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Heart Failure Awareness Week - February 12-18, 2023

Heart disease is the primary cause of death in the United States, affecting over 6 million people and accounting for over 600,000 deaths annually. This is why different health organizations in the country observe Heart Failure Awareness Week every second week of February, helping spread awareness about heart failure and its prevention, treatment, and management.

The theme for Heart Failure Awareness Week 2023 – Heart Success: Function Not Failure – aims to shed light on all that can be done to treat HF based on how a patient’s heart is functioning.  

 

History of Heart Failure Awareness Week

The observance of Heart Failure Awareness week right on the week of Valentine’s Day was approved by the US Senate in 2000 and has been sponsored by the Heart Failure Society of America (HFSA) since then. The HFSA, in partnership with private companies and health professionals, uses the week to promote heart disease awareness, innovative research about heart health, and support patients with heart failure.

About 6.2 million adults in the United States are living with heart failure, and the course of treatment and patient prognosis can vary greatly by individual. Despite this staggering number, patients living with HF can indeed lead normal, active lifestyles. The Heart Success: Function Not Failure campaign aims to empower patients living with HF and their caregivers or loved ones to learn about the how-tos of self-advocacy, shared decision-making, making healthy choices to improve their quality of life, and optimizing visits with their healthcare provider team.  The campaign will also provide information for at-risk individuals, including those who might be at risk, and how they can start a conversation about the risk factors and signs of HF.

 

Importance of Heart Failure Awareness Week

Awareness about this condition has increased significantly, with many people now aware that it can be managed effectively. However, much more needs to be done in order to raise awareness of this health issue among both patients and healthcare professionals.

Heart failure is not a disease but rather an indicator of other underlying conditions such as high blood pressure or diabetes. In fact, many people with heart failure also have one or more other diseases at the same time. Heart failure can be deadly if left untreated or if it doesn't improve over time because your body will not be able to get enough oxygen-rich blood through your heart's arteries which are weak from having too much fluid build-up around them (this is called left ventricular dysfunction).

The good news is there are things that you can do now to help prevent this from happening in the first place: eat healthy foods like fish and fruits and vegetables; exercise regularly; control your weight by exercising regularly; and talk with your doctor about ways you can manage high blood pressure, high cholesterol levels, and diabetes.

 

Understanding Heart Failure: Facts and Information

Many people with heart failure lead normal, active lives. They do so because they have learned to take good care of themselves by better understanding heart failure.

Heart failure is a common condition that occurs when the heart cannot pump blood as well as it should. This can happen for many reasons, such as disease or injury. The most important thing you can do if you have heart failure is to follow your doctor's recommendations and keep an eye on how you feel. This will help you manage your condition and avoid complications.

 

What is heart failure?

Heart failure is a progressive condition in which the heart’s muscle gets injured from something like a heart attack or high blood pressure and gradually loses its ability to pump enough blood to supply the body’s needs. The heart can be affected in two ways, either become weak and unable to pump blood (we call this situation systolic heart failure) or it become stiff and unable to fill with blood adequately (we call this situation diastolic heart failure). Ultimately, both conditions lead to the retention of extra fluid or congestion. So when patients develop symptoms, we call it congestive heart failure. Many people don’t even know they have it because symptoms are often mistaken for signs of aging. Heart failure does not develop overnight – it’s a progressive disease that starts slowly and worsens over time.

 

How common is heart failure?

Heart failure is very common.  Although we have made progress in the treatment of many forms of heart disease, heart failure is a growing problem in the United States.  Current estimates are that nearly 6.5 million Americans over the age of 20 have heart failure. One major study estimates that there are 960,000 new heart failure cases annually.  Not only is heart failure a major problem affecting many people, heart failure is also a major killer.  Heart failure accounts for about 8.5% of all heart disease deaths in the United States.  And, by some estimates, heart failure actually contributes to about 36% of all cardiovascular disease deaths.  One study notes that heart failure is mentioned in one in eight death certificates. Hospitalizations for heart failure are a huge burden on our healthcare system.  In fact, it remains the number one cause of hospitalizations in our Medicare population. 

 

What are the risk factors for heart failure?

Although heart failure may strike at any age, it is more common in people as they get older, making age an important risk factor. The risk of heart failure increases dramatically after the age of 65.

Other risk factors include the following:

  • Fat deposits creating blockages in the heart’s arteries (coronary artery disease)
  • High blood pressure (hypertension)
  • Heart attack (myocardial infarction)
  • Damage to the heart valves or history of a heart murmur (valvular heart disease)
  • Heart muscle disease and enlargement of the heart (cardiomyopathy)
  • Heart defects at birth (congenital heart disease)
  • Family history of enlarged heart (Familial cardiomyopathy)
  • Diabetes
  • Obesity
  • Sleep apnea (Cor pulmonale)
  • Severe lung disease (Cor pulmonale)

 

What are the common symptoms of heart failure?

The symptoms of heart failure may be subtle and are often mistaken for normal signs of aging. Common symptoms of heart failure are due to extra fluid or congestion. Typically starting with congestion of the lungs, then congestion of different parts of the body. At advanced stages, the cardiac output decreases. These three stages of symptoms can come sequentially or together.

 

Breathing Difficulties (congestion of the lung and left side of the heart)

  • Trouble breathing when resting or lying down
  • Shortness of breath from walking stairs or simple activities (dyspnea)
  • Waking up breathless at night (paroxysmal nocturnal dyspnea)
  • Needing more than two pillows to sleep (orthopnea)
  • Tiring Easily (Exercise Intolerance)
  • Frequent coughing
  • Coughing that produces a mucus or pink, blood-tinged sputum
  • Dry, hacking cough when lying flat in bed

Congestion of the right heart (and congestion of the other part of the body)

  • Increased need to urinate at night
  • Swelling of feet, ankles, or legs (edema)
  • Swelling of the abdomen (ascites)
  • Lack of appetite and nausea
  • Low cardiac output

Fatigue

  • Cold legs and arms
  • Difficulty concentrating

 

How is heart failure diagnosed?

Heart failure is diagnosed by a constellation of symptoms and signs of fluid overload due to either a weak heart (heart failure with reduced ejection fraction) or a strong heart with poor heart relaxation (heart failure with preserved ejection fraction).  Symptoms include shortness of breath, dry cough often worse at night, poor appetite +/- nausea, and fatigue. Signs include leg swelling and increase abdominal girth. Medical providers often order an echocardiogram, or “echo” to determine the strength of the heart.  An echocardiogram is an ultrasound of the heart that measures the ejection fraction (EF), wall thickness, and the flow of blood through valves in your heart.  People with a healthy heart have an EF of about 60%, while people with heart failure have either a reduced ejection fraction with EF < 40% (HFrEF) or a preserved ejection fraction with EF >50% (HFpEF).  Medical therapy including pills and devices are dependent on your stage of heart failure and your functional state.  With careful supervision, medical therapy, exercise, and compliancy with diet and fluid restriction, many patients with heart failure can enjoy their everyday activities and have a more normal life expectancy. 

 

How is heart failure treated?

Early detection and treatment of heart failure allow you to continue living an active lifestyle for a longer period of time while reducing the risk of hospitalization. Your initial treatment regimen will vary depending on the type of heart failure and the severity of your condition. Treatment regimens generally include a combination of medications, lifestyle changes (smoking cessation, diet, exercise), and surgical procedures that allow your heart to continue meeting the demands of your body. You may even be eligible for a heart transplant at some point, depending on the severity of your condition and various other factors.

To best optimize your care, a medical provider will use a multi-disciplinary approach. This will consist of physicians, nurse practitioners/physician assistants, pharmacists, nursing staff, and dietitians working collaboratively to modify treatments in order to suit your changing needs best. Above all, you are the most important part of the treatment puzzle. Through focused education, the team will teach you to look for certain signs and symptoms that may be signaling to adjust or change treatment. As we continue to make strides in our understanding of heart failure, new medications, and procedures will continue to become available that improve survival and quality of life.

 

Living with Heart Failure

While heart failure is a life-altering disease, with appropriate management and lifestyle changes, individuals are able to maintain a consistent quality of life for a longer period of time. Understanding your condition and remaining educated will be crucial to success. By incorporating the steps below and ensuring you have a clear understanding of each, you can stay one step ahead of the disease.

Education: Knowledge is power! It is essential that both you and your family understand what heart failure is, what the symptoms are, what you should do if your symptoms change, and how your doctor treats the disease.

Medication Adherence: Taking your prescribed medications as directed is crucial to the health of your heart. While the doses of your medications will be fine-tuned over time, never stop taking a medication before consulting with your medical team. If you have concerns about side effects or the way a medication is making you feel, reach out to the team right away.

Dietary Choices: Watching your salt consumption and fluid intake (water, soda, juice, etc.) is necessary to prevent your heart from working harder than it needs to. Talk with your dietitian to ensure you understand what foods will work best for you and your heart.

Exercise: In addition to medicine and diet, exercise will help your heart and keep you physically strong. Make sure to talk with your doctor before beginning an exercise program, as they may want you to gradually build towards certain goals.

Daily Weight: You should also be weighing yourself on a daily basis. Large changes in weight may be a signal that your medications or diet needs an adjustment.



Sources:

https://hfsa.org/heart-failure-awareness-week-2023/heart-function-not-failure#:~:text=February%2012%2D18%2C%202023%20is,to%20supply%20the%20body's%20needs.

https://hfsa.org/heart-failure-awareness-week-2023/heart-function-not-failure

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