Heart failure affects millions of people worldwide. In Canada, about 1% of the adult population is living with this condition, with the prevalence rising to 10% among those over 65.
This makes it one of the leading causes of hospitalizations among seniors, highlighting its significant impact on the healthcare system.
Origin of Symptoms
The symptoms of heart failure arise from two main mechanisms.
- On one hand, the heart struggles to efficiently transport oxygen and nutrients to the organs.
- On the other hand, it also fails to remove waste by directing it to the liver and kidneys for filtration.
Symptoms and Presentation of the Disease
This dysfunction leads to symptoms such as shortness of breath, which can worsen with exertion or when lying down.
Signs of fluid retention, often visible as swelling in the feet, legs, or abdomen, are also common. Some patients experience an increased need to urinate at night, caused by the reabsorption of fluids when lying down.
Other symptoms include persistent and often pronounced fatigue, as well as occasional palpitations“Palpitation” is a symptom related to an abnormality in heartbeats. There are several types of arrhythmias. This term is like a surname that encompasses several first names..
Classification Based on Symptom Severity
The severity of heart failure is assessed based on the limitations it imposes and is categorized into four groups:
- Class I: No limitations during ordinary activities.
- Class II: Mild symptoms, such as shortness of breath or fatigue during moderate exertion, like climbing two flights of stairs.
- Class III: Fatigue or shortness of breath during simple daily activities, such as personal hygiene.
- Class IV: Fatigue or shortness of breath even at rest.
This classification helps healthcare professionals better understand the severity of the condition and tailor treatments according to the functional limitations of patients.
Categories of Heart Failure Based on Ejection Fraction
The ejection fraction, which measures the percentage of bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pumped out of the left ventricle with each heartbeat, is used to classify heart failure according to the type of cardiac dysfunction.
When the ejection fraction is reduced, (Heart Failure with reduced Ejection Fraction-HFrEF) often below 40%, the heart struggles to contract effectively, leading to decreased bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flow.
A moderately reduced ejection fraction, between 41% and 49%, causes intermediate symptoms.
When the ejection fraction is preserved at 50% or higher (Heart Failure with preserved Ejection Fraction-HFpEF), the heart contracts normally but has difficulty relaxing.
Common Causes
Heart failure results from various factors that can weaken or damage the heart over time. These include:
- Coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease: Heart attacks leave scars that impair the heart’s ability to contract.
- High bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure: The heart works harder to pump against increased pressure, leading to long-term strain.
- Heart valve diseases: These conditions increase the heart’s workload.
- Cardiac infections and myocarditis: Inflammation can reduce the heart’s pumping capacity.
- Alcohol and toxic substances: Substances such as alcohol or drugs can weaken the heart muscle.
- Infiltrative cardiac disease: Secondary to systemic conditions, this leads to deposits of material in the heart muscle.
Diagnosis
Diagnosis involves several tests. Echocardiography measures the ejection fraction and examines heart structure.
BloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood tests, particularly BNP or NT-proBNP levels, help confirm heart failure.
An electrocardiogram (ECG) detects potential abnormalities, while stress tests, scintigraphy, or coronary angiography may be used to identify coronary arteryThe two coronary arteries, the right and the left, form the blood network that supplies the heart with oxygen and nutrients. They are located directly on the surface of the heart and branch into smaller vessels that disease.
Prognosis
Heart failure is a chronic condition. Although advancements in treatment have improved outcomes, it remains serious, especially for those with a reduced ejection fraction.
Close medical monitoring and adherence to treatment can significantly enhance quality and longevity of life.
Non-Medication Approaches
Lifestyle changes play a crucial role in managing heart failure.
Paying close attention to fluid restriction and reducing salt intake helps limit water retention, thereby easing the heart’s workload.
Additionally, a moderate exercise program supervised by professionals improves heart function without overburdening the organ.
Fluid Restriction: An Essential Strategy
To optimize heart failure management, adhering to a daily fluid limit is vital.
Typically, this limit ranges between 1.5 and 2 liters, or 48 to 64 ounces, equivalent to approximately 6 to 8 standard glasses. For example, a bottle of beer or a can of soda contains about 350 milliliters, slightly more than one glass.
Practical Tip for Monitoring Fluid Intake
An effective way to track daily fluid limits is to use a graduated container that indicates the set limit (1.5 or 2 liters). 
Each time a liquid is consumed, an equivalent amount is poured into this container. This method provides a clear visual of the remaining allowance for the day, helping to prevent exceeding the limit.
What Counts Toward the Fluid Limit
It is crucial to understand that the restriction includes anything that is liquid or can become liquid in your body. Examples include:
- Beverages: coffee, tea, water, juice, soda, beer, or wine.
- Liquid or semi-liquid foods: soups, Jell-O, yogurt, liquid sauces.
- Other items: melted ice cream, ice cubes.
Unquenchable Thirst
Patients with heart failure often experience persistent and difficult-to-satisfy thirst. This symptom is linked to the water retention commonly associated with this condition. When the heart fails to pump bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood effectively, the kidneys respond by retaining more salt and water, leading to fluid buildup throughout the body.
Thirst becomes a misleading signal. Although it drives the patient to drink more water in an attempt to alleviate the sensation, this can worsen the situation. Excess fluid may accumulate in the lungs, causing pulmonary edema—a severe and potentially life-threatening condition—or in other parts of the body, such as the legs and abdomen.
To better manage this unquenchable thirst, patients must adhere to strict guidelines. It is crucial to limit fluid intake based on their doctor’s recommendations, which are adjusted according to the severity of the condition. Reducing salt consumption is also essential to prevent fluid retention.
Daily weight monitoring is a valuable tool for detecting signs of increased water retention. Sudden weight gain may signal cardiac decompensation, requiring immediate consultation with a healthcare professional.
Suggested reading: Water “in” the lungs,also known as Pulmonary edema
Practical Tip: Frozen Berries to the Rescue!
To manage persistent thirst while staying within your fluid restriction, a simple and effective trick is to use frozen berries. Freeze fruits like blueberries, raspberries, or grapes, and enjoy one whenever you feel the need to quench your thirst. Let it melt slowly in your mouth before swallowing.
Unlike ice cubes or popsicles, frozen berries do not count toward your fluid intake, while still providing a refreshing sensation. As an added bonus, they deliver vitamins and antioxidants that are good for your health.
To keep things interesting, try different fruits or create a colorful mix. It’s an enjoyable way to manage thirst while adding a refreshing touch to your routine.
Extra Tip: Chewing sugar-free gum can also help relieve discomfort and reduce the sensation of thirst.
Consult Your Pharmacist Before Buying Over-the-Counter Medications
Before purchasing over-the-counter medications, it is crucial to seek advice from your pharmacist, as some products may pose risks to your health.
For example, they may reduce the effectiveness of your prescribed medications, increase their side effects, or even lead to greater toxicity. Anti-inflammatory drugs, such as Advil (ibuprofen), are particularly concerning, as they can cause water retention and worsen heart failure symptoms.
Your pharmacist is your ally in ensuring the safety and effectiveness of your treatments.
Medication Treatments
Medication treatments are the cornerstone of heart failure management.
Angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor blockers (ARBs) reduce the workload on the heart. Beta-blockers slow the heart rate, while diuretics help eliminate excess fluid.
Other medications, such as mineralocorticoid receptor antagonists (MRAs) and recently introduced SGLT2 inhibitors, often complement the treatment by improving heart function and limiting fluid retention.
Strict Follow-Up and the Importance of Compliance
Following medical advice is crucial for patients with heart failure. Taking medications consistently, maintaining a healthy lifestyle, and adhering to dietary recommendations are not mere suggestions but essential foundations for preventing decompensation.
Limiting fluid and salt intake, monitoring weight daily, and consulting a doctor regularly are effective strategies to maintain balance and avoid unnecessary hospitalizations.
However, managing persistent thirst, which is often difficult to satisfy, can present a significant challenge. It is important to understand that this sensation of thirst, although uncomfortable, is a symptom that needs close monitoring.
A thorough understanding of the disease and its effects enhances vigilance and better equips patients to handle complications. Ultimately, an informed patient is better prepared to face the challenges of heart failure.
Specialized Clinics
Heart failure clinics play a vital role in patient follow-up. They provide educational support not only to patients but also to their families, while ensuring ongoing treatment adjustments and offering a structured framework to assist those living with the condition.
These clinics emphasize the active involvement of patients in their care plans, equipping them with the tools needed to recognize signs of deterioration and respond quickly through an emergency plan they can implement at home.
Such a robust support network is essential for enhancing patients’ quality of life and reducing the risk of complications.
Palliative Care
Given the chronic and progressive nature of this condition, involving a palliative care team can be highly beneficial.
These services provide valuable support to both patients and their families, focusing on improving quality of life and offering tailored care for the advanced stages of the disease.
In Conclusion
Heart failure is a complex and demanding condition. However, with careful management, appropriate treatment, and a robust support network, patients can lead longer, healthier lives.
Active involvement in care and a comprehensive approach are crucial for preventing complications and enhancing well-being.
Related articles
Latest articles
