PLEASE WAIT, LOADING

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The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.

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Stage A

Definition of Stage

People at high risk of developing heart failure (pre-heart failure), including people with:

  • High blood pressure
  • Diabetes
  • Coronary artery disease
  • Metabolic syndrome
  • History of cardiotoxic drug therapy
  • History of alcohol abuse
  • History of rheumatic fever
  • Family history of cardiomyopathy
Usual Treatments
  • Exercise regularly.
  • Quit smoking.
  • Treat high blood pressure.
  • Treat lipid disorders.
  • Discontinue alcohol or illegal drug use.
  • An angiotensin converting enzyme inhibitor (ACE inhibitor) or an angiotensin II receptor blocker (ARB) is prescribed if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
  • Beta blockers may be prescribed if you have high blood pressure or if you’ve had a previous heart attack.
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Stage B

Definition of Stage

People diagnosed with systolic left ventricular dysfunction but who have never had symptoms of heart failure (pre-heart failure), including people with:

  • Prior heart attack
  • Valve disease
  • Cardiomyopathy
  • The diagnosis is usually made when an ejection fraction of less than 40% is found during an echocardiogram test.
Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) or angiotensin II receptor blocker (ARB)
  • Beta-blockers should be prescribed for patients after a heart attack
  • Surgery options for coronary artery repair and valve repair or replacement (as appropriate) should be discussed
  • If appropriate, surgery options should be discussed for patients who have had a heart attack.
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Stage C

Definition of Stage

Patients with known systolic heart failure and current or prior symptoms. Most common symptoms include:

  • Shortness of breath
  • Fatigue
  • Reduced ability to exercise
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Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) and beta-blockers
  • African-American patients may be prescribed a hydralazine/nitrate combination if symptoms persist
  • Diuretics (water pills) and digoxin may be prescribed if symptoms persist
  • An aldosterone inhibitor may be prescribed when symptoms remain severe with other therapies
  • Restrict dietary sodium (salt)
  • Monitor weight
  • Restrict fluids (as appropriate)
  • Drugs that worsen the condition should be discontinued
  • As appropriate, cardiac resynchronization therapy (biventricular pacemaker) may be recommended
  • An implantable cardiac defibrillator (ICD) may be recommended

Stage D

Definition of Stage

Patients with systolic heart failure and presence of advanced symptoms after receiving optimum medical care.

Usual Treatments

Treatment methods for Stages A, B & C apply
Patient should be evaluated to determine if the following treatments are available options: heart transplant, ventricular assist devices, surgery options, research therapies, continuous infusion of intravenous inotropic drugs and end-of-life (palliative or hospice) care.

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If your doctor tells you that you’ve got an enlarged liver, it means it’s swollen beyond its normal size.

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Symptoms

Most of the time, if you have a slightly enlarged liver, you won’t notice any symptoms. If it’s severely swollen, though, you may have:

  • A feeling of fullness
  • Discomfort in your belly

Depending on the cause of your enlarged liver, you may notice symptoms like:

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You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:

Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing

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irregular heartbeat

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Abdominal Pain

Abdominal (belly) pain is pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis.

It comes from organs within the abdomen or organs adjacent to the belly.

It is caused by inflammation, distention of an organ, or by loss of the blood supply to an organ.

In irritable bowel syndrome (IBS) it may be caused by contraction of the intestinal muscles or hyper-sensitivity to normal intestinal activities.

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Symptoms associated with it may include:

Bloating

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rarely, 

Chest Pain

Treatment for chest pain depends upon the cause.

It is best to be safe. Always seek medical care for the assessment of chest pain.

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Cough (Chronic Cough)

chronic cough is a cough that persists over time. Chronic cough is not a disease in itself, but rather a symptom of an underlying condition.

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Decreased Appetite

A decreased desire to eat is a symptom that is common to numerous medical and psychological conditions. Almost any illness can lead to a decrease in appetite.

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Fatigue

Nearly everyone is overtired or overworked from time to time. Such instances of temporary fatigue usually have an identifiable cause and a likely remedy.

Nausea and vomiting

Nausea and vomiting are common symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis — often mistakenly termed “stomach flu” — or the morning sickness of early pregnancy.

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Shortness of breath

Few sensations are as frightening as not being able to get enough air. Shortness of breath — known medically as dyspnea — is often described as an intense tightening in the chest, air hunger or a feeling of suffocation.

Wheezing

Wheezing is a high-pitched whistling sound made while breathing. It’s often associated with difficulty breathing. Wheezing may occur during breathing out (expiration) or breathing in (inspiration).

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