Blog

By Three Village Cardiology

The "Stages of Heart Failure," developed by the American Heart Association (AHA) and American College of Cardiology (ACC), will help you understand that heart failure is often a progressive condition and can worsen over time. The stages will also help you understand why a new medication is added to treatment plan and why lifestyle changes and other treatments are needed.

Note: The stages classified by the AHA and ACC are different from the New York Heart Association (NYHA) clinical classifications of heart failure. NYHA ranks patients as class I-II-III-IV, according to the degree of symptoms or functional limits. Ask your health care provider what stage of heart failure you are in.

Stage A

People at high risk of developing heart failure (pre-heart failure), including people with:

• High blood pressure
• Diabetes
• Coronary artery disease
• Metabolic syndrome
• History of cardiotoxic drug therapy
• History of alcohol abuse
• History of rheumatic fever
• Family history of cardiomyopathy

Stage B

People who have developed structural heart disease that is strongly associated with the development of heart failure (such as those with a history of heart attack, those with a low ejection fraction, valve disease with no symptoms) but without signs and symptoms of heart failure.

Stage C

Patients with known systolic heart failure and current or prior symptoms. Most common symptoms include:

• Shortness of breath
• Fatigue
• Reduced ability to exercise

Stage D

Patients with systolic heart failure and presence of advanced symptoms after receiving optimum medical care.

How Can I Prevent Heart Failure From Worsening?

"Keep your blood pressure low. In heart failure, the release of hormones causes the blood vessels to constrict or tighten. The heart must work hard to pump blood through the constricted vessels. It is important to keep your blood pressure controlled so that your heart can pump more effectively without extra stress." stated Dr. Giridhar Korlipara, MD, FACC, FSCAI.

• Monitor your own symptoms. Check for changes in your fluid status by weighing yourself daily and checking for swelling. Call your doctor if you have unexplained weight gain (3 pounds in one day or 5 pounds in one week) or if you have increased swelling.
• Maintain fluid balance. Your doctor may ask you to keep a record of the amount of fluids you drink or eat and how often you go to the bathroom. Remember, the more fluid you carry in your blood vessels, the harder your heart must work to pump excess fluid through your body. Limiting your fluid intake to less than 2 liters per day will help decrease the workload of your heart and prevent symptoms from recurring.
• Monitor your weight and lose weight if needed. Learn what your "dry" or "ideal" weight is. Dry weight is your weight without extra water (fluid). Your goal is to keep your weight within 4 pounds of your dry weight. Weigh yourself at the same time each day, preferably in the morning, in similar clothing, after urinating but before eating, and on the same scale. Record your weight in a diary or calendar. If you gain three pounds in one day or five pounds in one week, call your doctor. Your doctor may want to adjust your medications.
• Monitor your symptoms. Call your doctor if new symptoms occur or if your symptoms worsen. Do not wait for your symptoms to become so severe that you need to seek emergency treatment.
• Take your medications as prescribed. Medications are used to improve your heart's ability to pump blood, decrease stress on your heart, decrease the progression of heart failure, and prevent fluid retention. Many heart failure drugs are used to decrease the release of harmful hormones. These drugs will cause your blood vessels to dilate or relax (thereby lowering your blood pressure).
• Schedule regular doctor appointments. During follow-up visits, your doctors will make sure you are staying healthy and that your heart failure is not getting worse. Your doctor will ask to review your weight record and list of medications. If you have questions, write them down and bring them to your appointment. Call your doctor if you have urgent questions. Notify all your doctors about your heart failure, medications, and any restrictions. Also, check with your heart doctor about any new medications prescribed by another doctor. Keep good records and bring them with you to each doctor visit.

Source: American Heart Association

Source: webmd.com