US Pharm. 2022;47(2):15-16.


Heart Becomes Stiff or Weak

Heart failure is a term used to describe a condition in which the heart does not pump as well as it should. The heart acts as a pump in the body, receiving blood and pumping it back out. If the heart muscle becomes stiff or weak, the heart cannot pump enough blood to meet the needs of the rest of the body. Heart failure affects nearly 6 million individuals in the United States. It is one of the most common causes of hospital admissions for those older than age 65 years and is more common in some areas of the country than in others.

Not All Heart Failure Is the Same

Heart failure is divided into two subtypes based on the amount of blood the heart can pump, called the ejection fraction. One heart failure subtype has a reduced ejection fraction. In the second type, a normal ejection fraction is maintained. Both types of heart failure have similar symptoms. Heart failure with preserved ejection fraction is more common in women with a history of high blood pressure. People with coronary heart disease, diabetes, high blood pressure, obesity, and heart valve disease are at increased risk of developing heart failure.

Heart failure symptoms include shortness of breath, fatigue, swelling of the legs, feet, ankles, and rapid or irregular heartbeat. Heart failure can develop suddenly (acute) or slowly over time (chronic). The heart loses some of its pumping efficiency with age, but heart failure occurs when it is damaged or works too hard for too long. Heart damage can occur after a heart attack and lead to weakness of the heart muscle. Long-standing high blood pressure causes the heart to work extra hard to pump blood out through narrowed blood vessels. The presence of diabetes is another important risk factor, as people with type 2 diabetes are twice as likely to develop heart failure as those without diabetes.

Diagnosis Requires a Series of Tests

To diagnose heart failure, a physician will consider the symptoms present and the medical history. Specific tests can help determine if heart failure is present and the type and severity. Physicians use blood tests to measure B-type natriuretic peptide, a protein that the heart secretes to keep blood pressure stable. These levels increase with heart failure. Blood tests may also show substances in the blood associated with heart and lung damage. A chest x-ray may be used to measure heart size and check for the presence of fluid backing up into the lungs. Heart ejection fraction is measured via echocardiogram, an ultrasound of the heart.

Heart failure symptoms can be managed by incorporating important heart-healthy lifestyle changes. Healthy eating habits such as increasing consumption of fruits, vegetables, whole-grain fiber, and lean meats can improve overall heart health. People with heart failure may need to reduce sodium intake and temporarily decrease fluid intake to alleviate pressure on the heart. Daily light exercise and avoiding smoking and drinking are also recommended.

Combination of Medications to Treat Heart Failure

Heart failure is treated with several medications that either reduce the heart’s workload or improve the heart’s ability to pump blood. To dilate blood vessels and improve blood flow out of the heart, the doctor may prescribe angiotensin-converting enzyme inhibitors or angiotensin-II receptor blockers. Additionally, a beta-blocker may be prescribed to lessen the heart’s workload and prevent additional damage over time. A diuretic will eliminate excess fluids in the body by producing more urine. Lastly, digoxin might be added to strengthen heart contractions and reduce heart rate. It is essential to continue regular check-ups and discuss heart failure symptoms with a physician to prevent serious complications. Individuals with heart failure are at an increased risk of kidney damage, heart rhythm disturbances, heart valve problems, and liver damage. Severe cases of heart failure may warrant a pacemaker implant or even a heart transplant.

If you have questions about medications used to treat heart failure, including dosing and side effects, ask your local pharmacist or other healthcare practitioner.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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