Your Trusted Heart Failure (CHF)Treatment and Prevention Experts In South Dakota
What is Heart Failure (CHF)
Heart failure (also called congestive heart failure or CHF) occurs when the heart muscle is unable to pump blood normally to the body. There are many potential causes of heart failure, but all forms of CHF can result in fluid retention in the lungs, abdomen, legs or ankles. Treatment of heart failure may improve quality of life and help some live longer.
Symptoms of Heart Failure (CHF)
The most common symptoms of heart failure are due to the retention of water. Other symptoms may include:
- Shortness of breath, wheezing
- Waking up at night short of breath, or shortness of breath when laying down
- Fatigue, weakness
- Palpitations or irregular heart beat
- Persistent or worsening cough
- Weight gain, abdominal bloating, decreased appetite
- Swelling of feet, ankles, and legs (edema)
Risk Factors of Heart Failure (CHF)
coronary artery disease
High Blood Pressure
Diabetes
Obesity
Family History of Heart Disease
Diagnosis of Heart Failure (CHF)
The diagnosis of heart failure (CHF) is made by a doctor who asks questions about your medical history and personally examines you. Additionally, diagnostic testing such as blood tests, X-Ray, ultrasound (echocardiogram), CT imaging, cardiac MRI, and invasive coronary angiography may play diagnostic and therapeutic roles.
When diagnosed with heart failure, your doctor will classify you into one of four categories using the New York Heart Association (NYHA) and American Heart Association (AHA) classification systems:
- NYHA Class 1: No symptoms of heart failure.
- NYHA Class 2: Symptoms of heart failure, such as shortness of breath, with mild activity.
- NYHA Class 3: No symptoms at rest or with mild exertion. Shortness of breath with moderate to heavy exertion.
- NYHA Class 4: Symptoms of heart failure at rest. This is severe heart failure.
Treatment of Heart Failure (CHF)
Heart failure is a syndrome that can usually be treated effectively with medicine and lifestyle changes. Less often, patients require procedures or surgeries to open blocked arteries to improve blood flow to the heart. Rarely, heart transplantation is required.
- Weight loss
- Blood sugar control
- Low-salt diet (< 2 grams sodium per day)
- Increase physical activity, or cardiac rehabilitation
- Stop smoking
- Decrease alcohol intake
- ARB (angiotensin II receptor blockers). Losartan, Valsartan, and Olmesartan are three common ARBs. This class of medication helps strengthen the heart muscle and control blood pressure.
- ACEi (Angiotensin-converting enzyme inhibitors). Lisinopril and enalapril are two common ACEi. They may cause a dry cough. They act very similarly to ARBs.
- ARNIs (Angiotensin receptor neprilysin inhibitors). Sacubitril-valsartan, also called Entresto is the only ARNI available at present time. It helps decrease blood pressure and strengthen the heart muscle.
- Beta blockers. Metoprolol and carvedilol are two of the most common beta blockers. They slow the heart rate and help patients with heart failure live longer.
- Diuretics. Furosemide, torsemide, & bumetanide are common diuretics used in heart failure. Commonly referred to as “water pills,” this class of medication makes patients urinate more frequently to prevent fluid from building up inside your lungs, abdomen, and legs/feet.
- Sodium-glucose cotransporter-2 (SGLT2) inhibitors. This class of medication, which includes Empagliflozin (Jardiance) and Dapagliflozin (Farxiga), helps keep patients with heart failure out of the hospital and decreases mortality in patients with heart failure. They also help lower blood sugar, which can be helpful in patients with diabetes mellitus.
- Potassium-sparing diuretics. Also called mineralocorticoid receptor antagonists, or aldosterone antagonists, include two medications called spironolactone and eplerenone. In patients with heart failure and reduced ejection fraction, this medication helps patients live longer. They may also cause potassium levels to rise and require frequent potassium monitoring.
Many patients with heart failure are told “there is nothing that can be done,” or “you have blockages that can’t be opened.” While some patients may have complex coronary artery disease, those blockages can almost always be opened by an expert physician. Our physicians can open those blockages and discuss the risks and potential benefits of CHIP-CTO PCI.
- Remote Pulmonary Pressure Monitor (CardioMEMS HF): This very small implantable pressure monitor can be placed inside the pulmonary artery in the lungs to measure pressure. This device helps prevent hospitalizations for heart failure, prolongs and improves the quality of life, and allows your heart team to precisely manage your diuretic therapy.
- Heart Valve Surgery or Repair: Heart failure can be caused by heart valve disease. Some patients may be candidates for valve replacement or repair, either with open heart surgery or minimally invasive options through a vein in the leg.
- Cardiac resynchronization therapy (CRT) & Implantable cardioverter-defibrillator (ICD). In patients with heart failure and severely decreased heart function, a special pacemaker and possibly an ICD can be implanted under the skin on the chest wall to improve heart function and reduce the chance of sudden cardiac death.
- Ventricular assist device (VAD). A VAD is a mechanical heart pump implanted by a heart surgeon. This device is used only in patients with end-stage heart failure, or in those waiting for heart transplant.
- Heart transplant. In patients with severe end-stage heart failure, who are typically under the age of 65-70 years, you may be referred for heart transplant if no other options are available. There are approximately 3,500-4,000 heart transplantations per year in the United States.
Experienced Care for Heart Failure (CHF) Symptoms in the Black Hills
If you are having symptoms concerning for heart failure (CHF), please call us at (605) 503-8192 to schedule an appointment or discuss with your primary care physician (PCP).
