Heart failure is when your heart has difficulty pumping blood to the rest of your body. There are two types of heart failure – systolic heart failure and diastolic heart failure. Systolic heart failure is a decrease in the amount of blood your heart can pump with each heartbeat. Diastolic heart failure is the inadequate filling of your heart due to stiffer heart walls.
Some common causes of heart failure
Coronary artery disease
Heart valve disease
Alcohol and other illicit drug abuse
Symptoms of heart failure
Shortness of breath
Swelling of lower extremities
Irregular or rapid heart rate
Decreased ability to exercise due to chest pain and/or shortness of breath
Tests your hospitalist may recommend
Transthoracic echocardiogram – an ultrasound of your heart that allows the cardiologist to look at the pump function, valves, and basic structure of your heart.
Stress test – a non-invasive test that allows the cardiologist to assess for narrowing of vessels of your heart that may be causing damage to your heart muscles.
Angiogram – a procedure that involves injecting contrast into your vessels to allow the cardiologist to look at the vessels of your heart and to open up blocked vessels if necessary
Blood tests – some labs that may be checked include a BNP level. BNP is a protein that is released from the heart when there is excessive stretching and can be a measure of the presence and severity of heart failure. Other labs include tests to evaluate thyroid function, kidney function, and anemia.
EKG – an electrocardiogram assesses the rhythm of your heart
Chest X-ray – an image that can show the size of your heart and fluid around the heart and lungs
Treatment in the hospital and beyond
Varies depending on the type and severity level of your heart failure.
You may be prescribed medications that improve your heart’s pump function and prevent further damage to your heart, e.g. , beta blockers, ACE inhibitors, ARBs, spironolactone, nitrates, hydralazine.
You may be prescribed a diuretic to help decrease the amount of fluid in your body
You will need to adhere to a low sodium diet and limit the amount of fluid intake as recommended by your doctor
You will be weighed daily to monitor for weight gain and fluid retention
Your heart rhythm will be monitored for abnormal heart rate
An implantable defibrillator or biventricular pacemaker may be recommended for certain patients who have severe heart failure and irregular heart rhythms
Patients with end stage heart failure may be evaluated by the heart failure team and surgeons for a left ventricular assist device (a mechanical pump that is surgically implanted to help the heart maintain its pumping ability) or heart transplant
Once discharged from the hospital you will need to follow up closely with your primary care physician and cardiologist. Heart failure is a chronic condition. The best way to prevent recurrence of worsening heart failure symptoms is to work with your outpatient doctors to find a medication and lifestyle regimen that works best for you.