Norma has Type 2 diabetes. She’s 57 years old and admits that she has not made managing her diabetes a priority. She also has high blood pressure and high cholesterol, but she doesn’t like to take drugs, so she doesn’t always take the medicines her doctor has prescribed. Recently, however, Norma has been getting short of breath, especially when she lies down to go to sleep. This scares her, because she thought shortness of breath was only caused by exercise or by over-exertion. She visited her health-care team and was shocked — and a bit confused — when she was diagnosed with heart failure. She wasn’t sure what it meant for her heart to “fail,” and she wondered whether this new diagnosis was related to her diabetes. Her health-care team confirmed that heart failure is often related to diabetes, but assured her that both conditions can be successfully managed.
When the heart fails
Normally, the heart pumps oxygen-depleted blood to the lungs and oxygen-rich blood to the rest of the body. (See “The Heart” for a diagram of this organ.) A diagnosis of heart failure (also called congestive heart failure) means that the heart is not pumping blood as effectively as it once was. As a result, the organs and other body parts aren’t getting as much oxygen and other nutrients as they did previously. In addition, some of the fluid that would normally circulate through the blood vessels is “backing up,” causing swelling and edema.
Heart failure happens gradually. As the heart loses strength, it tries to make up for it by beating faster to get more blood moving. Unfortunately, this attempt to compensate causes the muscular walls of the heart to get larger and to stretch, which only makes it weaker and even less efficient at pumping.
As blood flow slows down, blood and fluid build up in parts of the body. If the lower left chamber of the heart, called the left ventricle, is not pumping properly, blood and fluid collect in the lungs and/or heart. This can cause shortness of breath. If the right ventricle is weak, fluid builds up in the legs and feet. In fact, fluid can build up all over the body, including in the face and especially around the eyes. It can also build up in the liver, which also causes shortness of breath as the liver presses against the lungs.
Currently, more than 5 million Americans have heart failure, and a large percentage of those people have diabetes. However, although heart failure is a serious condition, with adequate care and appropriate lifestyle changes, a person who has it can live a full and enjoyable life.
Causes of heart failure
With age, everyone’s heart loses some of its blood-pumping ability, but such age-related changes are not considered heart failure. Heart failure is caused by health conditions that either damage the heart or cause it to have to work too hard. Many of the complications associated with diabetes are causes of heart failure.
According to the American Heart Association, the following are common causes of heart
- Abnormal heart rhythm. If your heart beats irregularly, too fast, or too slow, it may not be able to pump enough blood to meet your body’s needs.
- Abnormal heart valves. Heart valve problems can result from disease, infection, or a birth defect. When your heart valves aren’t working properly, it causes the rest of your heart to work harder.