- in the early stages of heart failure the patient might not even have symptoms. and they might only have riskfactors for heart failure. this means that theyprobably have some kind of pre-existing condition that might, if you leave it unchecked, will lead to heart failure in the future. or lead to worsening heartfailure if it's already present. but these conditions haven'tled to full blown heart failure
with, with symptoms. so patients are likely still able to go about their daily lives. some example of risk factors might include something like hypertension,or high blood pressure, or coronary artery disease, or diabetes. the doctor mightrecognize these conditions as red flags for heart failure. and even though they're just seeing it
as these preliminarysigns and risk factors, they'll emphasize the importance of improving these conditions before heart failure gets worse. because most of the time especially with structuralchanges to your heart, where it starts to look different, these tend to be unidirectional. meaning that those changes
only tend to get worse not better. so with that said, a very important early stage treatment that'srecommended is exercise. with exercise yourcardiovascular fitness increases. this increases your heart's efficiency so your heart getsbetter at pumping blood. and we know that areduced pumping efficiency is a main theme in heart failure. and in addition to exerciseanother lifestyle change
that might be recommendedis a change in diet. and reducing salt intake is acommon and important change. and doing this tends toreduce your blood pressure, making it easier to pump blood out. and this lowers the chancesof the heart to start to compensate and startmaking structural changes to the heart's ventricleswhich, like we said, is a one way street. the doctor might also decideto prescribe medications.
and these will often be targetedat reducing blood pressure which, like we said, makes it easier for the heart to pump blood out. and reduces the chance of compensation and structural changes to the heart. so the first class ofmedications are ace inhibitors or a-c-e inhibitors. this stands forangiotensin-converting-enzyme and these are vasodilators.
and from this word we'vegot vaso which means vessels so your blood vessels. and then you've gotdilator which is to widen so these cause your bloodvessels to dilate or get bigger. and when they dilate they aren't squeezing theblood inside them as much and so the pressure in yourblood vessels goes down. and if the pressure in yourblood vessels goes down your heart's going to have aneasier time pumping blood out
to this lower pressure system. just remember that analogyabout trying to blow air through a really small strawand then a really big tube. which one's more difficult? it's the straw, right? well, in the same wayyour heart's going to have an easier time pumping blood through these dilated blood vessels. and another set of medicationsthat might be prescribed
are hydralazine and nitrates. and these also tend toreduce your blood pressure. hydralazine specificallyacts as a vasodilator for arteries and arterials. which are the blood vessels going away from the heart, right? and like we just mentioned this makes it easier foryour heart to pump blood out. nitrates, on the other hand,
although they can acton your arteries as well mostly act on your veins. so they act to reduce yourvenous blood pressure. and this reduces thepressure in getting blood back to the heart. which also reduces your preload. remember, that the preloadis one of those mechanisms of compensation. so if we reduce the preload
we can limit the structural changes that might start to happen as a result. finally, the last class of medications are called beta blockers. and these help inhibit the activation of the sympathetic nervous system. remember how the sympathetic response in the heart is activated, with these receptors on the heart.
well these receptors aregenerally known as beta receptors. so beta blockers tendto block these receptors from being activated. that makes sense. so if they were activated, the heart rate and pumpingforce increases, right? but if they're blocked this tends to slow down the heart rate and limits that sympathetic response.
and limiting this is important because just like increased preload, we remember that over activation of the sympathetic nervous system is a method of compensation which can lead to structuralchanges to the heart. and so we want to tryto reduce the chances of any structural changes.
