Every year there are over 250,000 deaths in the United States due to heart failure. It accounts for over 30% of all cardiovascular-related conditions and affects almost 6 million Americans of all ages. In fact, heart failure is responsible for more hospitalizations in the United States than all types of cancers combined. Heart failure is a serious and often life-threatening condition that needs prompt specialist medical attention.
How To Spot Heart Failure
Heart failure is essentially a weakening of the heart with a reduction and eventually a cessation of heart function. The heart pumps blood which is distributed throughout the body. If it becomes weak then it pumps less blood and with less force. Eventually the heart will stop working altogether without appropriate treatment or even a transplant and this will lead to death.
With less blood being circulated, the cells of the body do not have sufficient oxygen to function at its peak. Various organs and biochemical processes in the body become disrupted. For example, the kidneys under-function as well as receive less blood to filter. The blood flow through the legs is slowed down which, in addition to the kidney disruption, may cause fluid accumulation and therefore swelling of the legs.
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Why does the heart fail?
Heart failure may occur for various reasons. It does not always arise suddenly like a heart attack and may persist for months and even years before it results in death. However, there are instances where heart failure may develop suddenly, like after a non-fatal heart attack. In these cases it can turn deadly within hours to days. The signs and symptoms of heart failure may seem obvious but this is not always so, especially when it develops slowly.
The causes of heart failure are diverse. It can range from some of the more common causes like a heart attack, coronary artery disease, high blood pressure (hypertension), heart valve disease, congenital heart defects, diabetes mellitus to infections like myocarditis, drugs such as digoxin, substances like alcohol and illicit drugs (cocaine), anemia, hyperthyroidism and chronic pulmonary disease.
What does heart failure look like
A person with swelling in the legs, arms and limbs, severely fatigued, short of breath, coughing and with a pale to slightly bluish discoloration of the skin is likely to be in heart failure. However, heart failure is not always as easy to spot nor does it always appear so typically in the early stages. Therefore it needs to be diagnosed by a doctor and further tests may first be required.
Heart failure can be either acute or chronic. The symptoms of acute heart failure arise suddenly and tend to be severe. On the other hand the symptoms in chronic heart failure may develop gradually and are initially mild. Without proper treatment, heart failure will progress in most cases and may even lead to death within hours to days.
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The following signs and symptoms of heart failure are for reference purposes. Always consult with a medical professional if heart failure is apparent or suspected.
Shortness of Breath
Shortness of breath varies in severity. In the early stages, shortness of breath may only be noticed with exertion and is often ignored. However, as heart failure worsens this shortness of breath becomes more severe. A person may find it difficult to breathe when at rest, and even when lying down or sleeping. Fluid may accumulate in the lungs and a person with heart failure may need to lie almost upright in order to sleep.
Fatigue is another common symptom of heart failure and worsens as heart failure progresses. Initially there is fatigue with activity, although the degree of fatigue does not correlate with the level of activity. A person with heart failure may find that their physical stamina is reduced and ability to undertake strenuous activity like exercise is impaired. Eventually a person feels fatigued on a constant basis, even with very little physical activity.
Swelling is another common feature of heart failure. Initially it may be noticed in the legs and then the arms (peripheral edema) but as the condition progresses, swelling may occur in the abdomen (ascites) and eventually throughout the body (anasarca). As a result of the fluid retention, there is a sudden increase in body weight and this progressively worsens in line with the reduced urine output that occurs in heart failure.
Frequent urination at night (nocturia) where a person has to awaken to pass urine is one of the early symptoms of heart failure. This night time waking can further worsen fatigue as a person with heart failure is unable to rest sufficiently with regards to undisturbed sleep. Late in heart failure there is a significant reduction in urine output (oliguria) beyond the norm. This is in line with the worsening of swelling.
Coughing is another symptom seen with heart failure, especially as fluid in the lungs (pulmonary edema) arises. This cough is non-productive initially. It tends to be a persistent cough throughout heart failure and as it worsens there is also abnormal breathing sounds like wheezing. In late heart failure there is expectoration of pink frothy mucus with severe shortness of breath.
There are varying degrees of mental impairment, which is often not evident or present in the early stags. These mental symptoms may include poor memory, difficulty concentrating, insomnia, anxiety and confusion. In rare cases there may be symptoms of psychosiss such as hallucinations and delirium. The latter symptoms are more likely to arise in patients with narrowed arteries to the brain, and heart failure worsens the blood restriction to the brain.
Contrary to popular belief, heart failure does not always present with chest pain, at least not always in the early stages. In fact it is mainly when heart failure is due to a heart attack or pericarditis that chest pain will be noticed. This pain may vary from the typical constricting pain seen with a heart attack to a sharp pain in pericarditis. Symptoms like concomitant arm pain with the chest pain is more typical of a heart attack than any other cause of heart failure.