Heart failure affects more than five million Americans, with approximately 550,000 new cases each year. Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs and often results from damage caused by a heart attack, high blood pressure, diabetes, obesity or other conditions. In the early stages, common symptoms include shortness of breath and fatigue. As heart failure advances, swelling in the legs, weight gain from fluid buildup, loss of appetite, and a rapid or irregular heartbeat can occur.
Many early-stage heart failure patients are able to control their symptoms and might not need aggressive treatment for several years. In the early stages of heart failure, physicians attempt to limit risk factors and treat the underlying problem; for example, repairing a heart valve or controlling a fast rhythm such as atrial fibrillation.
Medications, diet and exercise are all very important.
As heart failure advances, the symptoms can worsen. The condition is then known as advanced-stage heart failure. The severity depends on how much pumping capacity (muscle strength) your heart has lost. In advanced heart failure, the heart has very little pumping capacity, and the chances for developing complications increase.
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Complications of advanced heart failure include kidney damage, heart valve problems, liver damage, heart attack, stroke and life-threatening heart rhythms. Fortunately, there are treatments that can help heart failure patients live longer and reduce the chance of developing complications. Treatment often involves a balance of the right medications, diet, exercise and devices that can help the heart pump and beat properly.
In advanced heart failure, one or more of these therapies can be considered: implantable cardioverter defibrillators, cardiac resynchronization therapy or biventricular pacing, ventricular assist devices and/or heart transplantation.
Dangerous heart rhythms can develop in advanced heart failure, and physicians might recommend a defibrillator, which monitors the heart rhythm. If a life-threatening rhythm occurs, it shocks the heart back into a normal rhythm.
Many people with heart failure have problems with their heart's electrical system, which causes their weak heart muscle to beat in an uncoordinated fashion, worsening heart failure. Biventricular pacing sends electrical impulses to the heart so the heart can pump in a more efficient, coordinated manner.
A ventricular assist device is a mechanical device that helps the heart to pump. It is implanted into the abdomen or chest and attached to the heart and can significantly extend and improve the lives of people with advanced heart failure who are not able to have heart transplantation or who are waiting for a new heart.