Heart Failure Facts
Heart failure is a chronic condition in which the
heart cannot pump enough blood to meet the needs of the rest of the
body. Also known as congestive heart failure (CHF), heart failure is
a complication of many serious diseases in which the heart loses its
full pumping capacity, causing blood to back up into other organs,
especially the lungs and liver. Heart failure develops over time, as
the pumping action of the heart grows weaker. While heart failure
can affect either or both sides of the heart, most cases involve the
left side where the heart cannot pump enough oxygen-rich blood to
the rest of the body.
The main causes of heart failure include coronary
artery diseases (CAD), ischemia, heart attack, high blood pressure,
diabetes and diseases of the heart valves. Other causes include
cardiomyopathy, congenital heart disease, severe lung disease,
cancer treatments such as radiation and certain chemotherapy drugs,
HIV/AIDS, severe anemia, hyperthyroidism and drug and alcohol abuse.
Symptoms of Heart Failure
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Shortness of
breath |
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Persistent
coughing and/or wheezing |
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Constant fatigue
and difficulty with everyday tasks |
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Swelling in the
ankles, feet, legs and sometimes the abdomen |
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Confusion,
impaired thinking, memory loss and disorientation |
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Increased heart
rate |
Quick Facts
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Heart failure is
the fastest growing cardiovascular disease in the U.S. |
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According to the
American Heart Association, nearly 5 million Americans are living
with heart failure, and 550,000 new cases are diagnosed each year |
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Heart failure
causes nearly 300,000 deaths per year, and is the number one cause
for hospital visits among people age 65 and older; two-thirds of
all hospitalizations for this age group are due to heart failure |
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Despite recent
medical advances, the estimated five-year mortality rate for heart
failure is 50 percent |
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An estimated $23
billion is spent annually on treating heart failure patients in
hospitals some estimates indicate an additional $40 billion is
spent annually on outpatient care |
Types of Heart Failure
Left ventricular (LV) heart failure
involves the heart’s left
ventricle—the chamber that pumps blood from the heart to the rest of
the body. When the left ventricle can no longer pump blood
efficiently (systolic failure), tissues throughout the body do not
receive sufficient amounts of oxygen and nourishment. When the
ventricle becomes unable to relax normally, the chamber doesn’t
properly fill with blood between heartbeats (diastolic failure).
Right ventricular (RV) heart failure
is usually a by-product of failure
on the heart’s left side. When the left ventricle fails, increased
fluid pressure is transferred back through the lungs, leading to
damage on the heart’s right side. When the right ventricle loses its
ability to pump blood properly into the lungs, blood backs up in the
veins, leading to swelling in the hands, legs and abdomen. Both left
and right ventricular heart failure can cause breathing difficulties
and a dangerous collection of fluid in the lungs and other organs.
Stages of Heart Failure
Physicians worldwide refer to the New York Heart
Association (NYHA) Classifications of Heart Failure to assess
patients with heart failure. In 2001, the AHA/ACC created guidelines
that divide patients into stages reflecting clinical signs of
disease.
While heart failure medication is the first line of
treatment for patients with heart failure, no consensus therapy
currently exists and patients must suffer their symptoms chronically
and have a reduced life expectancy. Medications may include ACE
inhibitors, beta-blockers, diuretics, inotropic agents,
vasodilators, potassium and other medications. Drug therapy for
heart failure is intended to reduce body fluid volume, reduce
peripheral vascular resistance and increase cardiac contractility.
The value of these medications has been well established in numerous
large-scale clinical trials. However, cardiologists indicate that
medical therapy often does not adequately control advanced disease
(i.e., Class III and IV, and some Class II patients), as some
patients do not improve with treatment or experience rapid
recurrence of symptoms.
Surgery isn’t often used to treat heart failure, but
may be recommended if a correctable problem such as a defect
or a blocked coronary artery is identified, or in
cases of severe heart failure.
In addition to medication and surgery, there is now
a new non-invasive treatment option for patients with heart failure.
This treatment is called EECP ®
external counterpulsation
therapy.
EECP therapy is a
non-invasive outpatient treatment that is believed to create new
pathways around blocked arteries in the heart by expanding networks
of tiny blood vessels that help increase blood flow to the heart
muscle. EECP treatment can reduce or eliminate the frequency and
intensity of chest pain, decrease the need for medication and
greatly improve the ability to participate in activities of daily
living. After receiving EECP treatment, patients often are able to
enjoy moderate exercise for the first time since developing heart
failure.
EECP is typically
given in 35 one-hour-sessions over seven weeks. Patients lie down on
a padded table and have their calves and lower and upper thighs
wrapped in blood pressure-like cuffs. The system, which is
synchronized to the individual patient’s cardiac cycle, inflates the
cuffs with air to create external pressure when the heart is resting
(diastole) and deflates the cuffs just before the heart beats
(systole). The system’s action, which pulses counter to the heart's
beating, increases blood flow to the heart muscle, decreases the
heart’s workload and creates a greater oxygen supply for the heart
muscle while lowering the heart's need for oxygen.
Sources: American
Heart Association.
Heart and Stroke Facts;
National Heart, Lung, and Blood
Institute.
Diseases and Conditions Index: Angina;
American Heart Association.
Angina Pectoris
Treatment; Patient Health
International.
Angina Fact and Figures;
American Heart Association.
Transmyocardial
Revascularization (TMR);
American Heart Association.
Heart Disease and Stroke
Statistics-2004 Update.
Dallas,Tex. American Heart Association;2003.
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