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

 

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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 .....

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