A = Activity limitation. People with heart failure get tired easily and are unable to carry out their normal activities.
C = Congestion. Fluid build-up in the lungs can cause coughing, wheezing, and shortness of breath.
E = Edema or ankle swelling. If the heart does not have enough pumping power to return the blood used in the lower extremities, fluid accumulates in the ankles, feet, thighs, and abdomen. Excess fluid can lead to rapid weight gain.
S = Shortness of breath. Fluid in the lungs makes it difficult for the carbon dioxide in the used blood to be replaced with new oxygen. It can also be difficult to breathe while lying down because gravity allows the fluid under the lungs to flow into the trunk.
While these five warning signs do not confirm a diagnosis of heart failure, they do prompt a sense of urgency to seek medical attention, Dr. Mehra said.
Further testing
In addition to a physical exam, doctors have two other important tools for detecting heart failure. The first is an echocardiogram (commonly called an echo), which is a simple, non-invasive test that uses ultrasound to visualize the heartbeat. If the echo shows that the amount of blood leaving the heart when the left ventricle contracts is less than normal, there is a high probability of damage to the heart muscle. Other findings suggestive of heart failure include abnormal thickening of the heart wall, balloon formation, and malfunctioning heart valves.
The next step in early detection of heart failure is to look for biomarkers in the blood, such as B-type natriuretic peptide, which is released when the heart is stressed. “I call these compounds ‘tears from the heart,’ because they indicate that the heart is crying out for help,” says Dr. Mehra. After the initial diagnosis is confirmed, additional tests will be needed to find out what is causing the heart failure and to determine the best treatment.
Drugs to avoid in heart failure
People with heart failure often take multiple medications. However, several prescription medications, over-the-counter medications, and supplements can interact dangerously to intensify heart failure symptoms. To be on the safe side, make sure all doctors have a list of all the medications you are taking. Compounds to watch out for include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). Commonly used pain relievers such as ibuprofen (Advil, Motrin) cause the body to retain sodium and fluid, making heart failure symptoms worse.
Medicines for heartburn and colds. These over-the-counter aids are often high in sodium, which can cause fluid overload.
Herbal medicines. Many so-called natural supplements include ephedra, St. John’s wort, ginseng, hawthorn, black cohosh, and green tea. All can react poorly to several common heart medications.
