Top Triggers of Heart Failure Exacerbations
A sudden worsening of heart failure, known as an exacerbation, usually occurs when some change places an increased demand on the weakened heart, which can't compensate by beating harder or faster. Heart failure exacerbations can be life-threatening, so it's important to recognize the signs of an exacerbation and know what to do.
When heart failure (sometimes called congestive heart failure is stabilized with good medication control and dietary management, it should be possible to prevent frequent exacerbations. Over time, however, the number of heart failure exacerbations is likely to rise as heart failure progresses and the heart is less able to handle increased loads. Often an exacerbation will require hospitalization until the doctor is convinced that the heart has stabilized. In severe cases, someone may need breathing support or IV medication, administered in an intensive care unit (ICU), to help the heart beat more strongly. The mechanical support of a ventilator may be needed until the acute symptoms have resolved.
Some triggers are within your control, and others are underlying conditions that can't be avoided. Here are the most frequent causes of exacerbations, along with how to avoid those that can be controlled.
Not taking medications correctly
Over time, many people with heart failure fail to follow the medication regimen the doctor has prescribed. One study found that nearly one-third of exacerbations occurred because patients failed to comply with their prescribed treatment. This happens for many reasons, including confusion and misreading labels, concern over side effects, and the high cost of medications. Often the medication regimen to control heart failure is complicated, requiring many medication doses throughout the day. Sometimes people with heart failure mistakenly think that because they feel better, they don't need the medications anymore.
How to avoid this trigger: The medications prescribed for heart failure treat the symptoms of the condition and rebuild the strength of the heart muscle. Careful medication management is key to preventing exacerbations and gives the best chance for recovery. Bring in all your loved one's medication bottles when you visit your doctor, so he or she can determine if any changes need to be made. Bringing in the bottles is always better then bringing in a list.
Pneumonia and the respiratory infections that lead to it -- such as colds, the flu, and sinus infections -- are the top cause of hospitalization for a heart failure exacerbation. Other common infections that can trigger exacerbations include urinary tract infections, shingles, and food-borne illnesses.
How to avoid this trigger: Make sure your loved one gets all the vaccinations recommended by the doctor, including a yearly flu shot and a pneumococcal vaccine every five years to prevent pneumonia. Help him or her avoid being in close quarters with people who are sick. Also, remind your loved one to wash his or her hands frequently, and make sure everyone in the family knows not to touch their eyes and nose with unwashed hands.