Heart failure

Dr. Ibrahim Abuasbeh

 What Is Heart Failure?
• Heart failure is a condition in which the heart
can't pump enough blood to meet the body's
needs.
• In some cases, the heart can't fill with enough
blood.
• In other cases, the heart can't pump blood to
the rest of the body with enough force.
• Some people have both problems
• The condition can affect the right side of the
heart only, or it can affect both sides of the
heart. Most cases involve both sides of the
heart.
• Right-side heart failure occurs if the heart
can't pump enough blood to the lungs to pick
up oxygen.
• Left-side heart failure occurs if the heart can't
pump enough oxygen-rich blood to the rest of
the body.
 What Causes Heart Failure?

• Coronary heart disease

• Diabetes
• High blood pressure
• Other heart conditions or diseases
• Other factors
 Coronary Heart Disease

• Coronary heart disease is a condition in which a

waxy substance called plaque builds up inside the
coronary arteries.
• These arteries supply oxygen-rich blood to heart
muscle.
• Plaque narrows the arteries and reduces blood
flow to heart muscle.
• The buildup of plaque also makes it more likely
that blood clots will form in your arteries.
 Diabetes
• In diabetes, the body doesn’t make enough insulin
or doesn’t use its insulin properly.

• Over time, high blood sugar levels can damage:

– and weaken the heart muscle

– and the blood vessels around the heart,
– leading to heart failure.
 High Blood Pressure

• Blood pressure is the force of blood pushing

against the walls of the arteries.
• If this pressure rises and stays high over time, it
can weaken your heart and lead to plaque
buildup.
• Blood pressure is considered high if it stays at or
above 140/90 mmHg over time
• If you have diabetes or chronic kidney disease,
high blood pressure is defined as 130/80 mmHg
or higher.
 Other Heart Conditions or Diseases

• Arrhythmia :
– Happens when a problem occurs with the rate or
rhythm of the heartbeat.

• Cardiomyopathy :
– Happens when the heart muscle becomes
enlarged, thick, or rigid.
• Congenital heart defects :

– Problems with the heart’s structure are present at

birth.

• Heart valve disease :

– Occurs if one or more of your heart valves doesn’t

work properly, which can be present at birth or
caused by infection, other heart conditions, and
age.
 Other Factors

• Other factors also can injure the heart muscle

and lead to heart failure. Examples include:
– Alcohol abuse or cocaine and other illegal drug
use
– HIV/AIDS
– Thyroid disorders (having either too much or too
little thyroid hormone in the body)
– Too much vitamin E
– Treatments for cancer, such as radiation and
chemotherapy
What Are the Signs and Symptoms of
Heart Failure?
How Is Heart Failure Diagnosed?

Clinical diagnosis
 Diagnostic Tests

• No single test can diagnose heart failure.

• ECG:
– Ischemia
– Arrythmia
– LVH
• Chest X Ray
– heart is enlarged?? CTR
– fluid in your lungs
• BNP Blood Test
– The level of this hormone rises during heart failure
• Echocardiography
– The test shows the size and shape of the heart
and how well the heart chambers and valves
work.
– identify areas of poor blood flow to the heart,
areas of heart muscle that aren't contracting
normally, and heart muscle damage caused by
lack of blood flow.
– EF
• HOLTER

• CATH

• STRESS ECG

• THYROID FUNCTION TEST

• Cardiac MRI:

– A cardiac MRI can show whether parts of your

heart are damaged

– used MRI in research studies to find early signs of

heart failure, even before symptoms appear.
 How Is Heart Failure Treated?

• Early diagnosis and treatment can help people

who have heart failure live longer, more active
lives.

• Treatment for heart failure depends on the

type and severity of the heart failure.
• The goals of treatment for all stages of heart
failure include:

– Treating the underlying cause, such as coronary

heart disease, high blood pressure, or diabetes
– Reducing symptoms
– Stopping the heart failure from getting worse
– Increasing lifespan and improving quality of life
• Treatments usually include :

– lifestyle changes
– medicines
– severe heart failure, also may need medical
procedures or surgery
 Heart-Healthy Lifestyle Changes
• Heart-healthy eating
• Maintaining a healthy weight
• Physical activity
• Quitting smoking
 Heart-Healthy Eating
• Fat-free or low-fat dairy products, such as skim milk
• Fish high in omega-3 fatty acids, such as salmon, tuna,
and trout, about twice a week
• Fruits, such as apples, bananas, oranges
• Legumes(‫)ﻗﺭﻭﻥ ﺍﻟﻧﺑﺎﺕ‬, such as kidney beans, lentils
(‫)ﻋﺩﺱ‬, chickpeas (‫ )ﺣﻣﺹ‬, black-eyed peas, and lima
beans
• Vegetables, such as broccoli (‫ )ﻗﺭﻧﺑﻳﻁ‬, cabbage(‫)ﻣﻠﻔﻭﻑ‬,
and carrots(‫)ﺟﺯﺭ‬
• Whole grains, such as oatmeal(‫)ﺍﻟﺷﻭﻓﺎﻥ‬, brown rice, and
corn tortillas
• avoid eating:

– A lot of red meat

– Palm and coconut oils ( ‫)ﺯﻳﺕ ﺍﻟﻧﺧﻳﻝ ﻭﺟﻭﺯ ﺍﻟﻬﻧﺩ‬
– Sugary foods and beverages
• Not all fats are bad.
• Monounsaturated and polyunsaturated fats
actually help lower blood cholesterol levels.
• Some sources of monounsaturated and
polyunsaturated fats are:
– Avocados
– Corn, sunflower, and soybean oils
– Nuts and seeds, such as walnuts
– Olive
– Peanut butter
• Sodium
• limit the amount of sodium that you eat. This
means choosing and preparing foods that are
lower in salt and sodium.
• Try to eat no more than 2,300 milligrams of
sodium a day.
• If you have high blood pressure, you may need
to restrict your sodium intake even more.
• Liquid Intake
• It’s important for people who have heart
failure to take in the correct amounts and
types of liquids.
• Consuming too much liquid can worsen heart
failure.
• Also, if you have heart failure, you shouldn’t
drink alcohol.
 Heart-Healthy Lifestyle Changes
• Heart-healthy eating
• Maintaining a healthy weight
• Physical activity
• Quitting smoking
 Maintaining a Healthy Weight
• Maintaining a healthy weight is important for
overall health and can lower the risk for heart
failure and coronary heart disease.
• Aim for a Healthy Weight by following :
– a heart-healthy eating plan and keeping physically
active.
• A BMI:
– Below 18.5 is a sign that you are underweight.
– Between 18.5 and 24.9 is in the normal range.
– Between 25 and 29.9 is considered overweight.
– Of 30 or more is considered obese.
• A general goal to aim for is a BMI below 25.
• Measuring waist circumference helps screen
for possible health risks.
– If most of your fat is around your waist rather than
at your hips, you’re at a higher risk for heart
disease and type 2 diabetes.
– This risk may be higher with a waist size that is
greater than 35 inches for women or greater than
40 inches for men.
 Heart-Healthy Lifestyle Changes
• Heart-healthy eating
• Maintaining a healthy weight
• Physical activity
• Quitting smoking
 Physical Activity
• Routine physical activity :
– can lower many coronary heart disease risk
factors, including LDL (“bad”) cholesterol, high
blood pressure, and excess weight.
– Physical activity also can lower your risk for
diabetes and raise your HDL cholesterol level. HDL
is the “good” cholesterol that helps prevent
coronary heart disease.
• Everyone should try to participate in :
– moderate-intensity aerobic exercise at least 2 hours and
30 minutes per week,
– or vigorous aerobic exercise for 1 hour and 15 minutes per
week.
• Aerobic exercise, such as brisk walking, is any exercise
in which your heart beats faster and you use more
oxygen than usual.
• The more active you are, the more you will benefit.
Participate in aerobic exercise for at least 10 minutes at
a time spread throughout the week.
 Heart-Healthy Lifestyle Changes
• Heart-healthy eating
• Maintaining a healthy weight
• Physical activity
• Quitting smoking
 Quitting Smoking
• Smoking can raise :
– risk for coronary heart disease and
– heart attack
– and worsen heart failure.
 Medicines

The following medicines are commonly used to

treat heart failure:
• ACE inhibitors lower blood pressure and reduce
strain on your heart. They also may reduce the
risk of a future heart attack
• Aldosterone antagonists trigger the body to
remove excess sodium through urine. This lowers
the volume of blood that the heart must pump.
• Angiotensin receptor blockers relax your blood
vessels and lower blood pressure to decrease
your heart’s workload.
• Beta blockers slow your heart rate and lower your
blood pressure to decrease your heart’s workload.
• Digoxin makes the heart beat stronger and pump more
blood.
• Diuretics (fluid pills) help reduce fluid buildup in your
lungs and swelling in your feet and ankles.
• Isosorbide dinitrate/hydralazine hydrochloride helps
relax your blood vessels so your heart doesn’t work as
hard to pump blood. Studies have shown that this
medicine can reduce the risk of death in blacks. More
studies are needed to find out whether this medicine
will benefit other racial groups.
 DHF, PULMONARY EDEMA
• Setting position
• O2
• Morphine
• GTN
• LASIX
• ICD ( implantable cardioverter defibrillator )
• CRTD ( cardiac resynchronization therapy
device)
• HEART TRANSPLANTATION
Thank you