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Right heart failure results in a build up of fluid in the legs that can extend over the lower back and onto the abdomen where it is known as “ascites”. The liver can become enlarged and there may be nausea and swollen veins in the neck. The extra fluid may cause weight gain, although severe chronic heart failure sometimes causes severe weight loss.
Diagnosis
A physical examination and a review of your medical history will help your GP diagnose heart failure. You may be asked to go for some hospital tests, such as:
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a blood and urine test, to check things such as blood count, liver function and other markers of heart failure such as B-
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an electrocardiogram (ECG), which traces the electrical activity in a heart
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an echocardiogram (heart ultrasound scan), to show the pumping action of the heart and valves
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a chest X-
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Medical treatment
A range of medicines can be used to relieve the symptoms of heart failure and slow down any worsening of the condition. Any underlying condition may be treated first - for example, drug treatment given to lower blood pressure.
The various types of drugs used to treat heart failure work in different ways.
ACE inhibitors
These drugs reduce the production of hormones which constrict blood vessels. This makes the walls of the blood vessels relax, which reduces pressure and makes it easier for blood to circulate. Overall, they improve the performance of the heart, reduce heart failure symptoms and prolong life. Side-effects can include a persistent dry cough, low blood pressure and faintness.
Angiotensin II antagonists
These act directly on the blood vessel wall to block the effects of the hormones which constrict them. Their action is therefore similar to those of the ACE inhibitors but they tend not to cause a dry cough. They are used if ACE inhibitors cause too many side-effects.
Beta-blockers
Beta-blockers are commonly used for treating high blood pressure. They also steady the heartbeat and make the heart more able to cope with exercise. In the past they were thought to be unsuitable
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www.churchatkirkburn.org,uk page 124 heart failure 3 of 5 sept 2008 29/11/10