Heart failure is the No. 1 cause of hospitalizations in Medicare-age individuals in the U.S., according to the Heart Failure Society of America. National Heart Failure Awareness Week is Feb. 14-21 and it’s appropriate to remind our community that this is a condition that can be identified and managed.
Heart failure is a chronic, progressive condition. The term heart failure is a bit of a misnomer. It does not mean that the heart has stopped beating, but rather that it is not pumping efficiently. As a result, the body does not get the nutrient-rich blood and oxygen it needs. It occurs when the heart muscle weakens and is unable to pump blood efficiently through the body.
Congestive heart failure is characterized by a build-up of fluids and sodium in the body’s tissues. Common signs and symptoms of heart failure are shortness of breath, fatigue, swelling in the legs, ankles and feet, difficulty breathing while lying flat, weight gain and a persistent cough.
In those with heart failure, the heart may try to compensate by enlarging or stretching to pump more blood; pump faster to accelerate the heart’s output; or build more muscle mass to pump a normal amount of blood through the body.
Also, blood flow may be jeopardized to organs such as the kidneys. It is often identified as left-sided heart failure or right-sided heart failure.
Among the factors contributing to heart failure are coronary heart disease, hypertension, obesity, high cholesterol, smoking, diabetes and chronic kidney diseases, which block the coronary arteries leading to heart failure. In addition, conditions such as cancer, treatment with some cancer medications and a few other toxic triggers can directly affect the heart muscle, leading to congestive heart failure.
While the number of people with heart failure is growing, so too, are the treatment options. Beyond traditional medications such as ACE inhibitors and ARBs, there are newer medications approved by the FDA and a few awaiting approval. Medications such as sacubitril /valsartan combination, beta blockers such as carvedilol, ivabradine, spironolactone, eplerenone, digoxin, and water pills such as furosemide have made a positive impact on outcomes in heart failure.
Medications such as empagliflozin and canagliflozin are approved to help in subjects with diabetes and established cardiovascular disease to prevent major adverse cardiovascular events. In addition, another agent, dapagliflozin, even in non-diabetics with heart failure is now approved for use.
Vericiguat was recently approved for heart failure management as well. Omecamtiv is awaiting FDA approval, currently in research.
In some cases of heart failure due to blocked arteries, angioplasty (a procedure to open up blocked arteries) and stents or bypass surgeries as well as heart valve repair or replacement without opening the chest may be considered. New technology in devices such as pacemakers, the barostim device, and cardiac contractility modulation are showing major improvements in heart failure outcomes.
The heart failure program at Abrazo Arizona Heart Hospital is accredited by the American College of Cardiology. Abrazo Arizona Heart Hospital in 2020 became the only hospital in the western U.S. to hold accreditation for treatment of chest pain, cardiac catheterization, heart failure and atrial fibrillation.
During the coronavirus pandemic, it’s important to know that delaying care for conditions like congestive heart failure can lead to further health complications. Signs of heart disease should not be ignored. Treatment options are available, and providers have safety precautions in place to protect their patients.
For more information on cardiovascular care at Abrazo hospitals, visit AbrazoHealth.com.
Dr. Kris Vijay is medical director of the Institute for Congestive Heart Failure at Abrazo Arizona Heart Hospital in Phoenix.