Heart failure
Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This helps to keep the blood moving for a short while, but in time, the heart muscle walls weaken and are unable to pump as strongly. As a result, the kidneys often respond by causing the body to retain fluid and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition. Heart failure is the leading cause of hospitalization in people older than 65.
To diagnose heart failure, AMC cardiologists will first inquire about patient symptoms and medical history.
- Are there any other health conditions such as diabetes, kidney disease, angina, high blood pressure or other heart problems
- Does the patient smoke
- Does the patient drink alcohol and how much
- What medications are being taken.
This will be followed by a complete physical exam with the cardiologist looking for signs of heart failure as well as any other illnesses that may have caused the heart to weaken.
- A battery of tests will be ordered to determine the cause and severity of heart failure. These include:
- Blood tests. Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia.
- B-type natriuretic peptide (BNP) blood test . BNP is a substance secreted from the heart in response to changes in pressure that occur when heart failure develops and worsens.
- Chest X-ray. Chest X-ray shows heart size and whether there is fluid build-up around the heart and lungs.
- Echocardiogram. This test shows a graphic outline of the heart's movement.
- Ejection fraction (EF). The EF test determines how well the heart pumps with each beat.
- Electrocardiogram (EKG or ECG). EKG records the electrical impulses traveling through the heart.
- Cardiac catheterization. This is one of the best tests for determining heart function and whether heart arteries are clogged.
- Stress test. The patient’s heart is “stressed” by walking on a treadmill or by giving medications to increase pumping of the heart.
With an accurate diagnosis in hand, AMC cardiologists can prescribe appropriate medication, or if need be, propose a suitable surgical procedure.