Signs of heart failure and how to treat it

For some, it’s the shortness of breath while exercising or a dry, hacking cough. For others, swelling in the abdomen, legs or ankles begins. There are a variety of symptoms — including sudden weight gain, fatigue, nausea and waking up with shortness of breath — that warn of heart failure. But not everyone heeds them as quickly as they should.

According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 6 million adults have heart failure in the U.S. That number is estimated to grow to 8 million by 2030.

“Congestive heart failure is caused by heart pump impairment, resulting in a variety of symptoms,” says Dr. Brian Jaski, a cardiologist affiliated with Sharp Memorial Hospital. “As the heart struggles to maintain output, the body holds onto extra fluid, and the vital organs don’t get enough oxygen.”

Causes of heart failure

Dr. Jaski reports heart failure is caused by a variety of cardiac conditions, including:

Each of these conditions can be influenced by genetics, Dr. Jaski says, such as race or family health history. Illnesses and lifestyle choices also play a role, including:

• High cholesterol

• Diabetes

• Obesity

• Advanced age

• Diet high in saturated fats

• Lack of physical activity

• Consumption of too much alcohol

• Smoking

“In a sense, heart failure can be viewed as the culmination of all insults to the heart over someone’s lifetime since, in general, heart muscle cells do not replicate after birth,” Dr. Jaski says. “Because of the many potential causes, getting a complete diagnosis is important for the treatment of heart failure.”

Treating heart failure

According to Dr. Jaski, measurement of the heart’s level of performance, as well as managing some of the risk factors for heart disease, are among the first steps to treating heart failure. This can be accomplished through medication; support of smoking, alcohol and drug use cessation; and education about healthy diet and exercise.

For some with a prolonged electrical activation of the heartbeat (irregular heartbeat), another treatment option is pacemaker therapy, which involves the implantation of a small electronic device in the chest. Additionally, gene therapy may one day be able to help the heart cells we have regenerate, or heal, themselves.

“The main heart cell calcium pump, which controls contraction and relaxation, becomes depleted as heart failure progresses,” Dr. Jaski says. “We are seeing exciting innovations in the use of gene therapy to reverse this.”

Advanced treatment options

Dr. Robert Adamson, a cardiothoracic surgeon affiliated with Sharp Memorial, says when advanced treatment for heart failure is required, a left ventricular assist device (LVAD) or heart transplant may be appropriate. Both can improve a person’s quality of life and prolong their life.

An LVAD is a device that supplements the pumping function of a heart that is too weak to sufficiently pump on its own. It can be used to help a heart become stronger in recovery or be used as a temporary support tool — or bridge — until a patient can receive a heart transplant. An LVAD can also be a permanent, or final, destination therapy that can prolong and improve quality of life.

A transplant replaces a patient’s heart with a donor heart and can give a patient with heart disease the opportunity to have a normal heart with normal blood circulation. Transplant recipients can live for decades with their new hearts, thanks to advances in transplant science, antirejection drugs and post-transplant rehabilitation.

“The first heart transplant in San Diego was performed at Sharp Memorial Hospital,” Dr. Adamson says. “Since then, we have performed more than 500 transplants with high survival rates.”

Drs. Jaski and Adamson advise people to talk with their doctor if they are experiencing any of the symptoms of heart failure or have concerns about their heart health. Together, individuals and their doctors can determine which lifestyle changes might improve their overall health and identify appropriate treatments to reduce their risk of disease and improve their quality of life.

Learn more about advances in heart failure treatment at a free on-demand webinar offered by Sharp Memorial Hospital.