Congestive Heart Failure: Life Expectancy and Prognosis



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Diastolic Heart Failure Vs. Congestive Heart Failure: What's The Difference?

Diastolic heart failure means there's a problem with your heart's ability to fill with blood. It's a type of congestive heart failure where your heart cannot work efficiently, leading to fluid overload in your body.

Congestive heart failure (CHF) is an umbrella term for heart failure that causes fluid buildup in the body.

Diastolic heart failure and systolic heart failure are two types of congestive heart failure. Both affect your heart's ability to pump blood to the rest of your body.

  • In diastolic heart failure, the muscles of the left ventricle stiffen and lose their ability to fill completely with blood between heartbeats. When this happens, the heart pumps less than normal amounts of blood into circulation. This is also known as heart failure with preserved ejection fraction, or HFpEF.
  • In systolic heart failure, the left ventricle loses its ability to contract normally and pumps less than normal amounts of blood into circulation. This is also known as heart failure with reduced ejection fraction or HFrEF.
  • Heart failure is a serious, lifelong condition that requires medical attention. It's also relatively common, with an estimated 6.5 million adults in the United States living with this condition.

    This article takes a closer look at diastolic and congestive heart failure.

    While heart failure is a serious condition, this doesn't mean that your heart has suddenly stopped working, as is the case with cardiac arrest. Instead, this means that your heart is not pumping blood like it should. The extent of heart failure also depends on its type.

    Diastolic heart failure

    Diastolic heart failure is a type of left-sided heart failure that occurs when the heart's left ventricle can't relax enough to fill with enough blood. This causes a smaller amount of blood to be pumped out to your body.

    When you have diastolic heart failure, your heart is still trying to pump blood, but it has to work harder to fulfill its basic functions.

    Diastolic heart failure may also be referred to as heart failure with preserved ejection fraction (HFpEF). Ejection fraction is a measure of how much blood is pumped out of the left ventricle every time your heart muscle contracts.

    Congestive heart failure

    Congestive heart failure is a term for any type of heart failure with symptoms of congestion.

    Congestive heart failure affects the pumping ability of your heart muscle and is chronic and progressive. When the ventricles of your heart can't pump enough blood to your body, blood and other fluids can eventually back up inside your:

  • lungs
  • abdomen
  • liver
  • lower body
  • The symptoms of diastolic heart failure are the same as congestive heart failure.

    Some types of diastolic heart failure will have additional symptoms based on the underlying cause. For example, cardiac amyloidosis can have other symptoms, such as:

  • carpal tunnel syndrome
  • lumbar spinal stenosis
  • neuropathy (numbness or tingling in hands or feet)
  • orthostatic hypotension (low blood pressure upon standing)
  • easy bruising
  • purple discoloration around eyelids
  • enlarged tongue
  • In their early stages, neither diastolic nor congestive heart failure may cause any noticeable symptoms. However, as the heart pumps less blood to cells and tissues over time, you may experience:

  • fatigue
  • decreased concentration or memory difficulties
  • shortness of breath, even while resting
  • coughing
  • wheezing
  • noticeable weakness during everyday activities, such as walking
  • difficulty exercising
  • fluid retention, especially in your legs, feet, and abdomen
  • coldness in your arms and legs
  • decreased appetite
  • nausea
  • sudden weight gain or loss
  • Heart failure — whether diastolic or congestive — is treated with diuretics and management of the underlying conditions.

    Doctors may also use medications to treat the underlying condition (such as high blood pressure) or to help relax blood vessels and improve overall heart function.

    These medications may include:

    Additionally, a doctor may suggest lifestyle modifications to help complement treatment for heart failure. These include:

  • regular exercise, which can help strengthen your heart muscle
  • decreasing dietary salt intake
  • quitting smoking if you smoke
  • limiting or avoiding alcohol consumption
  • stress management
  • A heart transplant may be necessary for refractory heart failure when other treatments don't work. Refractory heart failure is the term doctors use when symptoms are persistent and severe enough to affect daily life, despite having medical therapy.

    Overall, about 50% of people with heart failure live 5 years or longer. A 2019 study found that the average survival rate dropped to 35% after 10 years.

    The exact outlook depends on the type and severity of heart failure you have, as well as your age and any underlying conditions and complications.

    Also, experts consider diastolic heart failure difficult to treat compared with other types of heart failure. This is because many of the medications that are effective in systolic heart failure often don't show the same results in diastolic heart failure.

    There's no cure for heart failure, but treatments can help reduce symptoms and help protect your heart from further strain. This includes diastolic heart failure, which is a type of congestive heart failure.

    While diastolic heart failure affects the left side of your heart, and congestive heart failure is known for causing fluid buildup, both affect your heart's ability to pump blood normally. This can lead to serious complications if left untreated.

    Since heart failure doesn't usually cause any obvious symptoms in its early stages, regular checkups with a doctor are key to detecting related conditions in a timely manner. However, if you're experiencing possible heart-related symptoms, don't wait till your next scheduled appointment, see a doctor right away.


    What Are The Stages Of Congestive Heart Failure?

    Congestive heart failure (CHF) typically progresses through four stages, with varying symptoms. Your stage may influence your treatment approach and life expectancy.

    CHF is a medical condition in which your heart isn't able to pump blood efficiently. It can result from various underlying heart conditions, such as coronary artery disease, and can lead to fluid buildup in or around the lungs.

    The American College of Cardiology (ACC) and American Heart Association (AHA) categorize heart failure into four progressive stages, A through D. These stages are characterized by:

  • specific symptoms
  • levels of heart dysfunction
  • functional limitations
  • overall impact on your quality of life
  • Read on to learn more about the stages of heart failure and how they influence your treatment options and outlook.

    This initial stage is defined by conditions that raise your risk of developing heart failure. You don't experience any symptoms, and there's no evidence of structural issues with your heart.

    Conditions that can increase your risk may include:

    Treatment

    Since no symptoms or structural heart changes are present in stage A, the main focus is identifying and managing risk factors. These may include lifestyle changes, such as adopting a healthy diet and exercising regularly to prevent the progression of heart failure.

    In the second stage, there should be no symptoms or signs of heart failure. But there's evidence of at least one of the following:

    Treatment

    Stage B treatment aims to manage any underlying structural issues and prevent the development of symptoms. A doctor can prescribe medications like angiotensin converting enzyme (ACE) inhibitors or beta-blockers to improve your heart function and reduce strain on the heart.

    This stage is characterized by the onset of symptoms due to heart failure. These symptoms can vary in severity from mild to severe.

    They may include:

    Treatment

    In stage C, treatment aims to manage symptoms. A doctor may prescribe specific medications for heart failure. They may also offer education on heart failure, including fluid and salt restriction.

    In stage D, you experience severe symptoms despite receiving appropriate medical treatment. You may experience symptoms even at rest, making it difficult to carry out daily activities. You're also more likely to experience frequent hospitalizations due to worsening symptoms.

    Treatment

    Stage D CHF treatment is more aggressive and most often involves referral to an advanced heart failure specialist. They may evaluate you for treatment options such as:

    Generally, life expectancy tends to decrease as heart failure progresses from stage A to stage D. People in stage A and stage B, who are at risk or have structural heart irregularities, may have a relatively typical life expectancy with appropriate management.

    In stage C, where symptoms are present, life expectancy can vary based on factors such as treatment effectiveness and overall health.

    In stage D or advanced heart failure, the life expectancy is shorter, usually between 6–12 months.

    Doctors may also categorize CHF according to four classes established by the New York Heart Association (NYHA). These aren't the same as the four ACC/AHA stages. Still, the AHA notes that the classes apply to people with CHF in stage C or D.

    The NYHA classes categorize heart failure based on the physiological impact on your heart's pumping ability. The four classes are:

    Despite their wide use, there's ongoing debate among researchers as to how useful the NYHA classes are.

    CHF can be classified into four stages, A through D. These stages help doctors assess the severity of your condition and guide medical interventions to improve your quality of life. However, identifying symptoms early, following a treatment plan, and making lifestyle changes can significantly influence life expectancy at all stages.


    Mayo Clinic Minute: How Innovation Is Transforming Heart Transplants

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    Mayo Clinic doctors are using innovation to improve the lives of people who suffer from congestive heart failure and other chronic heart conditions. The Organ Care System, also known as "heart in a box," is potentially helping to expand the donor pool, which is crucial, considering that more than 4,000 people in the U.S. Are waiting for a new heart.

    Innovation is improving transplant surgeries. Typically, donor hearts are retrieved from a person who is declared brain-dead but whose heart is still beating. With the relatively new system, heart in a box, doctors can revive the donated heart by perfusing the organ with warm, oxygenated blood.

    "We now have new technology that allows us to place the donor hearts into a special machine which delivers blood and controls the temperature to the heart to allow it to start beating," said Lisa Dr. LeMond, a Mayo Clinic cardiologist.

    The perfusion system can preserve the donated heart for up to 12 hours. Before this technology, the donor heart would be on ice in a cooler to preserve it during transport, and doctors only had about four hours to get the heart to the recipient.

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