Heart Failure Exacerbation

What is Heart Failure Exacerbation

Heart failure exacerbation refers to heart failure symptoms that get worse.

Heart failure is a condition in which the heart does not fill up with enough blood, and therefore does not pump enough blood and oxygen to the body. When this happens, parts of the body do not get the blood and oxygen they need to function properly.

This can cause symptoms such as breathing problems, fatigue, swelling, and confusion.

The symptoms may get worse suddenly or develop slowly over time. Heart failure exacerbation is a serious medical problem that should be treated right away.

What are the causes?

A heart failure exacerbation can be triggered by:

  • Not taking your heart failure medicines correctly.
  • Infections.
  • Eating an unhealthy diet or a diet that is high in salt (sodium).
  • Drinking too much fluid.
  • Drinking alcohol.
  • Taking illegal drugs, such as cocaine or methamphetamine.
  • Not exercising.

Other causes include:

  • Other heart conditions such as an irregular heartbeat (arrhythmia).
  • Anemia.
  • Other medical problems, such as kidney failure.

Sometimes the cause of the Heart failure exacerbation is not known.

What are the symptoms of Heart failure exacerbation?

When heart failure symptoms suddenly or slowly get worse, this may be a sign of heart failure exacerbation. Symptoms of heart failure include:

  • Breathing problems or shortness of breath.
  • Chronic coughing or wheezing.
  • Fatigue.
  • Nausea or lack of appetite.
  • Feeling light-headed.
  • Confusion or memory loss.
  • Increased heart rate or irregular heartbeat.
  • Buildup of fluid in the legs, ankles, feet, or abdomen.
  • Difficulty breathing when lying down.

How is this diagnosed?

Heart failure exacerbation is diagnosed based on:

  • Your symptoms and medical history.
  • A physical exam.

You may also have tests, including:

  • Electrocardiogram (ECG). This test measures the electrical activity of your heart.
  • Echocardiogram. This test uses sound waves to take a picture of your heart to see how well it works.
  • Blood tests.
  • Imaging tests, such as:
    • Chest X-ray.
    • MRI.
    • Ultrasound.
  • Stress test. This test examines how well your heart functions when you exercise. Your heart is monitored while you exercise on a treadmill or exercise bike. If you cannot exercise, medicines may be used to increase your heartbeat in place of exercise.
  • Cardiac catheterization. During this test, a thin, flexible tube (catheter) is inserted into a blood vessel and threaded up to your heart. This test allows your health care provider to check the arteries that lead to your heart (coronary arteries).
  • Right heart catheterization. During this test, the pressure in your heart is measured.

How is this treated?

Heart failure exacerbation may be treated by:

  • Adjusting your heart medicines.
  • Maintaining a healthy lifestyle. This includes:
    • Eating a heart-healthy diet that is low in sodium.
    • Not using any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes.
    • Regular exercise.
    • Monitoring your fluid intake.
    • Monitoring your weight and reporting changes to your health care provider.
  • Treating sleep apnea, if you have this condition.
  • Surgery. This may include:
    • Implanting a device that helps both sides of your heart contract at the same time (cardiac resynchronization therapy device). This can help with heart function and relieve heart failure symptoms.
    • Implanting a device that can correct heart rhythm problems (implantable cardioverter defibrillator).
    • Connecting a device to your heart to help it pump blood (ventricular assist device).
    • Heart transplant.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not stop taking your medicines or change the amount you take. If you are having problems or side effects from your medicines, talk to your health care provider.
  • If you are having difficulty paying for your medicines, contact a social worker or your clinic. There are many programs to assist with medicine costs.
  • Talk to your health care provider before starting any new medicines or supplements.
  • Make sure your health care provider and pharmacist have a list of all the medicines you are taking.

Eating and drinking

  • Avoid drinking alcohol.
  • Eat a heart-healthy diet as told by your health care provider. This includes:
    • Plenty of fruits and vegetables.
    • Lean proteins.
    • Low-fat dairy.
    • Whole grains.
    • Foods that are low in sodium.

Activity

  • Exercise regularly as told by your health care provider. Balance exercise with rest.
  • Ask your health care provider what activities are safe for you. This includes sexual activity, exercise, and daily tasks at home or work.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Maintain a healthy weight. Ask your health care provider what weight is healthy for you.
  • Consider joining a patient support group. This can help with emotional problems you may have, such as stress and anxiety.

General instructions

  • Talk to your health care provider about flu and pneumonia vaccines.
  • Keep a list of medicines that you are taking. This may help in emergency situations.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have questions about your medicines or you miss a dose.
  • You feel anxious, depressed, or stressed.
  • You have swelling in your feet, ankles, legs, or abdomen.
  • You have shortness of breath during activity or exercise.
  • You have a cough.
  • You have a fever.
  • You have trouble sleeping.
  • You gain 2–3 lb (1–1.4 kg) in 24 hours or 5 lb (2.3 kg) in a week.

Get help right away if:

  • You have chest pain.
  • You have shortness of breath while resting.
  • You have severe fatigue.
  • You are confused.
  • You have severe dizziness.
  • You have a rapid or irregular heartbeat.
  • You have nausea or you vomit.
  • You have a cough that is worse at night or you cannot lie flat.
  • You have a cough that will not go away.
  • You have severe depression or sadness.

Summary

  • When heart failure symptoms get worse, it is called heart failure exacerbation.
  • Common causes of this condition include taking medicines incorrectly, infections, and drinking alcohol.
  • This condition may be treated by adjusting medicines, maintaining a healthy lifestyle, or surgery.
  • Do not stop taking your medicines or change the amount you take. If you are having problems or side effects from your medicines, talk to your health care provider.
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