Understanding Congestive Heart Failure
The heart is your body’s engine, pumping nourishing blood from head to toe every moment of every day. But when the heart starts to fail, a cascade of other problems begin. This condition – called congestive heart failure – is the most common reason for hospital admissions among seniors. Nationwide, over six million Americans have heart failure, and among them, 10% have an advanced form of the disease. Heart failure occurs when muscles become too weak to effectively pump blood throughout the body. Advanced failure occurs when typical treatments are no longer effective, and symptoms occur even while at rest. Doctors can address congestive heart failure symptoms with medication and lifestyle adjustments during the early stages of the disease. But as the condition progresses, more intrusive interventions become necessary.
Signs and Symptoms of Congestive Heart Failure
Congestive heart failure symptoms manifest in every part of the body. They can include:
- Shortness of Breath: Heart failure makes breathing difficult during mild exertion. Patients with an advanced form of the disease may experience shortness of breath even while still.
- Sleep Problems: That same shortness of breath often makes sleeping difficult. As the disease progresses, sleep problems often worsen.
- Coughing: When the heart can no longer keep up with the blood moving between the heart and the lungs, fluid begins to build up in the lungs. As a result, congestive heart failure patients often develop a cough that produces white or pink mucous.
- Swelling: Also referred to as edema, swelling is caused by a buildup of fluid in the body. This occurs most often in the extremities and abdomen.
- Loss of Appetite: As the digestive system receives less blood, patients often feel full or nauseous and don’t want to eat.
- Racing Heartbeat: Because the heart has to work harder to move blood, patients with congestive heart failure often experience a racing or throbbing heartbeat.
- Anxiety: It’s also not uncommon for congestive heart failure patients to experience anxiety and depression as a result of their disease.
Treatments exist for these individual symptoms, but because the disease has no cure, the heart will continue to deteriorate until the body shuts down and the patient dies.
Common Causes of Congestive Heart Failure
Coronary artery disease, high blood pressure, long-term alcohol abuse, and certain heart valve disorders are the most common causes of congestive heart failure. Less common causes include viral infections and stiffening of the heart muscles.
How is Congestive Heart Failure Treated?
Patients with advanced heart failure have few treatment options, but they all come with significant risks. Stable patients may be eligible for surgical interventions like a coronary artery bypass graft or a pericardiectomy. But those aren’t permanent solutions. Other patients might opt for an implantable left ventricular assist device (LVAD) which functions as an artificial heart. But LVADs are powered by batteries worn outside the body, which puts the patient at greater risk of infection. The only true cure for congestive heart failure is an open heart transplant. But this procedure comes with its own set of risks including outright rejection. So when facing this diagnosis, patients – along with their families and doctors – need to find an acceptable balance between treatment options and the likely outcomes, and their desired quality-of-life.
To guide these shared decisions, the American Heart Association recommends:
- An annual heart failure review to discuss how the patient is functioning, current treatment goals, and their preferences for treating possible emergencies, such as kidney failure or sudden cardiac arrest.
- “Milestone” discussions to reassess treatment goals following a major event, such as a defibrillator shock, hospitalization or significant loss of function.
- Honest and thorough conversations about major side effects of treatment, quality of life, loss of independence, impact of worsening symptoms, and increased commitment by caregivers and families.
- Considering palliative care, offered alongside medical treatment, to help manage symptoms and assist patients and families with tough decisions.
- Developing a care plan for the end of life that ensures your needs and wishes are met.
Hospice or Palliative Care is a Common Choice for Congestive Heart Failure Patients
After examining all their options, many patients opt for palliative care and eventually hospice. This course of action is valuable because it allows the patient to choose their own care plan, act on it as their disease worsens, and ultimately maximize quality-of-life during their final months. Without palliative or hospice care, congestive heart failure patients risk dying in an ICU after experiencing a major event. And that’s far from an ideal outcome.
If you have questions about how hospice can serve patients with congestive heart failure, Southland Hospice is happy to help. Give us a call at (602)-497-4100 or fill out our contact page and we’ll get right back to you. Our Hospice Team provides comfort and dignity – to patients and their families – through physical, emotional, and spiritual support. And if it’s possible, we’d love to help you.