Heart Failure

Adjust and reinvent a new you with today's breakthrough treatments

PART I

• Systolic HF ,common after heart attacks,atrial fibrillation, hypothyroidism, post viral, diabetes, alcohol.

• Heart muscle gets weak, and the ejection fraction is lower than 50%

• Diastolic HF, common with aging and after longstanding HTN

• More common in women over 65: "older women's heart"
• Heart muscle is not weak but stiff and ejection fraction is normal or higher

​

There are two types of Heart Failure (HF)

Systolic HF

• Heart muscle is weak, loosing its power to pump the blood throughout the body.

• Heart cannot keep up with your activities; like a car engine : may still drive at 25m/h, but not faster or uphill

Know the Ejection Fraction: how much your heart pump is working.

Remember, normal Ejection Fraction is not 100%, but 55-65%

Systolic HF has < 50%

Best test to diagnose HF is echocardiogram

Signs of Systolic Heart Failure

• Shortness of breath, with daily activities, and then at rest
• Swollen legs
• Dry, hacking cough
• Fatigue
• Dizziness
• Difficulty sleeping when lying flat
• Loss of appetite, with weight gain due to water retention
• Chest pain, nausea, palpitations, fast heart rate

Diagnosing Heart Failure. Testing

• Echocardiography

• EKG

• Blood tests for thyroid, electrolytes, kidney function

• Angiogram

• Cardiac CT or cardiac MRI

Angiogram

Medications proved to improve Heart failure and survival

ACEI and ARB group

• proven to improve pump function
• important in HF to restore muscle function, not to reduce HTN; to be taken in HF despite low blood pressure
• Lisinopril, ramipril, benazepril, losartan, valsartan and more

Beta Blockers

• " heart antianxiety", improve pump function and regulate pulse
• Carvedilol, metoprolol, lopressor, atenolol

Aldosterone antagonist

• Help the body flush excess fluid and sodium
• Spironolactone, eplerenone

Hydralazine and Nitrates

• Help boost blood flow and relax blood vessels

Diuretics

• Help clear excess water from your body and lungs

Newly approved HF treatments

Entresto, approved in 2015

• A combination pill, shown to reduce cardiac mortality and decrease hospitalization

To be continued .....