Heart Failure

Depending on how weak the heart is or how well heart failure is controlled, symptoms may range from mild to severe.

Common symptoms include:

• Shortness of breath
• Swelling in the ankles or lower legs
• Sudden unexplained weight gain (2–3 pounds overnight or more than 5 pounds in a week)

Other symptoms may include:

• Chest pain or changes in heartbeat
• Loss of appetite
• Dry, hacking cough
• Confused or unclear thinking
• Weakness, dizziness or fatigue

If appropriate, your physician will refer you to the Heart Failure Clinic at Parkview Heart Institute.

Health conditions that lead to additional “wear and tear” on the heart may cause heart failure to develop. These conditions include:

• Coronary artery disease
• Past heart attack
• Abnormal function of a heart valve
• Heart muscle disease or inflammation
• Heart defects present at birth
• Severe lung disease
• Diabetes

Heart failure is among the illnesses in a broader category known as heart disease. Heart disease is a chronic illness that can start in childhood and continue throughout one’s lifetime. Many of the same risk factors that increase the chance of developing heart disease in general also make developing heart failure more likely.

• Uncontrollable risk factors include:
• Increasing age
• Family history of cardiovascular disease
• Ethnicity (African-American, Mexican-American, American Indian, Pacific Islander or Asian)

Risk factors that you can control through lifestyle or medical treatment include:

• Smoking or exposure to secondhand smoke
• High blood pressure
• High levels of LDL cholesterol
• Low levels of HDL cholesterol
• Lack of exercise
• Diabetes
• Excess weight (especially weight around the waist)
• Stressful lifestyle

At the Heart Failure Clinic, the care team will determine the best treatment options for you. Recommended treatment will depend on your medical history, a physical exam and how advanced your condition is currently. Treatment is often addressed through these approaches:

• Dietary changes which reduce sodium, cholesterol and saturated fat
• Medications to improve heart function
• Daily weight monitoring to detect fluid retention early
• Exercise to maintain heart function
• Quitting smoking

Typical medications for heart failure include:

• Angiotensin II receptor blockers (ARBS) – treats heart failure and high blood pressure
• Angiotensin II receptor - Neprilysin inhibitor (ARNIs) treats heart failure and high blood pressure, as well as helps the body to eliminate extra water and salt
• Angiotensin converting enzyme (ACE) inhibitors – treats heart failure and high blood pressure
• Aldosterone Antagonist (spironolactone or Epleronone) treats heart failure and is a potassium sparing diuretic
• Beta blockers – treats heart failure and high blood pressure while preventing overly fast heart rates
• Diuretics (also called “water pills”) – treats blood pressure and excess body fluid by prompting the kidneys to release water and salt through the urine.

Diet Modifications

Individuals often need to adjust their diets following a diagnosis of heart failure. The recommended sodium (salt) intake for heart failure patients is 1,500 – 2,000 mg per day. One teaspoon of table salt contains 2,400 mg of sodium!

Limiting sodium may be the most effective change in an individual’s daily activities to reduce symptoms.

Tips for reducing sodium:

• Eliminate the salt shaker
• Read food labels and be aware of sodium content
• Avoid highly processed foods and over-the-counter medications, such as:
  • Canned and prepared foods
  • Milk products
  • Deli meats
  • Fast food
  • Seasonings with monosodium glutamate (MSG)
  • Stomach, cold and headache medicines