Heart failure is a slowly progressive condition that can be managed but not cured without getting a heart transplant.
This article discusses advanced-stage heart failure in detail.
The heart still beats, but it is weak and damaged.
Verywell / Jessica Olah
Even more, the body is unable to compensate for the reduced blood the heart can pump.
As a result, fluid often backs up into the lungs, liver, abdomen, or legs.
The New York Heart Association classification system is the simplest and most widely used method to gauge symptom severity.
Palliative or hospice care and novel research therapies are usually discussed during the final stage of heart failure.
Symptoms include swelling of the feet, legs, and/or belly and having more shortness of breath.
You may also feel nauseous and lose your appetite.
During advanced heart failure, you may experience shortness of breath, ordyspnea, even with minimal exertion.
Edema
Severe heart failure can result in blood and fluid pooling in the legs and abdomen.
When you lie down, fluid accumulation in the lungs signals the body to wake up to prevent asphyxiation.
This phenomenon is called paroxysmal nocturnal dyspnea.
Many people with heart failure also havesleep apnea, so they may misattribute their symptoms.
Coughing and Wheezing
Fluid in the lungs, orpulmonary edema, can cause coughing or wheezing.
Sometimes medications may work to some degree but make you feel worse.
Decreased cardiac output worsens kidney function and activates the SNS and RAAS systems, enhancing sodium and water retention.
Diuretics may also instigate electrolyte abnormalities, further complicating treatment.
So what are the options at this point?
This includes:
Prognosis
Heart failure is associated with very high morbidity and mortality.
Stage D heart failure has a more grim prognosis.
Despite improving special therapeutic interventions, the oneyear mortality rate of refractory heart failure is approximately 50%.
Symptoms of advanced heart failure are manifestations of severely low cardiac output.
Feelings of anger, sadness, and fear are natural.
This may help them achieve some peace of mind and a sense of control.
Centers for Disease Control and Prevention.Heart failure.
American Heart Association.Advanced heart failure.
American Heart Association.Classes of heart failure.
American Heart Association.Types of heart failure.
American Heart Association.Managing heart failure.
White MF, Kirschner J, Hamilton MA.Self-care guide for the heart failure patient.Circulation.
2014;129(3):e293e294.
2008;117(4):e25e146.
doi:10.1161/CIRCULATIONAHA.107.187998
Friedrich EB, Bohm M.Management of end stage heart failure.Heart.
2007;93(5):626-631. doi:10.1136/hrt.2006.098814
Office of Minority Health.Heart Disease and African Americans.
