Treatments for CHF:

Heart failure caused by an excessive workload is curable by treating the primary disease, such as anemia or thyrotoxicosis or hypertension or diabetes.  Also, curable are forms caused by anatomical problems such as a heart valve defect.  These defects can be surgically corrected.

However, for the common forms of heart failure due to damaged heart muscle no known cure (like a heart attack that damages the heart muscle where the attack took place on the organ) but prevention of it happening again can take place in many cases through treatment of the disease or illness with being compliant in following up with your doctor for the disease or illness and being compliant in following doctor’s orders.   The worst thing you can do is ignore them.  The treatment seeks to improve patients quality of life and length of survival through lifestyle change and drug therapy.

Patients can minimize the effect of heart failure by controlling the risk factors for heart disease they may have.  Obvious steps include:  Don’t smoke or quit smoking, lose weight if necessary, abstaining from alcohol, making those dietary changes to reduce the amount of salt and fat consumed in your diet.

Also, regular with modest exercise is also helpful for many patients; though the amount and intensity should be carefully monitored by a physician.

Even with lifestyle changes, most heart failure patients must take medication but know good tips mention above + taking the meds the doctor prescribed for the congestive heart failure will help. 

Many patients receive 2 or more meds.  Types of common medications given are:  ACE inhibitors, Digitalis, Diuretics, Hydralazine, and Nitrates.

These are some of the meds given for heart failure.

Not all medications are suitable for patients, and more than one drug may be needed.  Always review the list your pharmacist provides in the action, side effects, with instructions of how to take the drug to make it most effective in your body with what to look for while on this medication to keep you the patient most informed on what you should be aware of since your on the medication.  You should know what your taking.

Results of studies over the years have placed more emphasis on the use of drugs:

1-angiotensin converting enzymes (ACE) inhibitors.  Several studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow perhaps even prevent the loss of the heart pumping activity.

This drug  prevents the transfer of your enzyme Angiotensin 1 to convert into Angiotensin 2 which prevents the vessels in your body to do vasoconstriction which prevents the pressure in the bloodstream to raise = high B/P (hypertension) but this medication prevents this from happening.  By the medication doing this it prevents stress to the heart; with vasoconstriction in causing the B/P to go high this now causes the  blood to get to the heart slowly and more difficult causing the heart to pump harder but the ACE inhibitor with allowing vasodilation (opening of vessels) keeps the pressure down to make the job easier= less stress on the heart.  Originally these medications where for patients in the treatment of hypertension but they help patients with heart failure, among other things, decreasing the pressure inside the blood vessels causing the heart to do its job easier.

2-Digitalis increases the force of the heart’s contractions, helping to improve circulation in the body.

3-Diuretics are for reducing the amount of fluid in the bloodstream and body by releasing them via the kidneys and having us void the excess of water out in our urine, these are useful for patients with fluid retention.

Those who aren’t prescribed or cannot take these meds already mentioned may be given a hydralazine medication and/or a drug in the Nitrate classification, each of which help relax tension in the blood vessels to improve blood flow.  Also, both Hydralazine and Nitrates function is they cause vasodilation in the vessels improving blood flow to the heart.

Sometimes heart failure is life threatening.  Usually, this happens when drug therapy and lifestyle changes fail to control its symptoms. In such cases, a heart transplant may be the only treatment option. However, candidates for transplantation often have to wait months or even years before a suitable donor heart is found.

Surgeries for some patients with CHF:

1-Heart Transplant

Studies over the years indicate that some transplant candidates improve during this waiting period through drug treatment and other therapy, and can be removed from the transplant list.

Transplant candidates who do not improve sometimes need mechanical pumps, which are attached to the heart.  Called left ventricular assist device (LVADs), the machine takes over part or virtually all of the heart’s blood-pumping activity.  However, current LVADs are not permanent solutions for heart failure but are considered bridges to transplantation. Worldwide, about 3,500 heart transplants were performed annually. The vast majority of these are performed in the United States (2,000-2,300 annually). Cedars Sinai Medical Center in Los Angeles, California has performed the most heart transplants in the last three consecutive years performing 95 transplants in 2012 alone. About 800,000 people have a Class IV heart defect indicating a new organ.  The degrees of CHF are I, II, III and IV.  In learning more about CHF with heart transplants (including becoming a candidate for one) go to wwwtransplantexperience.com or even hearttransplant.com.

2-Cardiomyoplasty

Another surgical procedure for heart failure that is available in America is cardiomyoplasty.  This is a surgical procedure in which healthy muscle from another part of the body is wrapped around the heart to provide support for the failing heart.  Typically the latissmus dorsi muscle is used which is the largest muscle in the upper body, a broad, triangular muscular covering the lower posterior thorax that works with the shoulder for extension, adduction and internal rotation. A special pacemaker is implanted to make the skeletal muscle contract.  The electrical stimulator causes the back muscle to contract, pumping the blood from the heart out into your blood stream delivering oxygen to body tissue parts all over the body (this allows the heart to do its job more effectively).c0

Complications of CHF:

Through the Mayo clinic as a reference regarding complications their website stated: “If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age. Complications can include:

• Kidney damage or failure. Heart failure can reduce the blood flow to your kidneys, which can eventually cause kidney failure if left untreated. Kidney damage from heart failure can require dialysis for treatment.
• Heart valve problems. The valves of your heart, which keep blood flowing in the proper direction through your heart, may not function properly if your heart is enlarged, or if the pressure in your heart is very high due to heart failure.
• Liver damage. Heart failure can lead to a buildup of fluid that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes it more difficult for your liver to function properly.
• Stroke. Because blood flow through the heart is slower in heart failure than in a normal heart, it’s more likely you’ll develop blood clots, which can increase your risk of having a stroke.

Tips for prevent and deal with Congestive Heart Failure:

• Closely follow your doctor’s instructions, being compliant with the instructions and taking your meds.  Control your weight in making it easier for your heart, that’s in failure, to function better (less stress).  It puts less stress on the heart, remember the heart is the size of your fist. Limit or stop alcohol consumption as your doctor informs you.The best defense against heart failure is PREVENTION!  Almost all the cardiac risk factors can be controlled by eliminating the bad unhealthy habits (smoking, obese, high cholesterol, high B/P, diabetes).If you are needing any guidance in how to lose weight through using all 4 food groups, with assistance in what to eat now to lose weight till you are in therapeutic range for your height rather than eating food from the market or if you need to understand how the body works with food and metabolism with where activity comes into play go to healthyusa.tsfl.com.  See what we can provide you in answering all these questions for you through Dr. Anderson and myself as your coach free.  SO LIVE AS HEALTHY AS POSSIBLE IN YOUR ROUTINE HABITS,  YOUR DIETING OF THE 4 FOOD GROUPS, MAINTAINING YOUR WEIGHT IN A THEREPEUTIC RANGE (look as calculating BMI online for free to find out what your weight range for your height is), and BALANCING REST WITH EXERCISE TO HELP DECREASE THE CHANCE OF GETTING HEART FAILURE.
• Recommended to anyone with heart disease before changing your diet, activity/exercise program review your changes with your doctor to get clearance first to maintain your safety.
• We can fulfill this goal, the one step America is by getting healthier (through diet, exercise, and living healthier habits) which would impact cardiac disease by decreasing it in time which would decrease congestive heart failure. Learn more about CHF on striveforgoodhealth.com with learning how to reach this goal. Let us the people of America take part on decreasing disease and not just leave it the health care or government’s hands. Look at the results already and we the society need to take be responsible in being better for ourselves, our children and our future generations.
• Going to the doctor, in particular a cardiologist, can be stressful but know he or she is there for you.  It is hard to remember everything you want to ask the doctor with everything you hear at your visit.  It helps to prepare a list of questions you may have and bring it with you at your appointment to address to the concerns you listed to the doctor.  In doing this it helps you with your appointment so you can record the answers by listing them on the paper you have.  Before you leave the doctor’s office, be sure you understand your condition, its treatment, including any medications your taking this doctor that he or she prescribes for you with that doctor knowing any other medications you may be on through a different doctor to prevent side effects or adverse reactions occurring but if you forget this about the medications there is always your pharmacist you can ask, than your personal M.D. later.  With you knowing all this information you will see why it is so vital for you doing all these actions or interventions for your disease that your doctor prescribed or ordered and you’re more out to follow them as well with understanding the whole picture about the treatment for CHF.
• Of course, stop smoking permanently if actively smoking.
• Watch what you eat and how much.  Watch the diet intake of cholesterol and sodium that can cause a negative impact on the heart by causing stress to the organ through either high B/P=high sodium intake that causes vasoconstriction or high cholesterol intake frequently that commonly causes blockage in an artery.  Both high sodium or high cholesterol cause diminishing of oxygenated blood getting to the heart.  Without oxygen to our tissues or cells this causes tissue & cellular starvation (ischemia).  What is starvation to the heart=ischemia to the heart=chest pain (what we call angina).  Take a brittle diabetic, the furthest area from the heart is the feet the first area to experience starvation is the toes, foot or lower extremity which is why this is usually the first to be amputated if necessary (you usually see an upper extremity amputated due to trauma not disease).
• Immediately call your doctor of any significant change in your condition, such as an intensified shortness of breath or swollen feet or weight gain of 3lbs or more within one week.
• See your doctor regularly in evaluating your CHF.
• Some people’s symptoms and heart function will improve with proper treatment. However, heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may require heart transplantation or support with an artificial heart device.

“Some heart conditions slowly leave the heart too weak or stiff to fill and pump blood properly. These conditions include narrowed arteries in the heart and high blood pressure.

Proper treatment may improve the symptoms of heart failure and may help some people live longer. Lifestyle changes can improve quality of life. Try to lose weight, exercise, use less salt and manage stress.

But heart failure can be life-threatening. People with heart failure may have severe symptoms. Some may need a heart transplant or a device to help the heart pump blood.

Heart failure also may be called congestive heart failure.”

MAYO CLINIC (Heart failure – Symptoms and causes – Mayo Clinic)

Congestive Heart Failure-signs&symptoms:

A number of symptoms are associated with heart failure (HF), but none is specific for the condition.

1-SOB or dyspnea-Perhaps the best -known symptom is short of breath or difficulty breathing (called dyspnea).  In heart failure, this may result from excess fluid in the lungs=pulmonary congestion=Congestive Heart Failure.  The breathing difficulties may occur at rest or during exercise.  In some cases, congestion may be severe enough to interrupt or prevent you from sleeping.

2-Fatigue or easy tiring-This is another common symptom.  As the heart’s pumping capacity decreases, muscles and other tissues receive less oxygen and nutrition, which are carried in the blood.  Without proper fuel (oxygen from the blood) provided by our engine (the heart), the body cannot perform as much work as it use to do (just like going from in shape to out of shape in time).  The ending line is this will result into fatigue.

3-Edema-Fluid accumulation will cause swelling in the feet, ankles, legs, and occasionally the abdomen (if the fluid building up in the body gets severe), what we medically call that edema.  The most common cause of right sided heart failure is left sided heart failure. You see this edema primarily with right sided heart failure.  Through gravity the blood goes backwards and our body allows water to transfer in the skin to allow the fluid to go somewhere other than the bloodstream to decrease fluid overload to the heart, which is your body trying to compensate with this excess fluid.  Its body compensation since the blood is going backwards from the heart causing fluid back up.  Excess fluid retained by the body will result into weight gain, which sometimes occurs fairly quickly (if you have CHF already you should always call your M.D. if you weight gain is 3lbs or more in a week, odds are high this is due to fluid building up).  This is why everyday a person in the hospital with CHF is weight scaled to keep an eye on fluid build up and report to M.D. anytime it goes over 3lb gain from the intial weight taken when it was therapeutic during that hospitalization.  If the weight gain is over 3 lbs a diuretic commonly used lasix will be given to remove the excess fluid till the weight is therapeutic and only if the pt has good kidneys to pee it out.

-4-Persistent coughing is another common sign, especially coughing that regularly produces mucus or pink, blood-tinged sputum.  Some people develop raspy breathing or wheezing.  Common with fluid in the lungs.

The process of how Heart Failure occurs:

Heart failure usually goes through a slow development, the symptoms may not appear until the condition has progressed over the years.  This happens because the heart first compensated by making adjustments with the heart that delay or slow down but do not prevent the ability of the heart to do its function that is stressed out or later due to some degree of heart failure, the eventual loss in pumping capacity occurs.  In time failure happens, just like a car in that when it gets older over several years is starts showing one problem after another and is exchanged for a newer car; same principle with the heart in that you show no signs and symptoms as your heart starts to slow down but after years of this compensating with the body gets to the point of heart failure and now signs and symptoms may show.  Know there are four stages of heart failure A, B, C, D and in stage A and B the pt has no symptoms yet so symptoms take time to start showing and this starts usually in stage C (Heart Failure) and definitely shown in D (Advanced Heart Failure).

How the heart compensates first for a person that is in Heart Failure:

The M.D. either treats the problem or get a transplant of the organ (which is unlikely to happen) as treatment but know this-the heart first hides the underlying process but compensates by doing this to your heart:

1-Enlargement to the muscle of the heart (causing “dilatation”) which allows more blood into the heart.

2-Thickening of muscle fibers (causing “hypertrophy”) to strengthen the heart muscle, which allows the heart to contract more forcefully and pump more blood.

3-More frequent contraction, which increases circulation.

By making these adjustments, or compensating, the heart can temporarily make up for losses in pumping ability, sometimes for years.  However, compensation of the organ can only last so long, not forever (like anything in life the living thing or an object will go through a ending life process to termination).  Eventually the heart cannot offset the lost ability to pump blood, and the signs of heart failure appear that are usually seen in stage C where symptoms start to show.

DIAGNOSIS:

1-MD examining the patient:  In many cases, physicians diagnose heart failure during a simple physical examination.  Readily identifiable signs are shortness of breath, fatigue, and swollen ankles and feet.  The physician also will check for the presence of risk factors, such as hypertension, obesity and a  history of heart problems.

Using a stethoscope, the physician can listen to a patient breathe and identify the sounds of lung congestion.  The stethoscope also picks up the abnormal heart sounds indicative of heart failure.

2-Lab Tests particularly cardiac enzymes and primarily measured is a B-type Natriuretic peptide or NT-pro BNP because this peptide releases by the heart when under stress, pressure, or volume overload = fluid build up.  With doing a simple CBC – complete blood cell test, and chemistry.

3-EKG-Electrocardiogram-If one or not both symptoms or the patient’s history point to a clear cut diagnosis, the physician may recommend any of a variety of laboratory tests, including, initially, an electrocardiogram (EKG)=12 lead EKG, which uses recording devices placed on the chest called electrodes to evaluate the electrical activity of a patient’s heartbeat which will be affected by CHF.  For example if the heart rhythm of the EKG shows Atrial Fibrillation or A Fib its a result from a weakened heart muscle.  Other arrhythmias like atrial flutter or even a very slow HR can also indicate or exacerbate CHF, often with palpitations, fatigue and SOB.  Also if the pt shows tachycardia (HR over 100)  or bradycardia (HR under 60).  Either heart rate (HR) can strain the heart, leading to or worsening heart failure.  Also PVC’s meaning Premature Ventrical Contractions seen in the arrhythmias or even normal sinus rhythm (normal and best rhythm to be in) are often found often in people with HF.

Echocardiography is another means of evaluating heart function from outside the body.  This works through sound waves that bounce off the heart are recorded and translated into images.  The pictures can reveal abnormal heart sizes, shape, and movement.  Echocardiography also can be used to calculate a patient’s ejection fraction which is a measurement of the amount of blood pumped when the heart contracts.

4-Chest X-ray which also determines the heart’s size and shape, as well as the presence of congestion in the lungs-fluid in the lungs.

Tests help rule out other possible causes of symptoms.  The symptoms of heart failure can result when the heart is made to work too hard, instead of from damaged muscle (like in a heart attack).  Conditions that overload the heart occur rarely and include severe anemia and thyrotoxicosis (a disease resulting from an overactive thyroid gland).

Prevention of CHF:

-If not diagnosed yet your already possibly ahead.  Without this diagnosis you can get started on making yourself further away from being diagnosed with this disease.  How to reach this goal is through living a routine life through healthy habits practiced, healthy dieting over all, and balancing rest with exercise during the week 30-40 minutes a day or 1 hour to 1.5 hours 3 times a week and not being obese.  They all would benefit the heart in not stressing it out making the heart’s function harder in doing its function.  When the heart stresses out it is at risk for lacking oxygen putting it at potential for angina (heart pain) to a heart attack with over time leading toward failure of the heart.  Need to learn more about what is and how to get your weight in therapeutic body mass index range through dieting of all 4 food groups, balancing exercise/rest, and knowing how the body works with all ingredients in foods including portion sizes (fats, calories, starches, carbohydrates, proteins with vitamins and minerals) to understanding how all this information takes effect in how your metabolism operates in being beneficial or against you?   Than get into a workout place or just go to channels on TV/cable that offer classes for free, read up on good foods vs. bad foods as simple as on the internet or even again TV/cable channels and balance rest with exercise; it is just taking action and doing what you need to stay healthy for the heart.

Remember, staying healthy for the heart is being healthy for so many other areas of the body (The heart is the engine to the body and is the only organ that pumps oxygen to our organs through red blood cells and without the pump either none if not pumping at all or low oxygen levels gets to the blood tissues.  Know that without oxygenation to the body tissues is oxygen starvation and we will die).  So, know that in CHF patients the pump or the heart is what is the main issue and many lead into oxygen problems at Grade C or D in congestive heart failure.

“Understanding heart failure is an important part of maintaining cardiovascular health.

Systolic heart failure occurs when the heart’s left ventricle loses its ability to contract effectively during each heartbeat. This leads to a decreased pumping capacity of the heart, eventually resulting in reduced blood flow throughout the body. There are several factors that can contribute to the development of chronic systolic heart failure.

Diastolic heart failure, which is also known as heart failure with preserved ejection fraction (HFpEF), occurs when the heart’s left ventricle becomes stiff and cannot relax properly during the filling phase of blood for that cardiac cycle.

Identifying and understanding the underlying causes of diastolic heart failure is essential for effective management and prevention of this condition.

One of the most common reasons of heart failure are cardiomyopathies such as the dilated or the hypertrophic cardiomyopathy.”

Heart Failure:

The definition of heart failure, it occurs when the heart loses its ability to pump enough blood through the body. Usually, the loss in pumping action is a symptom of an underlying heart problem, such as hypertension and CAD = coronary artery disease. The term heart failure suggests a sudden and complete stop of heart activity but actually the heart does not suddenly or abruptly stop. Instead the way it works is heart failure usually develops over time, years. The heart first compensates with the disease or illness the individual has but, just like a car, after wear and tear the heart goes into decompensating to heart failure due to the heart decline.

How serious is this condition? It varies from person to person depending on factors like an individual with obesity & unhealthy versus a person in healthier condition.

All people diagnosed with heart failure lose a pumping capacity of the heart that happens as they age but diagnosed with heart failure makes the engine of the body (the heart) a challenge in doing its function properly. The pump loss is more significant in the person with heart failure and often results from a heart attack (actual scaring to the tissue=death to that tissue area) or from other diseases that can damage the heart.

The severity of the condition determines the impact it has on a person’s life.

At the other end, extremes, treatment often helps people lead full lives if the person follows the meds ordered by the doctor including the diet and activity/exercise the doctor orders to the patient with heart failure (compliance so important and A MUST).

There are different levels of heart failure but even the mildest form is a serious health problem, which must be treated. If not the pump (the heart) will just get worse in doing its function properly.

To improve the chance of living longer in an individual with heart failure, patients must take care of themselves, see their physician (cardiologist) on a regular basis, and closely follow treatments (as ordered) with knowing what heart failure actually to understanding how the disease works (is the failure on the right side or left side? Which in time will effect the other side in time). In knowing what side the failure is on will make you understand what signs and symptoms to expect.

Types of Heart Failure

The term congestive heart failure (CHF) is often used to describe all patients with heart failure. In reality, congestion=the buildup of fluids in the heart for not pumping correctly, just like pipes in a home not working properly=back up of water in the pipes, happens with CHF also to the fluids (blood) backing up in the lungs.   This is just one feature of the condition and does not occur in all patients. There are two main categories of heart failure although within each category, symptoms and effects may differ from patient to patient. The two categories are:

1-Systolic heart failure (systolic is the top number of your blood pressure=the heart at work). This occurs when the heart’s (muscle-myocardium) ability to contract (pump=being active) decreases, particularly starting on the L side of the heart where the muscle of the heart is greatest (myocardium=heart muscle). The heart cannot pump blood with enough force to push a sufficient amount out of the heart into the circulation through the aorta. The aorta is a artery (vessel) that leaves the L lower chamber of the heart (left side of the heart=highly oxygenated rich blood). Due to the heart not using enough force pushing the blood forward in the aorta this causes the blood to back up and cause it to go back up into the L lower to the L upper chamber that goes further back up into the pulmonary vein into the lungs=congestion in the lungs=Congestive heart failure.  CHF is now with fluid in the lungs that’s how the word congestive comes in (pt coughing up fluids with mucus).

2-Diastolic heart failure (diastolic is the bottom number of your blood pressure which is the pressure when the heart is at rest). This failure occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle of the heart due to trying so hard to compensate over a long period of time with disease (ex. High B/P, Obesity, etc…) strains the heart in doing its function that failure finally starts that the muscle of the heart (myocardium) becomes stiff. This causes the heart to lose its ability to relax to allow proper filling of the heart in upper and lower chambers=back up of the blood.   This failure starts on the right side of the heart causing the blood to back up away from the heart and may lead this blood that is highly concentrated with carbon dioxide to accumulation especially in the feet, ankles and legs. Some patients may have lung congestion=Congestive Heart Failure now with fluid in the lungs (CHF).

Causes of Heart Failure:

As stated, the heart loses some of its blood pumping ability as a natural consequence of aging. How- ever, a number of other factors can lead to a potentially life-threatening loss of pumping activity.

As a symptom of underlying heart disease, heart failure is closely associated with the major risk factors for coronary heart disease: smoking, high cholesterol levels, hypertension (persistent high blood pressure), diabetes= abnormal blood sugar levels, and obesity. A person can change or eliminate those risk factors and thus lower their risk of developing or aggravating their heart disease and heart failure through healthy habits performed routinely, proper dieting, and balancing rest with exercise.

Among prominent risk factors, hypertension-HTN (high blood pressure) and diabetes are PARTICULARLY IMPORTANT. Uncontrolled HTN increases the risk of heart failure by 200 %, compared to those who do not have hypertension.   Moreover, the degree of risk appears directly related to the severity of the high blood pressure.

Persons with diabetes have about a two to eight fold greater risk of heart failure than those without diabetes. Women with diabetes have a greater risk of heart failure than men with diabetes. Part of the risk comes from the diabetes association with other risk factors for heart disease such as high cholesterol or obesity or other risk factors. However, the disease process of diabetes also damages the heart muscle.

The presence of coronary disease is among the greatest risks for heart failure. Muscle damage and scarring caused by a heart attack greatly increase the risk of heart failure. Cardiac arrhythmias, or irregular heartbeats, also raise heart failure risk. Any disorder that causes abnormal swelling or thickening of the heart sets the stage for heart failure.

In some people, heart failure arises from problems with heart valves, the flap-like structures that help regulate blood flow through the heart. Infections in the heart are another source of increased risk for heart failure.

A single risk factor may be sufficient to cause heart failure, but a combination of factors dramatically increases the risk. Advanced age adds to the potential impact of any heart failure risk.

Finally, genetic abnormalities contribute to the risk for certain types of heart disease, which in turn may lead to heart failure. However, in most instances, a specific genetic link to heart failure has not been identified but studies are showing genetic factors.

The relevance of gene mutations leading to heart diseases and hence heart failure has become evident. The risk for and the course of heart failure depends on genomic variants and mutations underlying the so‐called genetic predisposition. Genetic contribution to heart failure is highly heterogenous and complex.

In the last few years, novel sequencing technologies (named next‐generation sequencing – NGS) have dramatically improved the availability of molecular testing, the efficiency of genetic analyses, and moreover reduced the cost for genetic testing. Due to this development, genetic testing has become increasingly accessible and NGS‐based sequencing is now applied in clinical routine diagnostics. One of the most common reasons of heart failure are cardiomyopathies such as the dilated or the hypertrophic cardiomyopathy. Nearly 100 disease‐associated genes have been identified for cardiomyopathies. The knowledge of a pathogenic mutation can be used for genetic counselling, risk and prognosis determination, therapy guidance and hence for a more effective treatment. Besides, family cascade screening for a known familial, pathogenic mutation can lead to an early diagnosis in affected individuals. At that timepoint, a preventative intervention could be used to avoid or delay disease onset or delay disease progression. Understanding the cellular basis of genetic heart failure syndromes in more detail may provide new insights into the molecular biology of physiological and impaired cardiac (cell) function. As our understanding of the molecular and genetic pathophysiology of heart failure will increase, this might help to identify novel therapeutic targets and may lead to the development of new and specific treatment options in patients with heart failure.

One of the most common causes of heart failure are cardiomyopathies.

A clear distinction between acquired and inherited heart failure syndromes remains challenging.

In the end what to do in general:

SO LIVE AS HEALTHY AS POSSIBLE IN YOUR ROUTINE HABITS, YOUR DIETING OF THE 4 FOOD GROUPS, MAINTAINING YOUR WEIGHT IN A THEREPEUTIC RANGE (look as calculating BMI online for free to find out what your weight range for your height is), and BALANCING REST WITH EXERCISE TO HELP DECREASE THE CHANCE OF GETTING HEART FAILURE. Go to healthyusa.tsfl.com to learn what Dr. Anderson through his book of “Dr. A.’s Healthy Habits” and many other mentors in directing a healthy life; just research it.

CHF part 2 tomorrow and learn what the signs and symptoms with how its diagnosed, how its treated with tips on the disease (most importantly prevention).

“Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath.

Some heart conditions slowly leave the heart too weak or stiff to fill and pump blood properly. These conditions include narrowed arteries in the heart and high blood pressure.

Proper treatment may improve the symptoms of heart failure and may help some people live longer. Lifestyle changes can improve quality of life.”

MAYO CLINIC (Heart failure – Symptoms and causes – Mayo Clinic)

The heart is like the engine to a car but for us it’s the “pump” for the human body; without the engine the car won’t run and without the pump we won’t live. The normal size of the heart is about the size of your fist, maybe a little bigger.

It pumps blood continuously through your entire circulatory system. The heart consists of four chambers, 2 on the right and 2 on the left. The right side only pumps high carbon dioxide levels of blood, after all the oxygen was used by the tissues and returns to the heart in the right upper chamber and leaves to the lung from the right lower chamber. From the lungs it than goes to the left side of the heart now, which is a very short distance as opposed to where the left side pumps the blood. The L side of the heart pumps blood to the feet, brain and all tissues in between with high oxygen levels of blood.   This is why the L side of the heart does more work than the R side since the blood leaving the L side has a longer distance in distributing oxygen. The heart pumps the blood with high oxygen blood levels to reach all your tissues and cells, going to the feet, brain, and to all other tissues in between returning home again to the right side of the heart (upper chamber) to get sent to the lungs again for more oxygen. This is why the muscle on the L side of the heart is larger than the right, it works harder. Every time your heart beats (the sound we call lub dub) the organ is sending out a cardiac output of blood either to the lungs for more oxygen or to the body tissues through the aorta to give oxygenated blood to your tissues and cells. This is the mechanics of how blood is pumped by the heart. It pumps in our body to deliver oxygenated blood to organs and remove the carbon dioxide from our organs in our body to stay alive.

What happens when the heart is diseased:

Let’s see what can occur if the heart is not functioning properly. If your heart is not pumping out a sufficient amount of blood in your cardiac output to either the body (from left side of the heart); or removing carbon dioxide from the tissues (from the right side of the heart) than it tries to work harder where it does ok at first but over time weakens. As this weak heart struggles to pump blood the muscle fibers of the heart stretch out which is particularly from the left lower chamber, the biggest muscle of the heart.  As the struggle for this organ progresses over time this stretching leaves the heart with larger, weaker chambers. The heart enlarges (called cardiomegaly).   If this continues to go on this could go into R or L sided heart sided failure. When this happens, blood that should be pumped out of the heart backs up in the lungs=L sided failure or backs up into the tissues=R sided failure.

The side the failure is on doesn’t allow proper filling of the chambers on that side and back up happens; so much like pipes work in backing up when problems occur like a blockage.  If this condition occurs that is on the L side the fluids back up in the lungs or the R the fluids first back up in the veins which can expand to hold extra blood but at some point dump the extra fluids in your tissues (What can occur over time is edema in feet first due to gravity).   This is all due to overloading of the blood not filling up in the chambers of the heart to make a good cardiac output of blood due to poor pumping of the heart and in time the fluid backs up (bad pumping=backup of blood=fluid overload in the lungs (pulmonary congestion) to fluid staying in the skin (In time to the lower extremities due to gravity=feet which we call edema trying to send the blood back to heart for more oxygen at the lungs going back up the legs when the oxygenated blood is used up.).

This condition in time with no treatment will definitely go into congestive heart failure (CHF) to first one side of the heart and if not controlled can go to both sides of the heart. CHF can range from mild to severe.

There is 670,000 cases that are diagnosed with this every year and is the leading cause of hospitalization in people over 65 y/o. Causes of CHF are: heart attack, CAD (coronary artery disease), cardiomyopathy, other conditions that overwork the heart like high blood pressure, diabetes and obesity (These diseases can be completely preventable or at least well controlled).

There is many of us in this world with knowing how our activity/exercise, eating, and habits could be better for health but do little action or do nothing on their own to change it, which is a large part for certain diseases being so high in America (diabetes, stroke, cardiac diseases=high blood pressure, atherosclerosis, arteriosclerosis to CHF and more).

If people just were more healthy and more active regarding these diseases alone it would decrease in population creating a positive impact on how our health system with insurance presently (a disaster) with our economy (another disaster) for many which could get better with healthy people in the USA.

A healthy heart can pump to all parts of the body in a few seconds which is good cardiac output from the organ but when it gets hard for the heart to keep up with its regular routine it first compensates when healthy but if going into CHF, a unhealthy heart pump it will decompensate causing ischemia (lack of oxygen to the heart tissue). It’s like any tissue in the body, lack of oxygen=lack of nutrients to the body tissue=STARVATION and with lack of oxygen will come PAIN eventually to death if not treated. Take the heart, if it isn’t getting enough oxygen it can go into angina. That is reversible since it is heart pain due to not enough oxygen to the heart tissue=no damage but if left untreated what will occur is a heart attack=myocardial infarction (MI) and is permanent damage because scarring to the heart tissue takes place that is permanent damage to that area of the heart tissue where the MI occurred for life.

“An enlarged heart (cardiomegaly) isn’t a disease, but rather a sign of another condition.

The term “cardiomegaly” refers to an enlarged heart seen on any imaging test, including a chest X-ray. Other tests are then needed to diagnose the condition that’s causing the enlarged heart.

An enlarged heart (cardiomegaly) can be caused by damage to the heart muscle or any condition that makes the heart pump harder than usual, including pregnancy. Sometimes the heart gets larger and becomes weak for unknown reasons. This condition is called idiopathic cardiomyopathy.”

MAYO CLINIC (Enlarged heart – Symptoms & causes – Mayo Clinic)

Left Ventricle Enlarged

Heart Size Normal

Heart Enlarged

Think of a healthy heart like a firm biceps muscle. An enlarged heart is just the opposite.

When your heart is enlarged, it’s like a soft biceps — it’s weak and out of shape. What happens is the heart muscle enlarges because the heart is trying so hard to do its function, PUMP, but it gets too difficult and the muscle of the heart enlarges/thickens causing the organ not to work properly.  So this causes back up with circulatory blood, think like a plumber–your pipes are backing up.  So what does this ends up causing?  Your body starts to retain fluid, your lungs get congested with fluid and your heart begins to beat irregularly.  If the heart is effected in working so will the lungs in time and visa versa.   Think like the car if the engine (the heart) is effected working properly the transmission (the lungs) will be also in time.

“In general the term ‘enlarged heart’ refers to heart failure,” said Clyde Yancy, M.D., past president of the American Heart Association and chief of the Division of Cardiology and the Magerstadt Professor of Medicine at Northwestern University Feinberg School of Medicine in Chicago. “This is a common condition that’s more likely to occur in older patients. It’s most strongly related to a history of high blood pressure or a previous heart attack.”

About one in five adults over age 40 is affected, with African-Americans facing a greater risk due to the dieting and heridity.  Take high blood pressure as a major risk factor since

Cardiosmart American College of Cardiology say in 2018 “Black adults are up to two times more likely to develop high blood pressure by age 55 compared to whites, with many of these racial differences developing before age 30, concludes a study recently published in the Journal of the American Heart Association.”.

“There are other reasons for an enlarged heart or heart muscle disorders (like cardiomyopathies, which are diseases of the heart muscle) and not everyone with heart failure has an enlarged heart,” Dr. Yancy said. “But when we speak of an enlarged heart we are typically referring to heart failure.”

What to Look For
Shortness of breath, fluid retention (edema) and having a harder time exercising are among the key symptoms of an enlarged heart or heart failure. Irregular heartbeats (arrhythmias) — potentially even serious irregular heart rhythms and strokes — are likely as well, Dr. Yancy said.

The symptoms of an enlarged heart can affect the quality and length of your life, Dr. Yancy said.

“This is why treatment is so important and why we are so encouraged that good treatments are available today,” he said.

How to Prevent and Treat It
“Despite all of the great advances in treatment, the best treatment is to never have an enlarged heart,” Dr. Yancy said. “Prevention should be the true thrust. The simple stuff works — managing your weight, getting plenty of physical activity, controlling your diet, reducing your cholesterol and avoiding diabetes.”

But there’s good news for those who have been diagnosed with an enlarged heart.

“Whereas this condition was a dreadful diagnosis 20–25 years ago and resulted in death shortly afterward, the outlook for those with heart failure is now so much better,” Dr. Yancy said. “More and more patients are living longer, healthier lives with heart failure due to breakthrough medical and device treatments.”

If you or a loved one has heart failure, seek a care provider who has experience treating enlarged hearts.

“This condition is no longer about ‘failure,’” Dr. Yancy said. “On the correct drugs and with support from the correct devices, you can be successful in overcoming heart failure.” Dr. Yancy said there’s a nationwide “small army” of expert nurses focusing on heart failure.

”When a heart failure nurse is involved, you can expect to get better — a lot better,” he said.

Drugs and devices can strengthen the heart, and pacemakers and implantable defibrillators (ICDs) also offer hope. Surgery may be another option for patients who also have heart vessel disease and /or heart valve disease. “For those with very advanced disease, we now have very effective mechanical heart devices and we do heart transplantation very well,” he said.

And the future may hold more promise for enlarged hearts, Dr.  Yancy said.

“We expect to have cell-based therapies that will help us repair damaged hearts; easier surgeries that will halt the progression of heart disease and even more insight into preventing heart disease,” he said.