In heart failure, the heart muscle does not pump blood efficiently enough to meet the body’s needs. It can involve the left ventricle, right ventricle or both sides of the heart. However, heart failure often starts with the left ventricle, which is the heart’s main pumping chamber.

There are two different types of heart failure:

• Systolic failure: The heart cannot pump blood out of the heart very well.
• Diastolic failure: The heart is stiff and does not fill up with blood easily.

Some of the causes of heart failure include:

• High blood pressure
• Heart attack
• Lung Disease
• Infections of the heart
• Heart valve problems

Heart failure can be diagnosed in several ways:

• History and physical exam that includes medical history review, blood pressure screening, weight measurement, and listening to the heart and lungs.
• Lab work, which will likely include blood tests.
• Chest X-Ray that may reveal an enlarged heart or congested lungs.
• Electrocardiogram (ECG) to determine whether there has been damage to the heart or if the heart rhythm is abnormal.
• Echocardiogram (echo) to evaluate the function of the heart muscle and valves with ultrasound.
• Stress test to determine how the heart responds when put under stress and assess for underlying heart disease.

There are many different medications your physician may prescribe. It is important to take your medications exactly as prescribed.

Common heart failure medications prescribed are:

• Diuretics (water pills): Rids your body of extra fluid and helps to relieve the heart’s workload.
• Angiotensin Converting Enzyme (ACE) Inhibitor/Angiotensin Receptor Blocker (ARB): Lowers blood pressure and relaxes blood vessels.
• Beta Blocker: Decreases heart rate, decreases blood pressure, and helps the heart not work as hard.
• Angiotensin Receptor Neprilysin Inhibitor (ARNI): Relaxes blood vessels and decreases the buildup of salt (sodium) and fluid.
• Hydralazine: Opens arteries to decrease blood pressure.
• Aldosterone Antagonist: Makes your diuretic (water pill) more effective.
• Isosorbide: Opens blood vessels and reduces blood pressure.

These are just some of the medications your doctor may prescribe. If you are unsure of what your medications are for, ask your doctor to explain your medication.

Along with taking medications and other medical therapies, it is very important after a heart failure diagnosis to make lifestyle changes to help your heart.

Some important lifestyle changes include:

• Quit smoking. Tobacco increases heart rate, blood pressure and reduces the amount of oxygen-rich blood circulating through the body.
• Track your daily fluid intake. Your doctor may place you on a fluid restriction. This helps prevent the accumulation of too much fluid on your body.
• Avoid or limit alcohol.
• Avoid or limit caffeine.
• Eat a low sodium diet. Sodium is salt. It is recommended you do not consume more than 2000 mg of sodium (salt) per day. It is important to understand food labels and choose low sodium options.
• Add physical activity to your day. Discuss your level of physical activity with your doctor. It may be beneficial to participate in a cardiac rehab program.
• Manage stress.
• Keep track of heart failure symptoms. Keeping track of symptoms can help your doctor better manage your care. It can also help you realize worsening symptoms before it becomes an emergency. Using a heart failure zone tool and weight tracker (see a weight tracker tool example) can help you monitor for trends.

• Implantable cardioverter defibrillator (ICD): Used for some heart failure patients who have arrythmias (irregular heartbeats).
• Cardiac Resynchronization Therapy (CRT): A special pacemaker that makes the ventricles of the heart contract more normally.
• Left Ventricular Assist Device (LVAD): An implanted battery-operated pump that helps blood move from the left ventricle of the heart to the aorta whenever the heart is no longer able to do this on its own.
• Percutaneous coronary intervention (PCI or angioplasty): Procedure where the doctor opens up the arteries of the heart to achieve better blood flow to the heart muscle. This is done through a small catheter placed in the groin.
• Coronary Artery Bypass (CABG): Surgeons bypass the part of the artery in the heart that is clogged with a graft via open heart surgery. This also restores blood flow to the heart muscle.
• Valve Replacement: When the valves of the heart don’t work properly, it can lead to strain on the heart muscle and lead to heart failure. There are many options for valve repair today.
• Heart Transplant: When heart failure cannot be managed by any other therapies, the patient may qualify for a heart transplant.

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Many people are able to comfortably manage their heart failure and live relatively normal lives. When diagnosed with heart failure, it is important to remember the following:

• Take your medications exactly as prescribed by your doctor.
• Keep regular doctor’s appointments to monitor your condition.
• Make healthy lifestyle choices.
• Eat a low sodium diet.
• Limit fluid intake.
• Weigh yourself daily to monitor for fluid retention.
• Talk to your family about your advanced directives and your goals of medical care. Learn more here.
• Call your doctor with worsening symptoms.