HEART FAILURE

More than half a million patients in Canada

More than half a million people suffer from heart failure in Canada, and according to the most recent information, 50,000 people develop this condition every year. The heart is a muscle used as a pump for the blood circulation. With each contraction of the heart muscle, a part of the blood volume is expelled in a large blood vessel called aorta.

A fraction of the blood volume of the heart is ejected with each beat

Even under normal conditions, the heart is never completely empty. The portion of ejected blood is called ejection fraction. For a normal individual, the ejection fraction is of 55% and more.

Various tests are related to the measurement of the ejection fraction, which is commonly called LVEF for left ventricular ejection fraction.

Several types of heart failure

Different factors cause heart failure. When the LVEF is lowered, it is referred to as heart failure by systolic dysfunction. When the LVEF is normal, we refer to it as diastolic dysfunction or heart failure with preserved ejection fraction.

Several possible causes

The most common causes of heart failure are the following::

Idiopathic (no identifiable cause)
Viral
Toxic (due to alcohol, drugs, chemotherapy, and radiation therapy)
Valvular (defective valves)
Tachyarythmy (heart beats too fast in a prolonged way)
High blood pressure
Congenital malformation (birth defect)

What causes the symptoms

The symptoms of heart failure are due to the fact that the heart is unable to move nutrients and oxygen to the body organs, and to bring back waste that needs to be filtered by the liver and the kidneys.

A classification, depending on the severity of symptoms

Depending on the importance of the symptoms and that of limitations, the degree of heart failure is classified into four groups:

Class I: no limitation with ordinary activities
Class II: light symptoms of shortness of breath or fatigue with moderate efforts such as climbing 2 flights of stairs
Class III: shortness of breath or fatigue with activities of the daily life (personal hygiene)
Class IV: shortness of breath or fatigue at rest

Why follow medical recommendations

The treatment can help slow down, stop the progression or in certain cases reverse heart failure.

To make the diagnosis

Several tests will be required by your doctor to make the diagnosis of heart failure and to try to find what caused it. The tests that may be required are a rest ECG, a cardiac echography or a stress MIBI (or with Persantin), a coronary angiogram, a Holter monitoring, and an ABPM (ambulatory blood pressure monitoring), and various blood tests.

You must take an active part in the treatment of your heart failure. You have to agree to follow the recommendations that are aimed at modifying your lifestyle, and to be rigorous in taking your medication.

The basis of the treatment is to reduce the work of a failing heart

Your treatment will reduce the work of your heart and prevent an overload of liquid; it will decrease your symptoms or even eliminate them altogether.

The treatment includes the following:

To take the prescribed medication
An adequate diet especially low in salt
A limit of daily fluid intake
Alcohol in moderate quantity
Physical activity
Periods of rest
Quit smoking

It is important to follow the recommendations related to your medication. Stopping prescribed medication on his own is often the cause for the person to be hospitalized anew.

Ask your pharmacist before buying over-the-counter drugs

Consult your pharmacist before buying over-the-counter drugs because they may be harmful to you. Indeed, some drugs can decrease the efficacy of your prescribed medication, trigger side effects or increase the risks of toxicity. For example, it is known that anti-inflammatory drugs (ex.: Advil Ibuprofen) can cause water retention and worsen your symptoms.

Dietary habits

It is important to acquire good eating habits with a well-balanced diet, to reduce salt intake (sodium) because it can cause water retention. Do not cook with salt or put salt on the table, and check the salt content of the food you buy, which is available on the packaging. Your goal should be a consumption of 2 to 3 grams of salt per day. Pay special attention to cured meat and fast food items.

It is possible to improve the taste of food without using salt. For instance, try herbs, lemon juice, salt-free seasonings and garlic.

Although the majority of people think that they do not drink much, findings from a calculation are sometimes surprising. Illness increases the sensation of thirst… drinking becomes a continuous temptation

The heart is a pump… beware of overload

The recommended quantity of liquid is 1.5 litre or 48 ounces per day (6 regular glasses per day), a bottle of beer or a soft drink are 350 ml.

An easy way of doing the calculation is to take a container and draw a line on it, iindicating 1.5 litre. For each fluid intake, pour the equivalent of that liquid in your container. Liquid includes coffee, tea, water, juice, soft drinks, beer, Jell-O, yogurt, Popsicles, etc.

A trick to quench your thirst

Illness causes thirst.

Here is a pleasant way to quench one's thirst, and deal with the restroction of liquid. Have berries in the freezer. Put some in your mouth, let them melt, then swallow. It is refreshing and does not count in your limitation of liquid, contrary to ice cubes and Popsicles.

Weigh yourself regularly

Weigh yourself regularly and write down your results. Weigh yourself at the same time every day with an empty bladder. For example, a weight gain of 1.5 kg over 3 to 5 days is abnormal. One does not build up fat over such a short period of time… the weight gain is due to excess fluid in the body.

Moderate alcohol consumption

Drink alcohol in moderation and occasionally. Do not forget to include it in your fluid intake calculation. Limit yourself to 1 to 2 drinks per day.

Beneficial impact of exercise

Do moderate physical activity on a regular basis. A cardiovascular rehabilitation program could be appropriate for you. It would help you develop a better cardiovascular endurance, lose weight, enjoy an improved quality of life and extend your life expectancy.

Take a break, get some rest and quit smoking

Rest before and after meals. Quit smoking or get help to get rid of that unhealthy habit.

Other possible interventions

Your doctor may decide to recur to more specialized therapeutic or preventive interventions.

Here is a list of possible options: