The human heart, on average, pumps blood 100,000 times a day without slowing down. However, despite its importance, this organ is prone to a series of debilitating diseases that are broadly referred to as heart disease. Heart disease is not a simple problem. It is a set of issues, including clogged arteries and electrical malfunctions, which can affect the effectiveness of the heart. One of the most serious of them is heart failure. It is a chronic, progressive disease in which the heart cannot pump sufficient blood to satisfy the body's needs. This is not an abrupt stop but a slowdown, usually the result of years of heart disease without treatment.

It is vital to know how these conditions are interconnected, and the sooner, the better, because the early diagnosis and treatment of these life-changing diseases can significantly change their course. Get in touch with the Las Vegas specialists at Suarez Physical Therapy, and the information below will help you better understand heart disease and failure.

Heart Disease vs. Heart Failure

Heart disease and heart failure, though used interchangeably, are different. Heart disease is a generalized term used to cover various conditions in the heart's structure and functionality. Heart failure, however, is a definitive, extreme condition in which the heart becomes unable to pump sufficient blood to satisfy the requirements of the body.

Coronary Artery Disease (CAD) is one of the most prevalent types of heart disease. It is a condition that affects the arteries that supply blood to the heart muscle and become narrow or blocked, typically with plaque. It may result in impaired blood circulation, which can cause chest pain (angina) or even a heart attack.

High blood pressure, also known as hypertension, is another significant risk factor for heart disease. In the long run, chronic high blood pressure may destroy the arteries and strain the heart to pump blood, resulting in several problems.

These conditions, like valvular heart disease or arrhythmias, are the causes of the underlying "problems" that can damage the heart. The effect is heart failure, or congestive heart failure, a weakening in which the heart cannot pump blood effectively, causing symptoms including shortness of breath, fatigue, and swelling. It is the place where the heart can reach when different types of heart disease are not taken care of.

How Untreated Conditions Develop into Heart Failure

How, then, does heart disease result in heart failure? It is a complicated biological chain reaction in which the initial damage to the heart gradually undermines its pumping capacity. Think of your heart as a highly sensitive engine. The whole system is affected when some components wear down or break off.

Take an example of a heart attack. This is a devastating condition that happens when the blood supply to some part of the heart muscle is suddenly cut off, leading to the death of the heart muscle tissue. This damaged muscle is replaced by scar tissue in the body. The main issue is that scar tissue, unlike the healthy heart muscle, does not contract and pump blood. The healthy heart muscle that remains must therefore work a lot harder to cover the lost function. With time, this extra load exerts unimaginable pressure on the rest of the muscle. The heart muscle first thickens and enlarges, a process known as hypertrophy, to adapt to it. This may increase pumping action in the short run, but ultimately, this is harmful. The heart muscle stiffens, becomes less efficient, and becomes weaker. The effect is the inability to pump blood effectively, which is the hallmark of heart failure.

In the same way, chronic hypertension is a relentless challenge to the heart that is required to pump against an elevated resistance. It is like pumping water uphill continuously, requiring constant extra effort. The heart tissue has to thicken and stiffen to produce the additional power to force the blood through the constricted and hardened arteries. This continuous burden takes a toll. The hypertrophied muscle may become less pliable and unable to fill adequately with blood, reducing its pumping capacity. The untreated heart disease causes a vicious cycle of harm and reparation, which ends up weakening and failing in its essential functions.

Diagnosis and Identifying the Symptoms

Early signs of heart failure are subtle and, at times, obvious. In many cases, these symptoms may be confused with normal aging or other milder conditions and result in potentially life-threatening delays in diagnosis. However, paying attention to your body and consulting a doctor when these persistent changes appear can help greatly.

Some of the most important symptoms that people experience include:

  • Shortness of breath (Dyspnea) — This is one of the most common and, often, earliest symptoms. Initially, it may only be experienced with physical exertion. However, as heart failure progresses, it may appear with little or no effort, or even when resting, especially when the patient is lying flat (orthopnea).

  • Fatigue and weakness — As the heart fails to pump sufficient oxygenated blood to satisfy the body's needs, you feel constantly tired and generally weak, and even the simplest day-to-day activities become a challenge.

  • Edema (swelling), particularly in legs and ankles — When the pumping action of the heart is diminished, it can cause blood to pool in the veins, causing fluid buildup in the body's tissues. This is often seen as swelling of legs and ankles (edema), although it can occur in the abdomen (ascites) or even the lungs.

  • Rapid or irregular heartbeat (palpitations) — The heart can attempt to compensate for its diminished pumping capacity by increasing its speed or beating irregularly.

  • Decreased exercise capacity — The apparent loss of the capacity to do physical exercise that one could easily do before, because of the shortness of breath and fatigue.

Diagnosis of Heart Failure

As soon as symptoms trigger suspicion, a physician will start a process of heart failure diagnostics, which proceeds through the initial assessment and a series of specific diagnostic procedures. All these steps are taken to ensure that there is, indeed, heart failure, as well as to establish the cause of the condition and its extent.

An echocardiogram is a key non-invasive diagnostic tool. This non-invasive heart ultrasound gives in-depth pictures of the heart chambers, valves, and pumping capacity. One of the most critical measurements that can be derived using an echocardiogram is the ejection fraction (EF). An ejection fraction test is a test to measure the proportion of blood pushed out of the left ventricle, the heart’s primary pumping chamber, with every heartbeat. Normal ejection fraction should be 50% to 70%. A reduced EF means that the heart is not pumping as well as it is supposed to, a characteristic of heart failure.

The purpose of the BNP blood test is another crucial diagnostic tool. BNP (B-type natriuretic peptide) is a cardiovascular hormone. The heart releases larger amounts of BNP when stressed or overworked, like in heart failure. The higher the BNP levels in the blood, the higher the chances of heart failure, and the levels tend to be related to the extent of the condition.

In addition to these tests, doctors use a system to help them classify the stages of heart failure, as described in a popular system, the New York Heart Association (NYHA) Functional Classification. Under this system, patients are classified into four classes depending on the extent to which the symptoms affect their physical activity:

  • Class I — No limitation

  • Class IV — Symptoms at rest

This staging makes it easier to make treatment decisions and prognosis, and serves as a clear map of how to handle the patient's condition.

A Team-Based Strategy of Heart Failure Management

Heart failure management is not a one-person affair but a multifaceted, multidimensional approach that requires a team-oriented approach to cardiac care. This teamwork is an effort by different healthcare professionals to collaborate with the patient and their family to maximize their treatment, enhance their quality of life, and slow the progression of the disease.

An effective heart failure management program aims to reduce symptoms, avoid hospitalization, and increase survival. The program involves the following:

Medication Management

Treatment of congestive heart failure is based on pharmacological interventions. Various drugs are used, sometimes in combination, to curb multiple facets of the disease and the causes thereof.

  • Diuretics (water pills) — These drugs aid the body in getting rid of excess fluid and sodium and therefore help reduce swelling and ease breathing by reducing the amount of fluid in the lungs. Furosemide and bumetanide are examples.

  • ACE inhibitors/ARBs/ARNIs — Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and angiotensin receptor-neprilysin inhibitors (ARNIs) help to relax blood vessels, decrease blood pressure, and take the load off the heart. A more recent form of ARNIs, including sacubitril/valsartan, has considerable advantages in most patients.

  • Beta-blockers — These medicines lower the heartbeat rate and decrease the amount of work the heart does so that the heart can pump effectively. They also assist in safeguarding the heart against the detrimental effects of stress hormones.

  • Mineralocorticoid Receptor Antagonists (MRAs) — Spironolactone and eplerenone are drugs that assist the body in getting rid of excess sodium and fluid levels and prevent heart muscle damage.

  • SGLT2 inhibitors — Newer medications, for example, empagliflozin and dapagliflozin, which were initially used to treat diabetes patients, have demonstrated impressive effects in reducing hospitalizations and improving the outcomes of patients with different types of heart failure.

  • Other drugs — Other medications could be prescribed depending on the needs of the individual, like digoxin (to increase the strength of the contractions of the heart) or ivabradine (to decrease the heart rate).

This medication regimen is critical, and patients are informed about the aim of every drug and possible side effects to achieve the best possible adherence.

Lifestyle Modifications

In addition to medication, much importance is given to lifestyle changes that heart failure patients can make to enhance their health and cope with symptoms. The changes can be just as effective as medication in improving outcomes.

  • Sodium restriction — Reducing salty foods to minimize the fluid retention leading to swelling and difficulty breathing is essential. The patients are also educated on reading food labels and making heart-friendly food choices.

  • Fluid management — Doctors may prescribe fluid restriction depending on the level of heart failure to avoid fluid overload.

  • Regular physical activity — It is crucial to have regular and proper exercise under medical supervision. Heart failure programs of cardiac rehabilitation are structured, medically supervised programs that integrate physical exercise training, education, and counseling to enable patients to safely increase their physical fitness and general health.

  • Weight management — Being at a healthy weight limits the load on the heart.

  • Smoking cessation and alcohol moderation — The most important step to take to enhance cardiovascular health is to quit smoking and to limit or avoid alcohol consumption drastically.

  • Stress management — Stress management skills, relaxation methods, or counseling may benefit the heart.

  • Daily weight monitoring — This would allow the daily tracking of weight changes and thereby provide an early indication of fluid retention so that medical attention can be provided immediately.

Technological Support: Device Therapy and Procedures

In certain patients, medication and lifestyle interventions are not sufficient, and device therapy in heart failure is required as a component of their treatment regimen.

  • Pacemakers and Cardiac Resynchronization Therapy (CRT) — Patients with slow heart rates or electrical dyssynchrony (the heart does not contract in a coordinated manner) may benefit from pacemakers or CRT devices that can synchronize the contractions of the heart to improve pumping.

  • Implantable Cardioverter-Defibrillators (ICDs) — In those with a high chance of experiencing hazardous heart rhythm disorders, an ICD will monitor and correct unusual rhythms through electrical shock, thus averting sudden cardiac arrest.

  • Ventricular Assist Devices (VADs) — VAD is a mechanical pump that can be installed in severe cases to assist the heart in pumping blood to the body. VADs may serve as a bridge to transplant or a long-term solution (destination therapy) for people who are not eligible for transplant.

  • Heart valve repair or replacement — In case the damaged heart valves are contributing to heart failure, repair or replacement of the valves can go a long way in restoring the functioning of the heart.

  • Coronary Artery Bypass Graft (CABG) or Angioplasty/Stenting — In the case of heart failure due to coronary artery disease, restoring blood supply to the heart muscle is important.

Treatment Options When Heart Failure Progresses

More aggressive interventions can be used in instances of advanced heart failure treatment where the standard treatment options are no longer sufficient.

  • Heart transplant — In eligible heart failure patients with end-stage conditions, heart transplant provides them with a second chance in life, where the diseased heart is removed and replaced with a healthy donor heart.

  • Palliative care — Palliative care is essential, no matter what stage of heart failure. This special medical treatment aims at alleviating the symptoms and stress of a severe disease. It intends to enhance the patient's and his/her family's quality of life. It may be offered together with curative treatments.

The whole process of the heart failure management plan is dynamic and needs regular follow-up with the health care team. This collaborative effort means that the patient's treatment is constantly optimized to keep up with the changing nature of heart failure to enable the individuals to live as well as and as comfortably as possible.

Some of the interventions during this stage include:

Medical Interventions

The effective management of heart failure depends on a mix of medical and non-medical interventions, like prescribed drugs and advanced procedures that your doctor skillfully chooses to boost heart performance, reduce symptoms, and improve the overall quality of life.

Use of Advanced Procedures and Devices

In addition to the medications, medical equipment may be an important aid to your heart at this stage of heart failure. Doctors would recommend:

  • ICD (Implantable Cardioverter-Defibrillator)

  • Pacemakers

Cardiac Rehab and Physical Therapy as a Solution to Heart Disease and Heart Failure

The most important component of cardiac rehabilitation is physical therapy, which is essential in the management of heart disease and heart failure. It helps heal and strengthen the heart and, in general, improve the quality of life.

Physical therapy helps the heart muscle by increasing its strength and efficiency in pumping blood. This is crucial for recovery from heart attacks or surgery and for managing heart failure. It also improves circulation by enabling oxygen use and lessening the heart's workload. Slowly building up endurance and strength will help you carry out daily tasks using less energy.

Therapy also minimizes risk factors. Exercise reduces blood pressure and assists in the control of blood sugar and cholesterol. It aids in weight loss, which relieves the heart and even stress. Symptoms like shortness of breath or fatigue are alleviated and become functional with physical therapy. Therapists assist in safe increments in activity that enhances independence. More importantly, they teach patients self-management, lifestyle modifications, and identifying symptoms.

Furthermore, physical therapy will prevent recurring cardiac events by establishing sustainable cardiac-healthy lifestyles. It enables people to have more nutritious and active lives despite their condition through customized exercise routines, close supervision, and constant learning.

Find a Physical Therapist Near Me

Heart disease and heart failure can be a big challenge, but they do not have to be a part of your life. With the active prevention measures and the adoption of the team-based and comprehensive approach to management, you will significantly enhance your health outcomes and be able to live a full life.

Maybe you want to stop heart disease, or you are already in the process of coping with it, or you want to restore your strength and independence by undergoing a special cardiac rehabilitation program. No matter what it is, now is the time to act. The beginning of your path to a healthier heart is in the hands of a professional and an individual approach.

Do not wait to get your heart health in control. Contact Las Vegas specialists at Suarez Physical Therapy today at 702-368-6778 to learn how our special programs can enable you to live a full and vibrant life.