Description: Heart failure is a situation where the heart is not pumping strongly enough to keep the circulation moving satisfactorily. Blood pressure may be low, and blood can back up before the heart if it cannot pump it all out. There can be many causes for heart failure – heart attack, heart muscle disease called cardiomyopathy, abnormalities of the valves inside the heart, excess fluid in the body, some drugs − especially anticancer drugs, toxins and some heart infections, high blood pressure and congenital heart disease.
The usual symptoms are breathlessness with exercise or when lying flat; tiredness, lack of energy, and fluid build up with swelling in the legs and stomach.
What doctors can do
Investigations
- Physical examination and history usually reveal the diagnosis, but in all cases the doctor should also order an ECG, chest X-ray, blood tests and an echocardiogram. (Heart failure is not a diagnosis, you must know what is the cause and an echocardiogram is crucial to make this diagnosis.)
- Sometimes the doctor will organise a cardiac catheterisation test or angiogram to study the heart and its valves in greater detail.
Treatments
- Drugs. Diuretics, such as frusemide, which remove excess fluid; ACE inhibitors, which reduce the effect of some hormones and lower the load on the heart; and sometimes other drugs such as digoxin, beta blockers, spironolactone and anticoagulants, can be added.
- Surgery. If there is a cause which can be treated (abnormal valve, blocked arteries, hole in the heart) this should be attended to.
- Devices – ICD – implantable defibrillator in people at risk of dangerous rhythms.
- CRT – cardiac resynchronisation techniques – patients with LBBB on their ECG can improve if their heart conduction pathways are changed with a procedure similar to a pacemaker
What you can do
Acute heart failure – breathlessness, wheezing, can’t lie down, sometimes bubbling breathing or just worsening of the usual shortness of breath.
- Call for an ambulance – which can provide you with oxygen
- Sit in the most comfortable position – usually sitting up with feet dependent.
- Take 2 puffs of GTN spray if you have some, and repeat every 5 minutes x 3
- If you have oxygen – use this.
- Try to relax. I know it is hard, but being tense tightens the chest muscles and makes breathing harder.
- If you have any, take 300mg of coenzyme Q10, 500mg of magnesium and 80mg of frusemide.
Lifestyle
- Mild exercise is beneficial, but not to excess. Daily regular exercise has been shown to reduce symptoms and improve long-term outlook.
- Little or no alcohol is important
- A good night’s sleep makes a difference, raising the head of the bed up 4-6 inches if night time breathlessness is a problem
- Diet – limit the salt or sodium in the diet.
- Obesity increases the work the heart has to do, so if overweight, try to lose some.
- Stress is not good for the heart, and some studies suggest that relaxation, meditation, even having a dog beside the bed can help people with severe heart failure.
Nutritional supplements
- A good multivitamin/multimineral makes sure that the heart has all the nutrients and minerals it requires to beat as well as it can. A good multi should have plenty of vitamin B1 (lack of which causes beriberi heart failure).
- Selenium is very important for heart function, and in areas with low selenium in the soil, supplemental selenium, 150-200 micrograms should be taken daily. This can be a very powerful additional therapy. It should be in a good multi tablet.
- Omega 3 fish oils, 1 to 2 grams daily, can reduce the risk of the more serious rhythm disturbances which can occur in heart failure.
- Co-enzyme Q10 is essential to create energy in the heart muscle cells. Taking statin drugs reduces the levels of CoQ10 in the body. Everyone with heart failure should be taking a good quality CoQ10, 100 to 400mg daily.
- Calcium and magnesium, 800–1,000mg/day, are essential for the heart muscle to contract and relax.
Other therapies
- Testosterone ( in men) – men with heart failure often have low testosterone levels, and studies have shown testosterone replacement can help the heart failure.
- Hawthorne – this has been used for the treatment of ‘dropsy’ (heart failure, since the middle ages. Many people swear by their hawthorne treatment and a Cochrane review of all trials has shown it is effective in the treatment of heart failure. Doses used vary, but for heart failure standard extract of 300mg/day is suggested.
The Nutritional supplements I use and recommend to my patients
For Heart failure patients – USANA – Cellsentials *, Biomega, Active Calcium plus, Coquinone –
Hawthorne – a good preparation of standard extract.
Other therapies
There are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.Nutritional supplements
I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.