Heart failure is a common occurrence in Israel and around the world. It occurs when the heart does not function in accordance with the body’s needs. Heart disorders such as cardiac arrest or myocardial infarction affect the heart’s functioning and cause heart failure. Sometimes the illness appears without any apparent reason. Heart failure largely manifests itself in breathlessness, stress, edemas and weakness.
The number of people suffering from heart failure is growing. It is estimated that 2-10% of people over the age of 65 suffer from the disease. It is a chronic syndrome with an ongoing pattern of worsening and remission that can cause terrible suffering and even death. Having said that, modern medicine has the tools to treat it. The correct treatment can prevent repeated hospitalization and complications and improve the patient’s quality of life, even allowing him or her to lead a perfectly normal existence.
Heart failure treatment is lengthy and requires the full cooperation of the patient and his or her family. Knowledge and understanding of the causes of the disease and the ways to treat it can allay concerns and improve chances of success.
Tests
When you begin displaying symptoms that could indicate heart failure, the doctor will listen to your medical history, ask clarifying questions to gather the necessary data, examine you and, if necessary, refer you for comprehensive tests:
- Full physical examination
- Blood pressure, pulse, level of oxygen in the blood
- Checking the veins in your neck. If there is increased pressure in the right atrium, the veins in the neck swell and stand out, which testifies to an excess of fluid in the body and more severe heart failure. The doctor will examine your neck veins while you are lying at a 30°-45° angle.
- Listening to your lungs and heart using a stethoscope. Grunting sounds during breathing could indicate an accumulation of liquids in the lungs and heart murmurs could signify problems in valve activity.
- Examining the abdomen, ankles and legs, which could swell due to the accumulation of fluid.
- Weighing – the accumulation of fluid can lead to an increase in weight.
- Blood tests, including full blood count, electrolytes, liver and kidney function, glucose, TSH lipid profile, and in relevant cases your digoxin and blood iron levels.
Treating Heart Failure
The treatment of heart failure is designed to reduce the characteristics of the illness, improve the patient’s quality of life, prevent deterioration and more hospitalization and even extend life expectancy. The team prepares an individual treatment and monitoring program for each patient in accordance with his or her medical situation. Depending on the severity of the illness, a variety of treatment options are offered.
These include:
- Maintaining a healthy lifestyle
- Regular, consistent medicinal treatment according to doctor’s instructions
- Periodical monitoring tests as directed by the medical team
- Maintenance of pacemakers and catheterization
- Surgical operations
Guidelines and Tips for Taking Medications
- It's important that you are familiar with the medications prescribed to you, their effects, the required dosage, and the frequency of taking them. Each medication has a generic name and brand names provided by the marketing company, so there may be multiple names for a specific medication. If you are unsure about the name of a medication, don't hesitate to seek assistance from the medical team.
- You should take your medications consistently and as directed by your doctor. If you forget to take a dose, do not take a double dose the next day.
- If you have stopped taking a medication or changed the dosage, you should inform your treating physician.
- Any therapeutic treatment may have side effects. If you experience a new side effect that you haven't felt before while taking the medication, you should report it to the medical team.
- If you intend to use non-prescription medications or homeopathic remedies, it's important to report and consult with your treating physician.
- Maintain medical follow-up - schedule regular appointments with your treating physician to ensure proper monitoring of your medication regimen.
- When you visit the clinic, make sure to bring your medication packages so that the medical team can accurately understand which medications you are taking at home and adjust your treatment accordingly.
Specialized Cardiac Procedures and Pacemaker Implants
In some cases, the treating physician may recommend a procedure called cardiac catheterization to assess whether blockages or vascular problems contribute to heart failure symptoms. If significant blockages are found, it may be considered to treat them with a therapeutic catheterization procedure (using a balloon and stent) or through bypass surgery. In certain cases where the coronary arteries have a role in heart failure, treatment may include interventions such as angioplasty and stenting.
Pacemakers and Implantable Cardioverter-Defibrillators (ICDs) - Some heart failure patients may benefit from a specialized pacemaker known as "CRT" (Cardiac Resynchronization Therapy) or a dual-chamber pacemaker. This treatment can alleviate certain symptoms but is not suitable for all heart failure patients. If it is determined to be appropriate for your case, your doctor will discuss it with you.
To prevent life-threatening rhythm disturbances, some patients who suffer from heart failure are advised to undergo implantation of a specialized pacemaker capable of detecting and treating rapid rhythm disturbances. This device is called an implantable cardioverter-defibrillator (ICD), and it is typically implanted similarly to a standard pacemaker in a minor procedure.
Surgical Interventions
For advanced heart failure patients who have exhausted the above treatment options but still suffer from severe heart failure, advanced surgical treatments may be considered. These surgical options include:
- Artificial Heart Transplantation
- Human Heart Transplantation
The suitability for these surgeries is individual and complex. The decision regarding the need for and suitability of these surgeries typically requires ongoing evaluation and a deep understanding of the patient's condition, often involving the entire healthcare team.