Congestive Heart Failure

Heart failure is common. Millions of adults in the United States live with it, and it becomes more common as people get older.

It is one of the most frequent reasons older adults go to the hospital. People with high blood pressure, diabetes or heart artery disease have a higher chance of getting it.

Your provider may use these terms. Knowing them can help you follow your care plan:

• Reduced pumping (HFrEF): the heart muscle is weak and squeezes out less blood with each beat.
• Preserved pumping (HFpEF): the heart squeezes normally but is stiff, so it doesn't fill well between beats.
• Left-sided heart failure: often causes fluid in the lungs and shortness of breath.
• Right-sided heart failure: often causes swelling in the legs, ankles and belly.
• Long-term (chronic) vs. sudden (acute): heart failure can build slowly or flare up quickly. A sudden flare needs fast care.

Heart failure usually happens because something has hurt or overworked the heart over time. Common causes and risks include:

• Coronary artery disease (narrowed heart arteries) or a past heart attack
• High blood pressure that has been high for years
• Diabetes
• Heart valve problems
• Irregular heart rhythms, such as atrial fibrillation
• Being overweight
• Smoking, heavy drinking or drug use
• Some medicines, infections, or heart muscle conditions that run in families

Symptoms often start slowly. You might notice:

• Feeling out of breath when you walk, climb stairs or do chores
• Trouble breathing when you lie flat, or needing extra pillows to sleep
• Waking up at night feeling short of breath
• Swelling in your feet, ankles, legs or belly
• Quick weight gain, such as a few pounds in a day or two
• Feeling tired or weak most of the time
• A cough that won't go away, or wheezing
• Feeling full quickly or not wanting to eat
• A fast or pounding heartbeat
• At your visit, your provider checks your weight, blood pressure, pulse and oxygen level. They listen to your heart for extra sounds or murmurs and to your lungs for crackles, look at the veins in your neck, and press on your legs and ankles to check for swelling.

There is no single test for heart failure. Your provider puts together your symptoms, your exam and test results.

Blood tests your provider may order include: BNP or NT-proBNP (a heart strain marker), a basic or comprehensive metabolic panel (kidneys, salts like sodium and potassium, liver), a complete blood count (CBC) to check for anemia, thyroid tests, and sometimes blood sugar (A1C) and cholesterol.

You will likely also need an ECG (a recording of your heartbeat) and an echocardiogram (an ultrasound of the heart that shows how well it pumps). We do ECGs in our office. We don't do X-rays or other imaging at our office. If you need a chest X-ray, echocardiogram or other imaging, we refer you to a trusted outside center and review the results with you.

These tools are used by clinicians. Bring your results to your visit; they don't replace a medical evaluation.

• MAGGIC Risk Calculator for Heart Failure ↗ (opens in a new tab)Estimates longer-term outlook in heart failure using things like age, heart pumping strength, blood pressure and kidney tests.

Treatment aims to ease symptoms, help your heart work better and lower the chance of a hospital stay. Your plan may change over time. Common parts of a plan:

• Medicines: some help remove extra fluid ("water pills"), and others help your heart pump better or work less hard. Take them exactly as prescribed, even when you feel well.
• Weigh yourself every morning, after using the bathroom and before eating. Write it down.
• Follow the salt (sodium) and fluid limits your care team gives you.
• Stay active in ways your provider says are safe for you.
• Stop smoking and limit alcohol.
• Keep blood pressure, diabetes and cholesterol under control.
• Some people need a heart specialist for devices or procedures. We can coordinate a referral.
• Keep all follow-up visits and lab checks.

Heart failure is usually a long-term condition. How it goes is different for each person. It depends on the cause, the type, your other health conditions and how well treatment works for you.

Many people feel better and stay active with treatment and daily self-care. There can also be times when symptoms flare up. Spotting changes early, like quick weight gain, gives you and your care team the best chance to act. No one can promise a specific result, but your team will work with you to keep you as well as possible.

Your primary care team at Moaddel Medical is your home base. We review your symptoms, adjust your plan and help you keep track of your weight, blood pressure and medicines.

We order the lab tests you need and go over the results with you. When you need a heart specialist or imaging, we refer you to a trusted partner, share your records and review the findings together, so your care stays connected.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.