Heart failure is a chronic condition in which the heart muscle cannot pump blood efficiently enough to meet the body's demands. Despite its name, heart failure does not mean the heart has stopped — rather, it means the heart is not working as well as it should. It affects more than 6 million Americans and is a leading cause of hospitalization. Heart failure can affect the left side, right side, or both sides of the heart. Left-sided heart failure is most common and results in fluid backing up into the lungs (pulmonary edema), causing shortness of breath, especially when lying flat or during exertion. Right-sided heart failure causes fluid to accumulate in the legs, ankles, feet, and abdomen. The underlying causes of heart failure include coronary artery disease (the most common cause), high blood pressure, diabetes, cardiomyopathy, valve disease, and previous heart attacks. Some patients develop heart failure after chemotherapy, infections, or alcohol abuse. The condition is classified by ejection fraction — the percentage of blood the heart pumps out with each beat — and treatment strategies differ depending on whether ejection fraction is reduced, mildly reduced, or preserved. Symptoms of heart failure include persistent shortness of breath, fatigue, swelling in the legs and ankles, rapid weight gain from fluid retention, reduced ability to exercise, and a persistent cough or wheezing. These symptoms often worsen gradually, and patients may be unaware of how much their activity has been limited until a frank discussion with their doctor. Management of heart failure combines medications (including ACE inhibitors, beta-blockers, and diuretics), lifestyle modifications such as a low-sodium diet and fluid restriction, cardiac rehabilitation, and monitoring of daily weight and symptoms. For advanced heart failure, options include cardiac resynchronization therapy, ventricular assist devices, and heart transplantation. Our heart failure specialists at Silvaris work closely with patients to develop individualized management plans aimed at improving quality of life and reducing hospital admissions.
