Heart failure

Mona Denha, NP-C

Mona Denha, NP-C

Heart failure is a chronic and progressive condition. Heart failure happens when the heart is unable to pump enough blood and oxygen in your body to meet the needs of the other organs. The inability to pump properly means the blood flow from your heart slows down leading to fluid back up causing one to develop swelling of the feet, otherwise known as leg edema. According to the National Heart, Lung and Blood Institute, an estimated 5.7 million Americans are living with heart failure (HF). Half of those who develop the disease will die within five years of diagnosis.

HF can affect the right side of the heart or both. Right-sided heart failure occurs when your heart cannot pump enough blood to the lungs to get oxygen, whereas left-side heart failure means your heart can't pump enough oxygen-rich blood to the rest of the body.


What causes the disease?

Diseases or conditions that damage your heart increase your risk of developing HF. The most common conditions in the United States are Hypertension (high blood pressure), coronary artery disease where the arteries in your heart become narrow, and diabetes. These conditions, if not well controlled, will overwork your heart leaving the heart muscle weak and stiff and making it difficult to pump.


Unhealthy habits can also increase your risk which includes:

  • Smoking

  • A diet high in fat, cholesterol and sodium (salt) consumption.

  • Little exercise or a sedentary lifestyle 

  • Obesity (being overweight)


What are the symptoms or when should I see my physician?

If you have more than one of these symptoms, even if you haven't been diagnosed with a heart problem, you should seek an evaluation from your family physician or cardiologist.


Symptoms may include:

  • Shortness of breath on exertion with daily activities or at rest

  • Difficulty breathing when lying flat or needing 2-3 pillows to sleep

  • Persistent Cough and wheeze

  • ·Weight gain with noted swelling of the feet, legs or abdomen (stomach)

  • Fatigue (consistently tired or generally feeling weak)


Presently there is no cure for heart failure; however you can take steps to prevent HF. Steps such as knowing what your blood pressure is and being screened for hypertension (high blood pressure). The 2017 American Heart Guidelines defines high blood pressure to be anyone with a systolic blood pressure (SBP) ≥ 130 mmHg or diastolic blood pressure (DBP) ≥ 80 mmHg. Many patients think a diet high in sodium doesn’t pose an immediate risk, however this is a common misconception. As a person ages, they are more susceptible to developing hypertension (high blood pressure) and over time consuming foods high in sodium will increase the likelihood of having hypertension. Eating a diet low in sodium is as simple as reading food labels.  The amount of sodium should not exceed more than 2,000 mg a day. To put it into perspective, 1 teaspoon of salt equals 2,400 mg sodium.


Patients need to recognize the following foods that tend to be sodium laden:

  • Breads and rolls

  • Sausage/kabob

  • Cold cuts

  • Soups

  • Bottled dressings

  • Savory snacks including chips, popcorn, pretzels and snack mixes

  • Pickled vegetables (which is commonly found in the Chaldean/Assyrian/Middle Eastern diet)

  • ·Cheese


Diagnosing and Treating Heart Failure

The first step is to have a yearly physical or health screening with your primary healthcare provider (this may be your physician, nurse practitioner or physician assistant). A regular check up should include blood pressure screening, weight measurements, blood tests such as a lipid panel once a year (which checks cholesterol) and depending on your age a cardiac screening.  After your yearly physical, your primary healthcare provider will determine what further tests are needed or warrant a consult to a cardiologist.

If you are diagnosed with heart failure your cardiologist may prescribe medications that can prevent or alleviate symptoms.  Through evidence based studies there are specific classes of drugs, known as guidelines directed medical therapies that are used to treat heart failure and have been shown to prolong life and improve the heart’s function. These medications include: Beta Blockers, Angiotensin-Converting Enzyme (ACE) Inhibitors, Angiotensin II Receptor Blockers (ARB’s) and Diuretics (also known as water pills). In addition to guideline directed medical therapies your cardiologist will also order tests to decide what type of heart failure you have and the level of severity. One type of test is an echocardiogram, which uses an ultrasound to reveal the health of your heart valves and heart muscle.

Mona Denha is a nurse practitioner with Eastlake Cardiovascular P.C. She is on the board of directors with the Chaldean American Association for Health Professionals, a member of the American Association of Nurse Practitioners (AANP), and Michigan Council of Nurse Practitioners (MICNP). You can make an appointment for evaluation with a cardiologist by calling: 586 498 0440.