2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology ...
Can Heart Failure Cause Weight Gain?
When your heart isn't able to pump effectively, it can lead to reduced circulation. If there's less blood flowing through your kidneys, it can cause extra fluid to build up in your body. This can cause weight gain.
Heart failure occurs when the heart muscle grows too weak to effectively pump enough blood to meet the body's demands. As a result, several complications and symptoms can develop. One potential symptom is weight gain.
Heart failure can cause a buildup of fluids in the body, especially in the lower limbs and abdomen. This is known as edema. When you have excess fluid in your body, it causes you to weigh more. In some cases, unexplained weight gain is the first obvious sign of heart failure.
This article will take a closer look at how heart failure causes weight gain and what it means.
When you have heart failure, your heart isn't able to pump an adequate amount of blood throughout your body. This leads to reduced circulation and less blood flow through your kidneys, which are responsible for getting rid of excess fluid and sodium in your body.
When blood flow through the kidneys is compromised, it can cause fluid and sodium to build up. Sometimes edema develops quickly. You might wake up one day and notice swelling in your legs or abdomen that wasn't obvious the night before.
If you've been diagnosed with heart failure, you may have also been advised to weigh yourself daily. This is the easiest way to identify early signs of edema that may not be apparent otherwise.
According to the American Heart Association, weight gain of 2 lbs – 3 lbs (0.9 kg – 1.36 kg) within 24 hours, or at least 5 lbs (2.26 kg) within a week, could be a sign of worsening heart failure.
Each 1 kg (2.2 lbs) of increased weight corresponds to 1 additional liter of excess fluid.
If you notice rapid weight gain but haven't been diagnosed with heart failure, let your doctor know. This is particularly important if you have a history of heart disease or if you've experienced other symptoms like:
The buildup of excess fluid in your body can put an extra burden on your organs, including your kidneys, lungs, and heart.
For example, fluid can build up in the lungs, causing a condition called pulmonary edema. This can lead to shortness of breath. In more severe situations, it may cause severe breathing difficulties that require immediate medical treatment.
In addition to monitoring your weight and taking note of any unexplained weight gain, the following may also be symptoms that heart failure is progressing:
If any of these signs and symptoms develop or worsen, contact your healthcare team immediately.
Because weight gain with heart failure is usually caused by edema, the best way to manage your weight is by reducing the amount of fluid buildup in your body. Your doctor may recommend diuretics, which are medications that help your body get rid of excess fluids and sodium.
Diuretics cause frequent and increased urination as the excess fluid and sodium are flushed out in the urine.
If you've been diagnosed with heart failure, your doctor may recommend cardiac rehabilitation. This program is designed to improve your cardiovascular health and quality of life if you have a problem with your heart.
A cardiac rehabilitation program is typically supervised by a team of medical professionals, like physical therapists, registered dietitians, doctors, and nurses, who will help you with:
Heart failure can make you retain water and develop edema, and it can happen fast. Having heart failure can make it difficult to lose weight because, in addition to water retention and edema, you can have symptoms like fatigue, shortness of breath, and coughing.
What are the 4 signs your heart is quietly failing?Four of the most common"quiet" early symptoms of heart failure include:
See your doctor immediately if you have these symptoms.
Weight gain is common if you have heart failure. When your heart isn't able to pump effectively, it can lead to reduced circulation. If there's less blood flowing through your kidneys, it can cause extra fluid and sodium to build up in your body, causing swelling and weight gain.
In some cases, unexplained weight gain is the first obvious sign of heart failure. Other symptoms of heart failure can include fatigue, swelling in your legs or abdomen, shortness of breath, and a change in your resting heart rate or blood pressure.
If you have unexplained weight gain that happens quickly, it's important that you get prompt medical attention.
Why Does Heart Failure Cause Swollen Feet?
What is heart failure?Heart failure is a chronic condition affecting about 6.2 million Americans. It occurs when the heart muscle is damaged—sometimes from something you can't control, like an injury, virus, or congenital heart disease—and struggles to pump enough blood to meet the body's needs.
However, heart failure can also result from conditions or lifestyles you might have some command over, such as high blood pressure, diabetes, coronary heart disease, untreated sleep apnea, obesity, or use of drugs and alcohol.
There are four stages of heart failure, and in the later stages, the heart weakens, gets larger, and can't pump enough oxygen-rich blood to supply the body's needs. When symptoms grow worse (more on this later), heart failure can cause swelling in the ankles and legs, as well as swollen feet.
This is due to edema, which is a fluid accumulation in the body—usually in the limbs and lungs—that often occurs as a result of heart failure.
Here's what you need to know about what causes swollen feet, how to treat it, and what it could mean for your heart failure.
Symptoms of heart failureIn the early stages of heart failure, people might not experience any symptoms. But as heart failure progresses, symptoms may occur one by one or all together—and yes, swollen feet is one of them.
Shortness of breath while doing simple, everyday activities like climbing the stairs or walking to the mailbox
Trouble breathing while reclining in a chair or lying down at night
Waking up and catching your breath
Tiring easily
Frequent coughing
Dry, hacking cough while lying down
Coughing that produces a pink or blood-tinged mucus
Swollen legs, feet, and ankles
Swollen abdomen
More frequent urination at night
Lack of appetite and nausea
Fatigue
Feet and hands feel colder than other parts of the body
Problems concentrating
The doctor's hands in gloves hold a foot with toe, infected with nail fungus for examination and diagnosis.
What causes swollen feet?An edema-related swelling or a bloated feeling occurs when excess fluid gets trapped in the body's tissues. Although edema can happen with heart failure, it can also occur with kidney disease, cirrhosis of the liver, pregnancy, or due to medications.
If you've ever felt bloated after eating a meal high in salt or you've had swollen feet after standing all day or sitting on a long flight, you've experienced edema. This kind of edema is short-lived and resolves on its own. Edema in heart failure occurs when the heart isn't pushing blood out of the heart efficiently. That leads to more blood left behind in the heart after each beat, leading to difficulty getting blood into the heart.
"The backup of blood waiting to get into the heart leads to increasing pressure in the veins draining into the heart," says Lee Goldberg, MD, a cardiologist and section chief, Advanced Heart Failure and Cardiac Transplant at the University of Pennsylvania, in Philadelphia.
"As the pressure in the veins increases, fluid is pushed out into the tissues leading to swelling or edema," says Dr. Goldberg, who is also a professor of cardiovascular medicine in the Perelman School of Medicine at the University of Pennsylvania.
The kidney's role in edemaWhen the heart starts to fail, the blood flow to the kidneys decreases. When this happens, it may prompt the kidneys to hold on to sodium and water, leading to edema.
"The kidneys attempt to maintain a normal state when they sense the decrease in blood flow," says Columbus Batiste, MD, an interventional cardiologist at Kaiser Permanente in Riverside, California. "As a result of attempting to maintain a normal fluid state (or blood volume), the kidneys trigger a cascade of chemical messengers in the form of the hormones renin, aldosterone, and vasopressin, which ultimately leads to increased sodium, water retention, and thirst."
Edema in other parts of the bodyWhen the right side of your heart—which receives oxygen-poor blood from the body and sends it to the lungs—isn't pumping effectively, blood tends to pool in the lower legs, ankles, and feet. Yet, it can occur in other areas.
"One of the largest veins in the body is the inferior vena cava that connects directly to the liver," says Dr. Goldberg. "As the venous pressures increase, fluid can be pushed out of the liver and into the abdominal cavity leading to abdominal edema."
Edema can also show up in the hands, back, and face. And when the left side of the heart—which receives oxygen-rich blood from the lungs and then pumps it to the rest of the body—isn't doing its job, fluid can accumulate in the lungs, in a condition known as pulmonary edema.
Symptoms of edemaBesides the swelling or bloated feeling, edema may cause the skin to look shiny or stretched. Another sure sign of edema is "pitting." A term used to describe a dimple that remains after the skin is pressed with a finger for several seconds.
Edema is present if the dimple doesn't bounce back and a dimple remains on the skin.
How to monitor edemaUntreated edema makes your heart work harder than it needs to. Heart failure patients should be on the lookout for edema daily by monitoring their overall amount of fluid and recording their weight daily. Dr. Goldberg says this should be done at the same time every day, wearing the same type of clothing, using the same weight scale.
"Sudden increases in weight may indicate increased fluid retention," says Dr. Goldberg. People may also use a tape measure to measure the legs or abdomen's circumference or the pitting test. If you gain two to three pounds overnight or three to five pounds in one week, check in with your doctor.
When to call the doctorCall your doctor if you notice redness, skin breakdown or wounds, weeping of fluid, inability to walk, fever, pain, increased shortness of breath, or chest pain.
Note that new edema, especially if it occurs on one side, should also prompt an evaluation, Dr. Goldberg says, as that might be a sign of a life-threatening blood clot.
Treatments for edema"The best way to treat edema due to heart failure is to manage the heart failure," Dr. Goldberg says. That encompasses sticking with healthy lifestyle habits, such as exercising daily, quitting smoking, limiting alcohol, and eating heart-healthy foods, as well as taking your heart failure (and non-heart-related) medications as prescribed.
Diuretics (water pills) are the most common medication to treat edema directly. They help remove sodium and fluid from the body.
Note: Over-the-counter or herbal supplements that are labeled as water pills are not acceptable for edema.
Budget salt intakeAs Dr. Goldberg mentioned, limiting salt minimizes edema. Another good reason to avoid salt— too much of it puts wear and tear on the blood vessel walls, forcing the heart to work harder. Unless your doctor recommends otherwise, heart failure patients should consume no more than 2,000 milligrams (mg) of sodium daily, and ideally no more than 1,500 mg a day, according to the American Heart Association. The Dietary Guidelines for Americans is 2,300 milligrams or less per day.
Jenifer Bowman, RD, a registered dietitian at UCHealth in Fort Collins, Colorado, advises her heart failure patients to look at salt intake like a daily budget. "I tell my patients they have 2,000 mg of sodium to spend on their foods and beverages every day, but avoid going over budget," she says.
She also advises patients to keep a food log to help track their salt and become familiar with the salt content of common foods.
Watch fluid intakeGenerally, later-stage heart failure patients are advised to limit fluids to two liters per day because processing more fluids puts undue stress and extra work on the heart. But fluids fall into other categories besides water and other beverages. Patients must also consider water-rich foods such as jello, ice chips, fruits, and veggies.
"Fruits and vegetables contain moisture and can add to our overall hydration," says Bowman. "General recommendations encourage two cups of fruit and three cups of vegetables daily. And your heart will thank you for choosing healthy beverages first."
Bowman encourages her patients to choose "beverages that provide good hydration," she says. "At least half of their daily fluids should be water. The other half can include other beverages such as coffee, tea, milk, and juice."
Compression socksCompression socks have come a long way from their ugly, drab nude color. Today, they are available in a rainbow of colors and designs. Of course, their best feature is that they help with circulation, reduce the appearance and pain of varicose veins, and in the early stages of heart failure, can improve edema.
"Their use has not been well studied in heart failure," says cardiologist Tamara Horwich, MD, associate clinical professor of medicine and cardiology at the David Geffen School of Medicine. Dr. Horwich says they are generally safe to wear in the early stages of heart failure. But they should be avoided in later stages (i.E., the New York Heart Association class III and IV) of heart failure due to lack of data and potential harm.
Compression socks come in different grades and varieties. Dr. Horwich advises socks that cover the entire foot and leg up to the knee, beginning with grade one. Generally, most people can put them on first thing in the morning and wear them until they go to bed. But you may be able to wear them during sleep.
Ask your doctor for the grade you should get and wearing instructions before buying a pair. If you don't wear compression socks, avoid standing or sitting for extended periods, and elevate your feet throughout the day as much as possible.
Pneumatic compression mechanical deviceImagine a blood pressure cuff worn on the body that intermittently inflates, compresses, and deflates through various cycles. That's the idea behind a pneumatic compression device.
They're typically sold as boots you slip into or as a large wrap that goes around your lower leg and fastens with velcro. They massage your legs, and a small study published in 2014 in Lympathic Research and Biology suggested that edema decreased or didn't get worse after using a pneumatic compression device for three years.
"There have been some very small studies showing their safety in heart failure," says Dr. Horwich. "But most physicians would say that more studies are needed to better clarify their use in heart failure patients." It may be worth a try, if not for edema then for achy legs. Just check with your doctor first.
Signs of Congestive Heart Failure What Is Acute Heart Failure? These Are the Four Stages of Heart FailureThe post Why Does Heart Failure Cause Swollen Feet? Appeared first on The Healthy.
What Is Heart Failure?
Heart failure occurs when your heart is unable to pump an adequate supply of blood to the body. It may require ongoing treatment to keep your body's major functions working properly.
Approximately 6.2 million people have heart failure in the United States, according to the Centers for Disease Control and Prevention (CDC).
Heart failure often happens when there is a problem with the ventricles, which are two chambers located in the lower part of your heart. They're responsible for pumping blood out of your heart.
Heart failure can be classified by the side of the heart that's affected (left or right). Both sides are often affected.
Congestive heart failure (CHF) is sometimes used synonymously with heart failure since the symptoms of both right- and left-sided heart failure include congestion.
In right-sided heart failure, there is congestion with fluid buildup in the abdomen and lower extremities. In left-sided heart failure, fluid builds up in the lungs.
Heart failure is a serious health condition that requires immediate medical treatment. Early treatment decreases your risk of complications over time.
The most common symptoms of heart failure include:
Other symptoms of heart failure may include:
Heart failure is a chronic condition. This type of condition requires ongoing, lifelong management.
However, you may experience acute heart failure, which is when symptoms come on suddenly. This is sometimes referred to as heart failure exacerbation or flares.
It may happen as an initial symptom when heart failure is diagnosed for the first time. Or, it may happen on top of chronic heart failure when your symptoms worsen.
Since heart failure may affect either side of the heart, the types of heart failure are right-sided heart failure and left-sided heart failure. Both types lead to the activation of hormones and the nervous system, which causes the body to retain fluid, leading to symptoms of congestion.
Left-sided heart failureLeft-sided heart failure occurs when the left ventricle in the bottom left of your heart doesn't pump blood out efficiently. Heart failure in this ventricle prevents your body from getting enough oxygen-rich blood.
There are two types of left-sided heart failure:
Systolic heart failure is more common in males. Diastolic heart failure is more common in females.
Right-sided heart failureThe right ventricle is located in the bottom right side of your heart. It's responsible for pumping blood to your lungs to collect oxygen.
Left-sided heart failure usually triggers right-sided heart failure. The accumulation of blood in the lungs makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail.
Heart failure happens when your heart muscle gets weak or stiff. This may then block or reduce blood flow to the heart.
The most common cause of heart failure is coronary artery disease (CAD). It happens when fatty deposits build up in your arteries, reducing the supply of blood and oxygen to the heart.
Other conditions that may increase your risk of developing heart failure include:
Certain behaviors may also increase your risk of developing heart failure, including:
A will doctor start by performing a physical exam and assessing your medical history to check for signs of heart failure.
They may also use an echocardiogram. This test is the most effective way to diagnose heart failure. It uses sound waves to create detailed pictures of your heart. An echocardiogram can help a doctor evaluate the damage to your heart and how it's functioning.
Other tests to help diagnose heart failure or its underlying causes include:
Treating heart failure depends on the severity of your condition and the type of heart failure you have.
Early treatment can improve symptoms fairly quickly. However, you should still get regular testing and follow up with a healthcare professional at least every 6 months.
The main goal of treatment is to increase your life span, prevent complications, and improve your quality of life.
MedicationMedications may treat early stages of heart failure. They can help relieve your symptoms and prevent your condition from worsening.
Certain medications are prescribed to:
These medications can include:
Speak with a doctor before taking new medications. People with heart failure should avoid some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin). These can worsen fluid retention in heart failure.
SurgeryYou may require surgery if you have heart failure. Options include:
You may require surgery to implant a device to help monitor your heart rhythm.
PacemakersThese small devices are placed into the chest to help control heart rhythms. They may slow your heart rate when the heart is beating too quickly or increase your heart rate if it's beating too slowly.
Biventricular pacemakers are sometimes used for cardiac resynchronization therapy. These may help your heart chambers pump in sync.
Left ventricular assist device (LVAD)An LVAD helps your left ventricle pump blood out to the rest of your body.
Implantable cardioverter defibrillator (ICD)This battery-powered device keeps track of your heart rate. It shocks your heart if it detects an abnormal heart rhythm. This restores the heart rate to a normal rhythm.
Doctors suggest an ICD for people with an ejection fraction of less than 30–35%. An ejection fraction refers to how much blood your heart pumps out of the left ventricle with each contraction. A normal range is 55–70%.
Some lifestyle measures can help treat heart failure and prevent the condition from developing.
These may include:
Untreated heart failure can eventually lead to CHF, which could be life threatening. This is when blood builds up in other areas of your body. You may experience fluid retention in your limbs and organs, such as the liver and lungs.
Additional complications of heart failure include:
Yes, and early diagnosis gives your doctor more time to find the best treatment for you and gives you time to treat the condition before it becomes critical. Early diagnosis involves recognizing the sometimes subtle signs and the main symptoms of heart failure:
Other signs and symptoms may include:
Yes. A B-type natriuretic peptide (BNP) blood test measures the levels of a hormone called the BNP hormone in your blood.
BNP helps keep your veins and arteries dilated and has a role in keeping salt and fluid balance in the body. If you have heart failure, your heart produces more BNP, and it's visible on a BNP blood test.
What's the most accurate test for congestive heart failure?Congestive heart failure is diagnosed using a combination of history and physical examination, blood testing, and imaging tests. Imaging tests provide details about the type and cause of heart failure.
An echocardiogram is performed to look at the heart's structure and function. This test uses sound waves to produce pictures of the heart. Cardiologists can look at the heart's structure, including heart muscle, chambers, and valves, along with the heart's pumping and filling.
Other tests that cardiologists may use to investigate heart failure include stress echocardiogram, nuclear imaging, cardiac magnetic resonance imaging (MRI), and cardiac computed tomography (CT).
What are possible signs your heart is quietly failing?Heart failure may not cause obvious signs or symptoms initially. Some people may have vague or quiet signs and symptoms that come on slowly, making it hard to recognize a problem.
Some of these subtle signs include:
If you notice these, contact a doctor for a checkup.
What are the 4 stages of heart failure?The four stages of heart failure are A, B, C, and D. These refer to the severity of symptoms and how your heart is functioning as your condition progresses:
The authors of a 2019 review of studies found that approximately 60% of people were alive 5 years after their chronic heart failure diagnosis. After 10 years, approximately 1 in 3 people were still alive.
Survival rates are just estimates. Your outlook depends on several factors, such as age, lifestyle habits, other medical conditions, and stage at diagnosis.
What are the serious signs of heart failure?The most common signs of heart failure include:
For someone with heart failure, any progression of symptoms is serious. Contact your cardiologist if you notice worsening symptoms. Some particularly concerning symptoms include:
Congestive heart failure (CHF) is another term used for heart failure. It emphasizes the congestion that occurs due to a backup of blood flow, which causes fluid retention, swelling, and pulmonary edema (fluid in the lungs).
Heart failure happens when your heart is unable to pump enough blood throughout your body.
It's typically a chronic condition that requires ongoing treatment to prevent complications and increase your quality of life.
Your outlook and treatment of heart failure varies depending on the type of heart failure you have. Early treatment is key in preventing the most serious cases of heart failure.
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