Show
Fluid buildup indicates worsening heart failure. Learn how to spot it and treat it early. The buildup of excess fluid in your body can take a variety of forms from belly bloating and swollen ankles to nausea, persistent coughing and fatigue. You may be tempted initially to dismiss this hodgepodge of problems as having little to do with your heart. However, they all signal water retention, which can mean trouble for people with a history of heart failure. "Fluid buildup can quickly escalate into a life-threatening situation," says Dr. Eldrin Lewis, a heart failure specialist at Harvard-affiliated Brigham and Women's Hospital. Heart failure may start with injury from a heart attack or develop as a result of damaged valves, infection or disease of the heart muscle cells. Many times, it is the product of years of toil against high blood pressure and clogged arteries. Regardless of what triggers the decline, heart failure culminates in a progressive weakening of your heart's power to pump. Consequently, blood circulates through your heart and body more slowly; your cells thirst for fresh oxygen and nutrients. To compensate for its weakened state, the heart undergoes a series of structural transformations. Other physical processes also come into play. When the kidneys detect the diminished blood flow, they activate hormones that prompt the body to retain fluid and sodium in an effort to boost the volume of blood in circulation. What to look forThe good news is that you can tell if you're beginning to retain fluid merely by getting on the scale. "Weight change is the earliest sign of a problem with fluid balance. Most people will retain 8 to 15 pounds of excess fluid before they see leg and belly swelling. However, symptoms such as coughing and shortness of breath, loose stools, nausea and feeling full when without eating much may develop at the 5-to-7 pound mark" says Dr. Lewis. He instructs his patients to take action as soon as they notice their weight going up. "Don't wait until you don't feel well, you may have gained 5 or more pounds by then and could be well on your way to a serious problem." Daily weighingThe best method to monitor your weight is daily weighing. Your goal should be to keep your weight as close as possible to your "dry weight." This is your regular weight when you are not retaining fluid. If you recently have been in the hospital or had your medicines adjusted, you may already know your dry weight. If not, your doctor or nurse can help you determine the right number. To get an accurate picture of your weight trends:
Taking action against fluid retentionIf you gain more than 2 pounds in a day or 4 pounds in a week, Dr. Eldrin advises taking these steps:
Image: Rostislav_Sedlacek/Getty Images Featured Experts: Congestive heart failure (also called heart failure) is a serious
condition in which the heart doesn’t pump blood as efficiently as it should. Despite its name, heart failure doesn’t mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a
result, it can’t keep up with the body’s demand, and blood returns to the heart faster than it can be pumped out—it becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the body’s other organs. The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contracts—but over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they don’t receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse. More than 5 million people in the United States have congestive heart failure. It’s the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause. “To avoid heart failure, there’s a need to prevent other heart problems,” says Johns Hopkins cardiologist Steven Jones, M.D. PreventionThe best way to avoid congestive heart failure is to avoid the conditions that contribute to it, or to carefully manage these conditions if they develop, says Jones.
DiagnosisThere’s no one test to diagnose heart failure. Your doctor will consider your medical history, family history, a physical exam and the results of various tests. These tests can include:
TreatmentThere’s no cure for heart failure. Treatment aims to relieve symptoms and slow further damage. TheI exact plan depends on the stage and type of heart failure, underlying conditions and the individual patient. Among the components of a treatment plan: Lifestyle changes. These are the same changes as those for preventing heart failure. In addition, you may be advised to avoid salt (because of fluid retention) and caffeine (because of heartbeat irregularities). Your doctor will advise how much fluid and what kinds to drink, as sometimes fluid intake should be limited. Medications. According to Jones, the types of medications typically prescribed include these:
Surgical procedures. In more severe cases, surgery is required to open or bypass blocked arteries, or to replace heart valves. Some congestive heart failure patients are candidates for a type of pacemaker called biventricular pacing therapy, which helps both sides of the heart work in concert, or an implantable cardioverter defibrillator, which shocks the heart into converting a potentially fatal fast rhythm to a normal one. Ventricular assist devices (VAD therapy) may be used as a bridge to heart transplantation or as a treatment in lieu of transplant, says Jones. A heart transplant is considered the last resort, with success rates of about 88 percent after one year and 75 percent after five years. Other treatments. Because sleep apnea—a condition in which the muscles that allow air into the lungs briefly collapse—is linked to heart failure, you may be evaluated and treated for it. Living With...Here are some of the things you’ll want to do in addition to sticking to the lifestyle changes that can improve the health of a damaged heart:
ResearchJohns Hopkins researchers are on the forefront of the study of congestive heart failure. Among their recent findings:
How do you reduce fluid in congestive heart failure?Take medications as prescribed: A doctor may recommend that a senior with CHF take a diuretic, or a “water pill.” This type of medication helps the body get rid of excess fluid. A doctor may also prescribe other medications to help manage CHF, like ACE inhibitors, ARBs, or beta blockers.
What causes fluid build up in congestive heart failure?When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you drink too many fluids, you may get symptoms such as swelling, weight gain, and shortness of breath.
Should you drink a lot of water if you have congestive heart failure?Drink The Right Amount of Fluids
As your heart failure becomes worse, your health care provider may limit your fluids to 6-9 cups (1.5-2 liters) a day. Having other conditions like kidney disease may factor into their decision, too. If you are not sure how much you should drink per day, ask your health care provider.
Where does the fluid go with congestive heart failure?Fluid may back up in the lungs, causing shortness of breath. Fluid may back up into the abdomen, legs and feet, causing swelling. The left ventricle can't contract vigorously, indicating a pumping problem.
|