Heart failure describes a condition in which the heart becomes unable to pump blood efficiently to meet the body's needs. Causes of heart failure vary but include coronary artery disease, high blood pressure, a previous heart attack, diabetes, complications from medications, and valve disfunction. Heart failure is classified by four stages. Symptoms worsen over time and stage four is considered end stage heart failure. Medications manage heart failure but often in end stages medications no longer work.
Shortness of Breath
In end stage heart failure the left side of the heart becomes so weak that blood backs up from the heart into the lungs. This fluid buildup causes shortness of breath and the feeling of air hunger. In earlier stages of heart failure, shortness of breath occurs with activity. According to the the University of Maryland Medical Center, shortness of breath occurs even when a person is resting in end stage heart failure. Shortness of breath also worsens at night when a person is laying flat. Often a patient must sleep with the head elevated to lessen shortness of breath.
Swelling
According to the Cleveland Clinic, fluid that backs up from the right side of the heart due to end stage heart failure results in swelling of the hands, feet, and abdomen. In earlier stages of heart failure, medications work to eliminate extra fluid from the body. In end stage heart failure, these medications fail to rid the body of excess fluid and swelling worsens. This is known as peripheral edema.
Confusion
End stage heart failure patients often suffer from confusion or lack of mental clarity. Short-term memory may also be affected. Confusion results from lack of oxygenated blood in the brain. Substances such as sodium also build up in the blood and cause confusion.
Fatigue
End stage heart failure causes severe fatigue and weakness. The heart muscle becomes so weak that the blood pumped is reserved for vital organs. As a result muscles become weak and patients tire easily. End stage heart patients often sleep most of the time or need frequent breaks to rest throughout the day. Loss of appetite that end stage heart failure causes also increases weakness and fatigue.
Cough
Coughing often occurs in end stage heart failure, according to "Medical Surgical Nursing." In earlier stages of heart failure, the cough is dry and hacking. In end stage heart failure, patients cough up white or pink tinged frothy secretions. The cause of the cough lies with the fluid buildup in the lungs. The cough reflex is triggered in the body's attempt to relieve the congestion in the lungs.
References
- "Medical Surgical Nursing"; D. Ignatavicius MSN, L. Workman PhD.; 2002
- The Cleveland Clinic: Heart Failure
- University of Maryland Medical Center: Heart Failure
