Features November 2017 Issue

Know How to Respond to Congestive Heart Failure Signs and Symptoms

Donít fail your heart. Recognize the warning signs of heart failure, and seek help to avoid long-term complications.

Winter can be difficult enough for the average person, but for the 6.5 million people in the United States living with heart failure, it may be even more challenging. Research presented at the American College of Cardiology’s Annual Scientific Session suggests that rates of hospitalization and death among heart failure patients are greater during the cold winter months.

So, as winter arrives, it’s vital to recognize heart failure symptoms and respond appropriately to minimize your risks. “The bottom line is if you feel symptoms, it’s time to go for an evaluation,” advises W.H. Wilson Tang, MD, research director of Cleveland Clinic’s Section of Heart Failure and Cardiac Transplantation Medicine. “The key is that patients and doctors are aware and have heightened suspicion when symptoms do occur.”

The Signs of Heart Failure

Winter symptoms

© Jean Paul Chassenet | Dreamstime.com

A worsening cough can indicate the progression of heart failure.

Heart failure occurs when the heart cannot fill with blood or pump it out adequately enough to meet your body’s demands. Blood that isn’t pumped out can back up, or congest, in the veins of the lungs and lower extremities—the term “congestive heart failure” is derived from this complication.

The accumulation of blood and fluid can cause symptoms such as breathing problems, coughing/wheezing, weight gain, and swelling in the lower extremities. Heart failure may cause fatigue, as well as an increased/irregular heart rate, nausea, and cognitive problems.

Individually, these symptoms may be attributable to heart failure or other causes. For instance, some drugs can cause swelling, while an upper respiratory infection may cause coughing, breathing troubles and fatigue. Regardless, see your doctor to identify the cause, especially if your symptoms persist.

“Shortness of breath that is progressive—particularly if you start noticing that you have problems doing the things you normally do, like going up stairs—is a concern,” Dr. Tang says. “There are some other, subtle signs. For example, symptoms can be exacerbated in stressful situations. Many times, the diagnosis is made when people go to high altitudes. Also, you may have trouble when you lie down. People with heart failure have a lot more trouble breathing at night and wake up feeling short of breath. If you have these problems and notice that you have more swelling, all of these are combinations that might indicate heart failure.”

Keep Tabs on Your Symptoms

A suspicion of heart failure may prompt your physician to look for underlying causes, such as coronary artery disease, heart-valve dysfunction, poor blood pressure control, or heart-rhythm abnormalities—all of which are amenable to effective therapies that may even reverse disease progression.

If you have heart failure, it’s critical to monitor your symptoms so that you can make any necessary lifestyle changes and adjustments to your treatment regimen. Report any coughing, shortness of breath during exertion, sleeping problems, swelling in your abdomen or lower extremities, or unexplained weight gain. Weigh yourself daily to track any changes. “If people have swelling for unclear reasons, I definitely ask them to watch their weight because water weight is measurable,” Dr. Tang says. Seek medical attention if your cough becomes more frequent, you have difficulty sleeping/lying down, or you experience shortness of breath even at rest, sudden weight gain, increased swelling in the abdomen and lower limbs, or new or worsening dizziness or cognitive problems.

Do Your Part

Follow your doctor’s advice for managing heart failure, such as adhering to a heart-healthy diet, optimizing your blood pressure and other risk factors, and participating in supervised exercise, such as cardiac rehabilitation. “Cardiac rehab is associated with improved outcomes, despite the fact that the heart has difficulty maintaining its functioning,” Dr. Tang says.

Additionally, take medications exactly as prescribed. In doing so, you can improve your symptoms, your quality of life, and, potentially, your overall survival. “These medications all improve hard outcomes. They reduce hospitalizations, and they reduce the number of deaths,” Dr. Tang explains. “We have many drugs now that actually improve the wellbeing as well as the survival of this otherwise devastating condition.”

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