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Heart Failure Diagnosis & Treatment

A proper diagnosis is important

Heart failure is a serious condition, and an accurate diagnosis is important as it helps ensure you receive the treatment you need to lead a healthier life and reach your potential.

That’s why it’s important to see your doctor as soon as possible if you experience any symptoms. In order to check for heart failure, your doctor will ask you questions, do a physical checkup, and send you for further tests.

Common symptoms of heart failure are shortness of breath, unexplained tiredness, persistent coughing, nausea, lack of appetite or increased heart rate and sweating. The doctor will listen to your heart, check heart rate and rhythm, check blood pressure and see whether there’s fluid in your lungs, legs or other parts of your body.

Common tests may include:

  •   Blood tests:

These are used to check blood count (measuring the amount of different kinds of cells in your blood) and to assess your kidney, liver and thyroid function.

  •    Chest X-ray:

This shows if the heart is enlarged and whether there’s a build-up of fluid around the lungs.

  •   Electrocardiogram (ECG):

This test is used to check your heart rhythm or determine if you have an enlarged heart muscle. This is done by measuring the electrical activity of your heart.

  •   Doppler Echocardiogram:

This is an ultrasound of the heart which can show if you’ve had previous heart attacks, or if your heart valves are damaged. It also measures the amount of blood that can be pumped out of your heart every time it beats.

  •   Stress test:

Often a specialist doctor will get you exercising on a treadmill or bike. This measures how well your heart is responding to exercise and tests the health of your arteries.

 

  Treating heart failure

Heart failure is a life-long disease, and the aim of treatment is to help you feel better, reduce the chance of it getting worse, and manage symptoms so that you can live a full and enjoyable life. For most people that means finding the right medical treatment and making positive lifestyle improvements. Sometimes surgery may also be required to fix a specific problem.

 

Common medicines to treat heart failure include:

  • Diuretics:

These help to help eliminate excess fluid and relieve swelling and shortness of breath.

  • Angiotensin-converting enzyme (ACE) inhibitors:

These manage high blood pressure and in turn, help the heart pump blood around the body.

  • Angiotensin II receptor blockers (ARB):

These are another option instead of using ACE inhibitors for managing high blood pressure and helping the heart pump blood.

  • Angiotensin receptor-neprilysin inhibitors (ARNI):

These may be used instead of ACE inhibitors or angiotensin II receptor blockers.

  • Beta blockers:

These work by slowing your heart rate and reducing blood pressure, and can help against heart damage.

  • Cardiac glycosides:

These can have positive effects in slowing down and strengthening your heartbeat.

  • Aldosterone antagonists or mineralocorticoid receptor antagonists (MRA):

These act like diuretics and block the effects of hormones that can increase symptoms of heart failure.

  • Sinoatrial current inhibitors:

These slow the heartbeat so the heart doesn’t have to work so hard. Often prescribed for people who are still having symptoms of heart failure despite taking other medicines.

  • Anticoagulants:

If you have increased risk of blood clots or stroke, anticoagulants can help prevent the blood clots from forming.

  Surgery and other medical devices

In some cases your specialist team will recommend surgery to target and fix a specific problem. Common surgical procedures are:

 

  • Heart valve surgery:

Damaged heart valves can cause heart failure, so sometimes the option is to repair or replace the valve.

  • Cardiac resynchronisation therapy (CRT):

A CRT device may be implanted when the bottom chambers of the heart are not beating properly together. The CRT device helps the heart to beat with a normal rhythm.

  • Implantable cardioverter defibrillator (ICD):

This is a device that it implanted to help restore a normal heart rhythm. It does this by sending an electric shock to the heart if it is beating abnormally or too quickly.

  • Ventricular assist device (VAD):

This is a device that helps maintain the pumping ability of the heart when it has trouble doing so on its own. Sometimes this device is used for people who are awaiting a heart transplant.

  • Coronary bypass surgery:

This procedure diverts the flow of blood around a blocked artery via a new path. This allows blood to flow freely through the heart via a new path.

  • Heart transplant:

In rare cases when surgery, medicines and life changes don’t work, a heart transplant may be suggested.

  Lifestyle changes to manage heart failure

There are many things you can do to help manage your heart failure. This can include looking after your own mental health and that of your carer, ensuring that you have the right support at home, taking part in a cardiac rehabilitation program, and seeing an exercise physiologist.

The right support can make a real difference to your wellbeing and confidence in managing heart failure. That’s why there are special heart failure management programs that can assist you in practical ways to stay healthy. They can also give you knowledge and tips to stay on top of your condition.

Some positive lifestyle changes you can make to manage your condition include:

  • Monitoring your fluid intake. Know how much fluid or drink you can have each day, and limit salt (don’t forget that salt that is hidden in some foods, such as bread).
  • Weighing yourself daily and talking to your doctor if you put on weight quickly (more than 2 kg in two days), as this can be a sign of fluid building up in the body.
  • A healthy diet can lead to a healthier heart. Eat more vegetables, fruits and embrace whole grains, poultry and seafood whilst limiting salt, sugar and saturated fats.
  • Physical activity is important. It only takes a small amount of physical activity every day to make a difference.
  • Aim to keep a healthy weight. If you are overweight or obese, your doctor may recommend losing weight.
  • Try to minimise stress by doing relaxing activities and spending quality time with friends and family.
  • Reducing your alcohol intake is good for the health of your heart. If you drink alcohol, make sure you only do so in moderation.
  • If you smoke, quitting is good for the health of your heart. Speak to your doctor or call Quitline on 13 7848 for support with giving up smoking.

Shared decision-making

Decisions about ongoing care for heart failure should be based on an individual’s needs. That’s why shared decision making is so important. Shared decision-making means you have all the information you need to make decisions about the management of your condition with your health care professionals and your family.

This usually brings together a multidisciplinary team (MDT) of health professionals with different skills. The MDT will recommend a treatment approach in consultation with you, and often family or close friends who are brought into the decision-making process. MDTs help make sure you receive care that considers your needs, as well as other factors in your life that affect your health and wellbeing

  Try to maintain a healthy state of mind

The journey from diagnosis to treatment of heart failure can be a mental health challenge as much as a physical one. You need to do all that you can to support your mental health moving forward.

Talking to a professional can help with your mental health. Counselling or psychological therapy can be very useful for managing mental health and your condition. Your doctor can provide you with some options, and give you a referral to a psychologist.

Alternatively, to talk to someone at hearts4heart about any concerns you might have about your heart failure, email [email protected] We can provide you with answers to your questions from a clinician, or a member of the patient advocate group.

When should you speak to your doctor?

You can never be too cautious in managing your condition, so be aware of changing symptoms and reach out to a doctor as soon as possible. Things to look out for include:

  • Generally feeling unwell, even if you can’t quite describe it
  • Increasing shortness of breath, especially when lying flat in bed
  • An unfamiliar or frequent cough
  • New swelling in ankles, legs or abdomen
  • Sudden weight gain in the space of days ie. 2kg in two days
  • Increased heart rate and/or palpitations
  • Feelings of increased and prolonged dizziness

When should you call 000?

Call an ambulance or get someone to take you to the closest hospital emergency department if you notice any of the following physical signs:

  • Pain in your chest, arm, jaw or back pain that is not stopping
  • Very severe shortness of breath
  • Fast heart rate (palpitations) that don’t stop when you are resting
  • Going in and out of consciousness