11 Heart Failure Facts Cardiologists Want You to Know
What is heart failure?
Heart attack, heart disease, cardiac arrest. Understanding the differences between cardiovascular conditions can get confusing. And what about heart failure, which affects approximately 5.7 million Americans? "Heart failure occurs when the muscles of the heart essentially die, or weaken,” says Suzanne Steinbaum, DO, the director of women’s heart health at the Lenox Hill Hospital in New York City and a national spokesperson for the Go Red for Women campaign. "As heart function weakens, the blood doesn’t push forward through the body as easily."
The result is a whole host of symptoms, from shortness of breath to swollen ankles to fatigue. Here, everything the experts want you to know about the condition, including symptoms, key risk factors, and lifestyle changes you can make right now to lower your chances of developing heart failure later on.
There's more than one type of heart failure
Heart failure can affect the left ventricle, right ventricle, or both. The most common form is systolic heart failure, when the heart muscle’s function is diminished and, as a result, blood doesn’t flow as readily throughout the body. Another form of heart failure, called diastolic heart failure, occurs when the heart experiences relaxation impairment and is unable to fill with blood properly due to stiffening of the muscle. "Diastolic heart failure is usually seen in older patients with hypertension and diabetes, especially in older females," says Biykem Bozkurt, MD, professor of cardiology at Baylor College of Medicine in Houston, Texas and chair of the American College of Cardiology Heart Failure and Transplant Council.
Heart failure is often referred to as "congestive heart failure," which means that fluid has accumulated in other parts of the body (such as in the lungs and liver) as a result of blood circulating improperly. But not all cases of heart failure are congestive.
Certain conditions may signal danger ahead
Heart failure tends to follow other conditions. Specifically, people who have diabetes, high blood pressure, coronary artery disease, or heart attacks are more likely to also experience heart failure down the line. Why? "Over time, having these diseases can lead to weakening of the heart muscle," explains Dr. Steinbaum.
The good news? Many of these conditions are connected to lifestyle choices (more on this later), so taking the right steps to keep your risk factors under control can significantly reduce your chances of developing heart failure.
Pinpointing symptoms isn’t always easy
Determining whether certain symptoms you're experiencing are indeed related to your heart health can be challenging. Still, when the heart is unable to meet the demands of the body, typical symptoms would include shortness of breath, swelling of the extremities (think: feet, ankles, and legs), chronic coughing, fatigue, a diminished appetite, or a quickened heart rate.
The cause of these uncomfortable symptoms goes back to your heart. Take your shortness of breath, for example: Since the weakened heart is unable to keep up with a constant supply flow, fluids begin to seep into the lungs, making it more difficult to breathe in and out with ease. As for why you may feel less hungry than usual? When less blood is sent to the digestive system, your appetite can get all out of whack, making you less likely to reach for that second serving.
Diagnoses are largely symptom-based
According to the American Heart Association, these symptoms on their own usually aren’t cause for concern (we’ve definitely all felt overtired before). But if you consistently experience a combination of one or more of the potential red flags, it’s a good idea to consult your doctor and make sure they aren’t cause for cardiovascular concern.
"Heart failure is diagnosed by symptoms more than anything," explains Dr. Steinbaum. "If someone has worsening shortness of breath, inability to walk down the street, or they can’t lie flat in bed without difficulty breathing, their doctor may want to do an EKG to look for heart damage or an echocardiogram, which looks at the function of the heart muscle." If you’re experiencing any of these symptoms, schedule an appointment with your doctor to make sure it's not signaling something more serious.
Saying no to smoking helps—a lot
Many types of heart disease (such as heart failure, heart attacks, and coronary artery disease) are preventable, says Dr. Steinbaum. Lifestyle factors play a huge role in lowering one’s risk of these cardiovascular disorders.
At the top of the list of habits to stop? Smoking. "Every time someone inhales from a cigarette, they’re potentially tearing the lining of the arteries, called the endothelium," says Dr. Steinbaum. As this lining gets worn down, she explains, a person's risk of developing coronary artery disease—as well as heart attacks and subsequent heart failure—goes up. "Stopping smoking is the most preventable thing we can do," she adds.
Need help figuring out how to kick the habit? Here’s the best way to quit smoking, according to science.
Getting sweaty helps
Beyond ditching cigs, it’s also a good idea to start exercising regularly if you’re at risk for heart disease. Aerobic activity prevents weight gain (lowering your chances of developing key heart failure risk factors, such as diabetes and obesity), and also keeps your arteries healthy and controls blood pressure and cholesterol levels. The American Heart Association recommends at least two and a half hours of moderate-intensity physical activity every week.
Steer clear of salty foods
Step away from the potato chips. As you probably know, consuming too much sodium causes the body to retain more water (it's why super-salty foods can make you feel bloated). So why is this important for heart failure? Excess salt raises your risk of high blood pressure, which in turn taxes the heart even more, explains Dr. Bozkurt: "Marked fluid overload can stretch the cardiac chambers and may contribute to impairment of pump mechanics of the heart in patients with heart failure." The easy kitchen fix? Try using alternative flavor-boosters that won’t send your sodium count soaring, such as parsley, basil, and ginger.
Opt for a heart-healthy diet
"A balanced diet is important for patients with heart failure," says Dr. Bozkurt. As with other forms of cardiovascular disease, be sure to load your plate with plenty of heart-healthy foods. Some of the best choices: salmon (it's packed with omega-3 fatty acids), avocados (another healthy fat), oatmeal (it's a great source of soluble fiber, which can help lower cholesterol), nuts (more fiber, plus vitamin E), and plenty of fresh produce, such as blueberries, citrus fruits, and tomatoes.
Tailored treatments abound
If you've been diagnosed with heart failure, know that there are multiple treatment options for managing the condition. Treating the underlying causes of heart failure—like coronary artery disease, high blood pressure, or diabetes—is often the first step. From there, doctors can do an angiogram or cardiac catheterization to look inside the arteries and determine whether there’s blockage, says Dr. Steinbaum. If plaque buildup is present, it’s likely that a doctor will prescribe medication.
Some treatment options include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, and diuretics (they work to get rid of excess fluid in the body). "These treatment strategies improve survival and reduce hospitalizations in symptomatic heart failure patients with systolic heart failure," says Dr. Bozkurt.
In more serious cases, heart failure patients may consider heart transplants or left ventricular assist devices, also known as LVADs. "These are only necessary if medications and lifestyle changes are really not working," says Dr. Steinbaum.
Embrace an all-around healthy lifestyle
The bottom line? Because lifestyle choices can make all the difference in preventing heart failure, Dr. Steinbaum stresses that patients have an important role to play to reduce their risk.
"Learning the best way to eat and making time to get up and move—even if it’s just walking 10,000 steps a day—is a huge part of staying healthy and preventing heart failure down the road," she says. "Plus, it’s a progressive disease. Let’s make healthy choices now so we never have to get there.”