan that is right for your specific needs. Pain medications to reduce pain, bronchodilators to open airways or steroids to reduce swelling may be prescribed.

Medications are often paired with relaxation and breathing exercises that can help manage your emotions, reduce the severity of your shortness of breath and assist you in becoming more aware of your lung function.

We also offer oxygen therapy as a viable treatment option. It delivers an extra supply of oxygen into your body and can help improve your shortness of breath. In the most serious cases, a mechanical ventilator may be used to regulate the levels of oxygen and carbon dioxide in the lungs. Highly specialized surgical intervention may also be an option if other treatments are ineffective and it is necessary for long-term survival.

Renowned Pulmonary Rehabilitation Program

Many UH patients with breathing and lung disorders benefit from comprehensive care offered through our Pulmonary Rehabilitation Program.

Our rehabilitation team uses a combined approach of exercise, education and counseling and works with cardiologists, nurses, exercise physiologists, dietitians and other specialists to create personalized rehabilitation plans. Through our rehabilitation center services, patients can expect to gain strength, reduce the risk of future cardiovascular and pulmonary illness and improve their overall quality of life.

Learn More about UH Services for Dyspnea

If you or someone you love is experiencing shortness of breath, contact one of our dyspnea specialists at any of our convenient UH locations.

What is Heart Failure | Medtronic

Definition

Heart failure, also known as congestive heart failure, occurs when your heart isn’t pumping enough blood to meet your body’s needs. As a result, fluid may build up in the legs, lungs, and in other tissues throughout the body.

Causes

Heart failure can occur for several reasons. Common causes of heart failure include:

• Coronary artery disease
• Previous heart attack (myocardial infarction)
• High blood pressure (hypertension)
• Valve disease
• Congenital heart disease (condition you are born with)
• Cardiomyopathy (enlarged heart)
• Endocarditis
• Myocarditis (infection of the heart)
• Diabetes

Symptoms

Heart failure symptoms aren’t always obvious. Some people in the very early stages of heart failure may have no symptoms at all. Others may dismiss symptoms like fatigue or shortness of breath as signs of growing older.

Sometimes, however, heart failure symptoms are more obvious. Because of the heart’s inability to efficiently pump blood and supply your organs (such as the kidneys and the brain), you may experience a number of symptoms, including:

• Shortness of breath
• Swelling of the feet and legs
• Lack of energy, feeling tired
• Difficulty sleeping at night due to breathing problems
• Swollen or tender abdomen, loss of appetite
• Cough with “frothy” mucus or phlegm
• Increased urination at night
• Confusion
• Impaired memory

Risk Factors

Some people are more likely than others to develop heart failure. No one can predict for certain who will develop it. Being aware of the risk factors and seeing a doctor for early treatment are good strategies for managing heart failure. Heart failure risk factors include:

• High blood pressure (hypertension)
• Heart attack (myocardial infarction)
• Abnormal heart valves
• Enlargement of the heart (cardiomyopathy)
• Family history of heart disease
• Diabetes

Diagnosis

Only your doctor can tell if you have heart failure and how far the condition has progressed. Your doctor will review your medical history, including past and present illnesses, family history, and lifestyle. As part of your physical examination, your doctor will check your heart, lungs, abdomen, and legs to see if signs of heart failure are present.

To rule out or confirm the diagnosis of heart failure, your doctor may order one or several of these diagnostic tests:

• Echocardiogram
• Electrocardiogram (ECG)
• Chest x-ray
• Exercise test (stress test)
• Cardiac catheterization

If you have heart failure, your doctor may also track your ejection fraction over time. Ejection fraction is the percentage of blood that is pumped out of the heart during each beat. It’s a key indicator of your heart’s health and doctors frequently use it to determine how well your heart is functioning as a pump.

Treatment Options

CARDIAC RESYNCHRONIZATION THERAPY

In some people with heart failure, the lower chambers of the heart don’t beat at the same time, forcing the heart to work harder. These people may benefit from cardiac resynchronization therapy (CRT), which is an implantable heart device, like a pacemaker.

CRT is a clinically proven treatment option for some individuals with heart failure. It sends small electrical impulses to both lower chambers of the heart to help them beat together in a more synchronized pattern. This may improve the heart’s ability to pump blood and oxygen to your body.

LIFESTYLE CHANGES

Your doctor may recommend lifestyle changes such as quitting smoking, limiting your sodium intake, losing weight, or reducing your stress level. These changes can help relieve some of the symptoms associated with heart failure and reduce strain on your heart.

HEART MEDICATIONS

Many kinds of medications are used for treating heart failure. Your doctor may prescribe ACE inhibitors, beta-blockers, blood thinners, and diuretics, among others. In general, a combination of heart medications is typically used.

HEART SURGERY

If your heart failure is caused or made worse by a weak valve, your doctor may consider heart surgery to repair or replace the valve. If your heart failure is serious and irreversible, heart transplant surgery may be considered.

Talk to your doctor about which treatment options are right for you.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

90,000 Heart failure: symptoms, diagnosis, treatment of heart failure

The main function of the heart is pumping, – the heart muscle pumps blood through the body. The task of the blood is to carry oxygen to all organs and tissues.

Heart failure is the inability of the heart to deliver the required amount of blood and oxygen to organs and tissues.
Many heart diseases (hypertension, heart attack, heart defects, myocarditis, etc.)) can lead to heart failure. Sometimes heart failure is a complication of diseases of other organs.

Symptoms of heart failure are varied, from very mild shortness of breath, which a person almost does not notice – to the most severe degrees of the disease, when a person practically cannot move (severe shortness of breath, massive edema, etc.) Shortness of breath and edema are the most specific symptoms of heart failure. Also, symptoms of the disease can be weakness and fatigue, hypotension, heart palpitations, blue lips and earlobes during physical exertion.
Most frequent symptom.

Shortness of breath is a rapid breathing caused by oxygen starvation of tissues. Normally, a person makes 14-16 breathing movements per minute. With heart failure, this figure can double. Shortness of breath caused by heart failure makes it difficult to breathe.
Initially, physical activity becomes a “provocateur” of dyspnea. There is a classification of heart failure into 4 functional classes, depending on the exercise tolerance.

• functional class – shortness of breath occurs during very intense physical exertion.
• functional class – shortness of breath appears with moderate physical exertion.
• functional class – small household loads already cause shortness of breath.
• functional class – dyspnea occurs at rest – the person does not move, but breathes very often.

The extreme manifestation of shortness of breath is the inability to sleep lying down (in the lying position, shortness of breath increases).As soon as a person tries to lie down, he begins to choke. This is due to the fact that when a person lies down, the flow of blood from the veins to the heart increases, but it is unable to pump it. Blood stagnates in the vessels of the lungs, so shortness of breath occurs. Sometimes patients with heart failure sleep half-sitting or even sitting, lowering their legs down – in this position, some of the blood goes into the veins and it is easier for the heart to work. The maximum relief from these symptoms is achieved by sitting in a chair – this is the easiest way for a person to breathe.
Shortness of breath with heart failure can lead to pulmonary edema. This is an acute condition, accompanied by weakness and panic attacks, cold sweat, blue lips. Shortness of breath becomes more and more severe, it is not stopped by the usual methods. If you experience such symptoms, you must immediately call an ambulance. Before the arrival of the brigade, take a half-sitting position with legs lowered, remove all items of clothing that are constricting the throat and chest, and provide fresh air.

Swelling.
Swelling usually occurs on the legs. Most often, swelling begins to appear on the ankles and legs. In the early stages, edema occurs after a long walk, in the evening – and disappears after rest, in the morning. Each person can check their own body for edema. To do this, it is enough to press on the lower leg in front, hold for a few seconds and release. If there is a trace (fossa), there is edema.
The location of the edema depends on how mobile the person is. If a person is mainly in bed rest, lies, edema can be localized on the face, on the sacrum, on the legs.The degree of edema depends on the degree of heart failure – only the ankles, or lower legs can swell, ankles, lower legs and thighs can swell at the same time. There may be swelling all over the body (including an edematous abdomen – accumulation of fluid in the abdominal cavity) – the highest degree of heart failure. In advanced cases of the disease, the kidneys suffer, which cannot cope with the excretion of fluid and it is retained in the body; liver and other internal organs.

Systolic and diastolic, left ventricular and right ventricular, heart failure
Heart failure is primarily subdivided into systolic and diastolic.Systole is the period of contraction of the heart muscle (the heart pushes blood), diastole is the period of relaxation (the heart is drawing blood). In systolic heart failure, the heart is unable to contract strongly enough. The heart muscle is weak and does not expel all the blood into the body. As a result, a certain amount of blood constantly remains in the heart, it begins to stretch, and all organs and tissues suffer from a lack of oxygen. Systolic heart failure occurs in diseases of the heart muscle itself, such as myocarditis, ischemic heart disease (IHD), scarring on the heart, myocardial infarction.
In diastolic heart failure , the heart muscle may contract and expel all the blood, but it is unable to relax enough. The heart takes in less blood than the body needs. Diastolic heart failure can occur with arterial hypertension, amyloidosis (the deposition of a certain protein on the inner wall of the heart, due to which it loses its elasticity), valvular heart disease, diabetes mellitus and other diseases.
To understand the mechanism of right ventricular and left ventricular failure, you need to imagine how blood moves through the body.
The heart consists of two sections – right and left. The right heart is venous. Blood in the heart flows from the veins into the right atrium, then enters the right ventricle, and from there into the lungs. This is a small circle of blood circulation. The blood in it is venous, “dirty”, blue. In the lungs, the blood is enriched with oxygen, it becomes not venous, but arterial. From the lungs, it flows into the left atrium, from there into the left ventricle, and the left ventricle sends blood to the aorta, from where the blood will go through all vessels to nourish organs and tissues.Gas exchange takes place in the smallest vessels (capillaries) – the blood gives off oxygen, takes carbon dioxide. From the capillaries, blood enters the small veins, and further through the veins “dirty” blood moves back to the heart.

Right ventricular heart failure – reduced ability of the right heart to take blood from the veins. Because of this, the veins begin to expand, sweating of part of the blood fluid into the intervascular bed of the subcutaneous fat occurs.Swelling occurs. Therefore, the main manifestation of right ventricular failure is edema. Right ventricular heart failure can develop with diseases of the lungs. For example, the primary disease is bronchial asthma. Due to the fact that the vessels of the lungs are very much changed, the right parts of the heart are forced to work with a very large overload in order to push blood into these changed vessels. The right parts of the heart are weak, not adapted to heavy loads. They do not have time to take blood from the veins.
Left ventricular failure – decreased function of the left heart. The left side of the heart must draw blood from the lungs and pump it into the body. If the left ones do not work well, blood from the lungs flows through the arteries, and the heart cannot pump it. Then some of the blood stagnates in the lungs. Shortness of breath occurs. From the left ventricle, blood is also ejected weakly – not enough blood – a person has low blood pressure, a person can faint. Edema with left ventricular failure can also occur, but the right heart is involved.

Diagnosis of heart failure
It is very important to diagnose the disease in time, to establish its causes. Sometimes, when the causes of heart failure are eliminated, the heart returns to normal functioning. Only a doctor can determine the scope of diagnostics for suspected heart failure based on the patient’s story – what exactly worries, how did the first signs of discomfort appear, etc.
As a rule, an EKG, ECHO KG (ultrasound examination of the heart) is performed.ECHO KG allows you to see how the heart contracts and relaxes (systole and diastole), to clarify the release of blood (amount of blood), to evaluate the work of the heart valves. A biochemical blood test is required, sometimes the function of the thyroid gland is examined. In each case, the scope of the necessary diagnostics is specified, depending on the symptoms.

Treatment of heart failure
In the treatment of heart failure , first of all, drug treatment is used.But in some situations, surgical methods have the best results. For example, for many heart defects, the most effective surgical treatment is valve replacement.
It is very important that in case of heart failure, the patient was observed by one doctor, because the therapy regimen, the selection of drugs is strictly individual. The doctor selects the dosage of the drug for each specific case, and carefully monitors the dynamics of the patient’s condition.

90,000 When there is not enough air: causes of shortness of breath

Almost everyone knows the feeling of shortness of breath when running or climbing stairs.

But there are cases when shortness of breath occurs when walking only a few tens of meters or even at rest. If in such situations it became difficult to breathe, then this is a serious matter.

Breathing is a natural process, so we don’t even notice it. But we immediately feel if something is wrong with our breathing. Especially when, for no reason at all, we begin to suffocate. The brain receives the appropriate signal, and our breathing becomes faster, and this process cannot be controlled by consciousness.Its frequency and rhythm, the duration of inhalation or exhalation have changed – in a word, you feel that you are clearly breathing something wrong. This is shortness of breath.

Types of dyspnea and treatment methods

In most cases, shortness of breath is associated with hypoxia – a low oxygen content in the body or hypoxemia – a low oxygen content in the blood. Which causes irritation of the respiratory center in the brain. The result is a feeling of lack of air, involuntary breathing rate.

There are 3 types of shortness of breath conditionally

• inspiratory dyspnea (difficult to breathe) – more common in heart disease
• expiratory shortness of breath (difficult to exhale), – most often occurs with bronchial asthma due to spasms
• mixed shortness of breath (when both inhalation and exhalation are difficult) – characteristic of a variety of diseases

The most important method of dealing with shortness of breath is to treat the disease that caused it.Once the specialist finds out the cause, an effective treatment plan will be determined. For example, with ischemic heart disease and myocardial infarction, treatment with pills is often used. With bronchial asthma – regular treatment with inhalers. Since the main cause of shortness of breath in many cases is low oxygen in the body, oxygen therapy is one way to reduce shortness of breath.

Causes and treatments

To determine the cause of shortness of breath, it is important to know how quickly it appeared.It can occur acutely – within minutes, hours, several days, or gradually – over several weeks, months or years. Let’s look at the main reasons.

• Poor physical condition

In principle, in this case, shortness of breath is more normal than a cause for serious concern.

Physiological shortness of breath appears after you climb stairs or catch up with a bus. The muscles involved in the work remove oxygen from the blood. The brain is trying to cover the resulting oxygen deficiency, that is, it makes us breathe more often.Such shortness of breath is not dangerous in itself, but if you are gasping for breath even after climbing a couple of floors, it’s time to think about your physical shape. In physically active and trained people, shortness of breath occurs less often.

What can be done to get rid of this shortness of breath? You need regular aerobic exercise, which leads to an increase in respiratory rate and heartbeat. If you don’t have time to go to the gym, brisk walks will do. Go down and up the stairs within 3-4 floors.

• Panic attack

As you know, intense excitement, anxiety, anger and fear stimulate the production of adrenaline.Once in the bloodstream, adrenaline forces the body to pass a lot of air through the lungs, provoking hyperventilation. Therefore, with serious experiences, the heart rate increases and shortness of breath appears.

What to do? Shortness of breath caused by such strong emotions is in principle safe for health. However, for severe panic attacks (and not just in the case of shortness of breath from anxiety), it is better to see a doctor. Severe shortness of breath during a panic may indicate a disease – for example, vegetative vascular dystonia (VVD).

• Anemia or anemia

The most common is iron deficiency anemia. Iron ions saturate the blood with oxygen, play an important role in the processes of hematopoiesis. With their lack, hypoxia develops and an emergency protective mechanism is activated – shortness of breath.

This condition is more typical for women, although in men there is often a lack of iron in the body. The presence of anemia is diagnosed based on the data of a clinical blood test.

What to do to get rid of anemia and shortness of breath at the same time? With a significant decrease in the level of hemoglobin, the doctor prescribes treatment with iron-containing drugs.They must be taken for at least two months and monitored for proper nutrition. Iron is perfectly absorbed from liver and red meat, but from plant foods, for example, buckwheat or pomegranates, which are considered a panacea for anemia, is rather poor. In order for the iron contained in the preparation or food to be better absorbed, vitamin C is also prescribed.

This is no longer just insufficient training, but a serious disease that requires a lot of effort from a person to improve his health. At the same time, the danger is not the external fat on the thighs or buttocks, but the internal one, since obesity is not just a cosmetic defect.
A layer of fat envelops the lungs and heart, preventing a person from breathing normally. In addition, in obese people, the heart bears increased stress, since it needs to pump blood into a large fat pad. Therefore, less oxygen is supplied to important organs.

The solution to the problem is one – to get rid of fat under the supervision of a doctor. You cannot start with vigorous workouts in the gym – the likelihood of loss of consciousness is high.

• Pulmonary diseases

Shortness of breath that occurs with diseases of the respiratory organs is of two types.Inspiratory – when there is difficulty in inhaling as a result of clogging of the bronchi with mucus or lung tumors, and expiratory – there is difficulty in exhaling as a result of spasms that occur with bronchial asthma.

To determine the causes of pulmonary dyspnea, it will be necessary to conduct an examination and treatment under the supervision of a specialist.

• Ischemic heart disease

In this case, shortness of breath is manifested by a feeling of lack of air. In general, shortness of breath is as common a symptom of coronary heart disease as constricting pain in the left side of the chest.
What to do? If you have shortness of breath and severe chest pain for the first time, call an ambulance right away. In men, especially young men, coronary heart disease sometimes manifests itself for the first time with myocardial infarction. When providing first aid, the scope of research is usually limited to a cardiogram, and after that, a cardiologist decides on the examination and treatment.

• Congestive heart failure

It is quite difficult to catch the early signs of this ailment – this is usually done with the help of special examinations.
With congestive heart failure, shortness of breath is always accompanied by a forced position of the patient. It occurs in a person lying on a low pillow and resolves when the patient is in a seated position. For example, US President Roosevelt slept in a sitting position in a chair for this very reason. This shortness of breath occurs due to increased blood flow to the heart in the supine position and overflow of the heart chambers.

Treating shortness of breath in heart failure is not an easy task, but experienced cardiologists and modern medications can sometimes work wonders.

• Cardiac asthma or paroxysmal dyspnea

Such a sudden shortness of breath, developing into choking, often appears at night. Shortness of breath does not go away either sitting or standing. The person becomes pale, moist rales appear in the chest, and the lungs begin to swell. Such a condition threatens the patient’s life, so an ambulance should be called immediately.

Usually, promptly performed treatment is effective and eliminates an attack of cardiac asthma.In this case, the patient will need to regularly visit a cardiologist, since only competent treatment of cardiovascular diseases will maintain health in a normal state.

• Pulmonary embolism

Almost the most common cause of shortness of breath is deep vein thrombophlebitis. At the same time, a person does not always have varicose veins on the surface of the skin, which would give a bell to consult a doctor. The insidiousness of deep vein thrombophlebitis is that the first episode proceeds quite easily – the leg swells slightly, pains and cramps appear in the calf muscle – the sensations are just like stretching, and they are not prompted to be examined by a doctor.The problem is that after that, blood clots appear in the veins of the problem limb, which can move into the pulmonary artery and block the lumen in it. And this, in turn, leads to the death of a portion of the lung – infarction pneumonia.

Signs of pulmonary thromboembolism are severe shortness of breath, stabbing pain in the chest, and a painful cough that appears sharply against the background of normal health. In especially severe cases, a person’s face turns blue.

Modern methods of medicine effectively treat this serious disease, however, it is better not to bring thromboembolism to thromboembolism, but to seek medical help in time for any suspicion of a pathology of the veins of the lower extremities.Signs can include swelling, heaviness in the legs, and cramps in the calf muscles.

As you can see, shortness of breath appears for many reasons, ranging from those requiring only a slight change in lifestyle and ending with those that require serious treatment. Fortunately, many conditions can be prevented or significantly alleviated by timely treatment for pulmonary and cardiovascular disease.

There are contraindications. Read the instructions or consult a cardiologist at the EMC clinic.
90,000 Pet Signs of Heart Disease

Pet Signs of Heart Disease

• B

  • Balashikha
  • Bykovo

• F

  • Railway
  • Zhukovsky

• K

  • Korolev
  • Kraskovo
  • Krasnogorsk
  • Kursk

• L

  • Lobnya
  • Lytkarino
  • Lyubertsy

• M

  • Moscow
  • Moscow
  • Mytishchi

• R

  • Ramenskoe
  • Reutov
  • Rostov-on-Don

• C

  • St. Petersburg

90,000 Cardiology – Congestive heart failure in cats and dogs

Congestive heart failure occurs with serious heart disease when the cardiovascular system is no longer able to function normally.

The function of the heart is like a water pump. If the basement water pump stops pumping water from the foundation during heavy rain, the basement fills with water. A similar thing happens in the body of a sick animal.

When the left side of the heart stops pumping blood adequately, the lungs fill with blood, and if the right side, the same happens to the abdominal and / or chest cavity. Thus, with left ventricular failure, pulmonary edema occurs, and with right ventricular failure, ascites or hydrothorax occurs.

How serious is congestive heart failure syndrome in cats and dogs?

The most common misconception is that congestive heart failure is completely fatal. Although, at present, the forecasts for most cardiac diseases are not long-term, but most animals can live for many months and even years, having a more or less stable quality of life. Early detection of heart disease is important.The earlier treatment is prescribed, the longer the survival rates in patients with cardiac diseases in cats and dogs.

How is congestive heart failure treated in cats and dogs?

Congestive heart failure in cats and dogs is treatable with medication. If your pet’s heart disease progresses and recurs, or congestive heart failure develops, treatment can be continued based on initial observations and, if necessary, a specific drug therapy can be added to establish clinical control.

Management of congestive heart failure is usually carried out in a three-tiered approach:

1. Reduce the preload of the heart (the volume of blood that must be pumped) so that it can function more efficiently. For this purpose, it is necessary to prescribe monotherapy or a combination of diuretics (diuretics): lasix (furosemide), spironolactone, hydrochlorothiazide.

2. Reduce cardiac afterload (the resistance the heart must overcome to pump blood) by dilating the arteries.For this purpose, it is necessary to prescribe vasodilators: angiotensin-converting enzyme inhibitors (enalapril, benazapril or lisinopril), beta-blockers (norvasc, amlodipine), arterial vasodilators (hydralazine).

3. Increase the heart rate and strength: By supporting and improving the work of the heart muscle, blood can be pumped out to the rest of the vital organs. For this purpose, positive inotropic drugs are used (to enhance the work of the heart muscle), in particular pimobendan (Vetmedin) and digoxin.Digoxin also lowers the heart rate by improving circulation to the myocardium and other organs.

What is the prognosis and control of the general condition of a cat or dog with congestive heart failure?

Some dogs may have increased thirst and frequent urination. If this seems excessive, you should contact the specialists of our clinic – you can change the doses of drugs in order to improve or completely resolve this problem.

Renal function and electrolyte levels during specific drug therapy should be monitored through serum biochemical analysis.Typically, your veterinarian will provide instructions on the frequency and type of blood tests to be done.

All drugs have certain side effects, and just like humans, cats and dogs can react completely differently to specific drugs. If you notice that your pet is apathetic, depressed, does not show interest in food, vomiting or diarrhea is observed, then you should contact a specialist in our veterinary clinic.

Most drugs are generally available and are generally well tolerated by small animals.Monitoring and monitoring frequently recurring signs of congestive heart failure at home:

• Increased cough;

• Difficulty breathing;

• Increased breathing intensity;

• Fainting;

• Weakness;

• Physical intolerance.

If you notice one of the above symptoms or have questions, please contact a specialist. Veterinary Center “In the world with animals” Serpukhov is always happy to help you.

Read more – Dilated cardiomyopathy

Congestive heart failure in cats. Cardiologist in Serpukhov

A pathological condition where the cat’s heart cannot deliver enough blood to the body, and therefore cannot pump all the blood from the lungs, is called congestive heart failure . There are many reasons for the development of congestive heart failure in cats.Most often it occurs due to a condition that is caused by thickening of the walls of the heart (hypertrophic cardiomyopathy), but also this pathology can be caused by diseases of the thyroid gland, high blood pressure or congenital heart defects.

A cat with congestive heart failure may have trouble breathing, be weak or tired, may refuse to eat, and may even die suddenly. Depending on the underlying heart problem, treatment may help control congestive heart failure and medications are available to reduce symptoms and improve quality of life.

General

Congestive heart failure is a broad medical term that means that a cat’s heart cannot deliver enough blood to all organs and tissues.

When the heart is unable to pump enough blood, the body can usually compensate for this so that the tissues receive blood and oxygen for their vital functions. However, when cardiac pathology is aggravated, these compensatory mechanisms become ineffective.The heart is then unable to pump enough blood to the body and fluid accumulates in the veins of the lungs. This condition can lead to pulmonary edema – hence the term congestive heart failure.

Although many conditions can lead to congestive heart failure in cats , one of the most common causes is hypertrophic cardiomyopathy. In this pathological condition, the muscle walls of the heart become so thick that they are unable to stretch and fill with enough blood for effective release.As a result, fluid will accumulate in the lung tissue, making it difficult to breathe. Fluid can also sweat into the abdomen, but this is less common in cats than in dogs with similar heart conditions. Often in cats, fluid is drained into the chest cavity

Other causes of congestive heart failure in cats include:

• Hyperthyroidism
• High blood pressure
• Insufficiency or stenosis of heart valves
• Defects in the walls of the heart
• Pathological shunts (patent ductus arteriosus)
• Accumulation of fluid in the pericardium
• Blood clots in the chambers of the heart
• Heart rhythm disturbances
• Inflammation of the muscle of the heart
• Tumors
• Anemia (small number of red blood cells)
• Pregnancy
• Stress

Congestive heart failure can occur at any age, in any breed and in cats of any sex, but it is most common in older older cats.

Symptoms and clinical signs

In the early stages of congestive heart failure, cats show no signs at all. As the disease progresses, signs may include:

• Difficulty or rapid breathing
• Blue or gray gums or tongue
• Loss of appetite
• Weakness or lethargy (fatigue)
• Collapse
• Hind limb paralysis
• Sudden Death

Congestive heart failure in cats is usually diagnosed based on symptoms and results of a physical examination.To definitively diagnose this pathological condition and determine its cause, veterinarians-cardiologists of the World with Animals center usually recommend a number of tests, such as:

• Echocardiogram (ultrasound to assess the structure and function of the heart)
• Chest radiographs (X-rays) to evaluate the heart, blood vessels and lung parenchyma
• Electrocardiogram (ECG)
• Blood pressure measurement
• Blood and urine tests including ACA, biochemistry panel, thyroid hormone test, heartworm test, FeLV / FIV test and urinalysis

Susceptible breeds

In all breeds of cats, as well as outbred and mestizo, congestive heart failure can occur, but in cats of the British, Scottish and Maine Coon breeds, this pathological condition is much more common.

Treatment

In some cases, such as feline congestive heart failure caused by hyperthyroidism, treatment of the underlying condition may resolve some or all of the heart problems. If the problem is caused by a congenital condition (heart defect or developmental defect), surgical correction may be a treatment option. However, in most cases, such a cardiac problem cannot be cured. However, pharmacological treatment almost always improves the quality and longevity of affected cats.

Cats with severe congestive heart failure may require hospitalization and active oxygen therapy. If fluid surrounds the lungs (pleural effusion) or is in the pericardium (pericardial effusion), it must be removed to improve respiratory function and help the heart work more efficiently as a pump.

There are many medications that can help treat cats with congestive heart failure.A low sodium diet may also be recommended to prevent fluid build-up.

Most cats with congestive heart failure require lifelong medication. Periodic blood tests, radiographs, and echocardiograms are often needed to monitor the effectiveness of treatment and to detect early progression of heart disease.

Prevention

There are no methods that can completely prevent the development of heart failure in cats, with the exception of optimizing breeding programs aimed at eliminating any animals with hereditary diseases from reproduction.

Veterinary clinic “In the world with animals” (Serpukhov, Voroshilova st., 133 \ 16) has the entire arsenal of necessary equipment for the timely detection of cardiac health problems in cats. Make an appointment with Andrey Anatolyevich Rudenko, Doctor of Veterinary Science, tel. +7 (4967) 75-34-53 and +7 (916) 245-65-05.

90,000 Scientist explained why coronavirus is dangerous for people with cardiovascular diseases

It is especially important for people with chronic diseases to take care of themselves.Chairman of the Board of the Society of Heart Failure Specialists, Doctor of Medical Sciences, Professor Albert Galyavich told Vechernyaya Moskva about the risks for people with heart disease.

– How common is chronic heart failure for Moscow in particular and for Russia in general?

– According to Russian scientific research, the prevalence of chronic heart failure is 7% – that is, it occurs in 7 out of 100 adults.With age, the likelihood of developing chronic heart failure becomes higher. This is due to age-related changes in the heart muscle and the presence of several concomitant diseases that can affect the work of the heart. The main causes of chronic heart failure are high blood pressure (hypertension), coronary heart disease, myocardial infarction, diabetes mellitus. All these diseases, with a prolonged course and insufficient treatment, lead to changes in the heart muscle, as a result of which the heart pumps blood through the vessels weaker.This is what the medical term chronic heart failure is.

– What are the first symptoms of chronic heart failure that should alert you?

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– The first signs of chronic heart failure may be weakness, increased fatigue, shortness of breath during normal physical activity, which was previously performed without these manifestations. The appearance of edema on the legs, the inability to sleep in a horizontal position are signs of an advanced stage of chronic heart failure.

– What are the risks for people with chronic heart failure during a pandemic? How dangerous is the coronavirus for them? Can chronic heart failure occur in a person who has had coronavirus?

– The new coronavirus affects the vessels of the heart and the heart muscle itself. Damage to the vessels of the heart (arteries) can be manifested by myocardial infarction: sudden pain behind the sternum, severe weakness, cold sweat. The defeat of the heart muscle by the virus is manifested by signs of inflammation (this is called myocarditis): an increase in body temperature, shortness of breath, severe weakness, interruptions in the work of the heart.It is often difficult to recognize inflammation of the heart muscle. To do this, it is necessary to conduct a number of laboratory and complex instrumental studies that are done in specialized clinics. Inflammation of the heart muscle (myocarditis) can lead to a pronounced decrease in the work of the heart, which will manifest itself with the symptoms described above, that is, heart failure. In this regard, if, after any viral infection (including after a mild form of coronavirus infection), such signs as weakness, increased fatigue, a feeling of interruptions in the work of the heart, it is necessary to undergo a special cardiological examination.For people with cardiovascular diseases, coronavirus is the most dangerous, as it can lead to additional damage to the heart muscle and aggravate existing heart failure.

– What’s new in the treatment of chronic heart failure?

– In the treatment of chronic heart failure, new drugs have appeared that reduce the manifestations of heart failure and prolong the life of the patient. Now these drugs are being introduced into the domestic standards for the treatment of patients with chronic heart failure.The question of the appointment of one or another drug for the treatment of chronic heart failure is taken by the attending physician after examining the patient.

– How can a person with this disease protect themselves in a pandemic?

– In the presence of chronic heart failure, the patient must first of all fulfill the general requirements – to maintain social distance, wash hands with soap, beware of hypothermia, try to be less exposed to stressful situations. The last two factors – hypothermia and stress – on the one hand, themselves can contribute to the deterioration of the patient’s condition, on the other hand, they reduce the body’s defenses and increase the likelihood of contracting coronavirus.It is very important for a patient with chronic heart failure to comply with medical recommendations on lifestyle, nutrition and the mandatory intake of medicines prescribed by a doctor.