What is High-Output Heart Failure?
“Your heart can’t pump enough blood to your body. Over time, heart failure can weaken your heart.”
“Many people with heart failure have low cardiac output. Cardiac output is the amount of blood pumped into your heart in a single minute. Your body’s organs don’t get enough blood when your cardiac output is low.”
A small number of people with heart failure have high cardiac output. This is called high-output heart failure.
“If you have high-output heart failure, your body’s need for blood is high or your blood vessels are relaxed, this is a sign of high-output heart failure. That causes your heart to work harder. Even though your heart is working well, you still have heart failure symptoms.”
High-output heart failure is caused by an underlying condition such as sepsis, hyperthyroidism, or thiamine deficiency. It is a serious medical condition that requires treatment.
“If you have heart failure, your heart can’t pump enough blood to the rest of your body.”
“In most cases, this is because your heart is weak or stiff and can’t pump blood efficiently. This is called low-output heart failure.”
There are two types of heart failure.
- Heart failure with reduced ejection fraction, or systolic heart failure, happens when your heart muscle loses its ability to contract. Ejection fraction is the percentage of blood that leaves your heart each time it contracts.
- Heart failure with preserved ejection fraction (HFpEF), or diastolic heart failure, occurs when your heart becomes abnormally stiff. This is usually due to heart disease or risk factors such as high blood pressure.
Your body releases chemicals to make your blood vessels smaller. People with low-output heart failure have increased systemic vascular resistance.
“If you have heart failure, you may have a heart that can pump blood. The heart can’t meet the demands of the body due to an underlying condition This is called high-output heart failure.”
Your body will release chemicals that dilate your blood vessels. This is called a decreased systemic resistance.
“In high-output cardiac failure, ejection fraction is usually normal or high. Doctors and healthcare professionals often misdiagnose people’s high-output heart failure as a more serious problem.”
The underlying cause of high-output heart failure is often not fully understood and it can be a mystery. A wide range of conditions can cause heart failure.
“The rise in your body’s demand for blood is caused by these conditions. Relaxing cells in the walls of your blood vessels is one way that your body adjusts to increased demand. This causes your vessels to dilate and increase blood flow.”
Underlying conditions that cause heart failure include:
- “It’s obese.”
- severe or chronic anemia (fewer red blood cells than normal)
- hyperthyroidism (overactive thyroid)
- There is a baby
- arteriovenous shunts are abnormal connections between an arteries and veins.
- liver disease (cirrhosis)
- beriberi (caused by a vitamin B1 deficiency, also known as thiamine deficiency)
- lung diseases (such as chronic obstructive pulmonary disorder [COPD])
- sepsis (an extreme immune system response to an infection)
- There are rare blood cancers.
Many of these conditions can result in low systemic vascular resistance.
Obesity is the most common cause of high-output heart failure. How “It’s obese.” causes high-output heart failure isn’t fully understood. Researchers suspect that an excess of fat tissue causes an increase in your metabolic activity, which may lead to the dilation of your blood vessels, and there may also be an increase in your blood volume.
High-output heart failure has the same symptoms as low-output heart failure. These include:
- fatigue
- The breath was very thin.
- Is it possible to exercise with exercise intolerance?
- weakness
- There is swelling of your hands, feet, or abdomen.
- weight gain
- Retaining fluid is a topic of discussion.
- dizziness
- A need to urinate more often.
- tachycardia (fast heart rate)
If you have other symptoms of the underlying condition, such as anemia or sepsis, you might have high-output heart failure.
A medical history and physical exam are important for the diagnosis of high-output heart failure, which is similar to low-output heart failure. Inform your doctor of any underlying medical conditions or medications you are taking during the physical exam.
A doctor can perform various heart function tests to diagnose heart failure and understand what type of heart failure you have. They may refer you to a doctor.
These tests may include some.
- Cardiac function and structure can be assessed with cardiac scans.
- chest radiography (X-ray) to see if your heart is enlarged or there’s fluid in your lungs
- echocardiogram to measure your ejection fraction
- The amount of oxygen in your blood is a good indicator of your cardiac output.
- stress tests, which involve you running on a treadmill while an electrocardiogram (EKG) machine monitors your heart function
- Blood tests.
If you have an underlying medical condition that may be causing this type of heart failure, your doctor may run additional tests to understand.
Options for treating high-output heart failure are limited. Treatments typically used for low-output heart failure, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers, may not be as effective in treating high-output heart failure. Still, they may be used to help manage chronic high-output heart failure.
The first goal of treatment is to stabilize your body. This may involve reducing the amount of salt and water in your diet. You may also need diuretics, commonly known as water pills, or oxygen supplementation. In some cases, you might need ventilation therapy or intubation.
Noradrenaline, phenylephrine, and ephedrine are some of the medications that a doctor may recommend. The efficacy and safety of these medications have not been shown in clinical trials.
Management of high-output heart failure will target the underlying cause once it is stable. For example:
- Antithyroid medication is one of the treatments for hyperthyroidism.
- IV fluids and antibiotics are used in the treatment of sepsis.
- End stage liver disease may require a transplant.
You can’t always prevent high-output heart failure. If you have any of the underlying conditions that can cause this type of heart failure, it’s important to get treatment right away. If you have “It’s obese.”, losing weight can help lower your risk of developing heart failure and other conditions.
Some strategies may help prevent “It’s obese.” or other underlying conditions that can eventually result in heart failure. These include:
- exercising.
- eating a low-sodium diet
- Managing stress.
- Not smoking.
- getting adequate sleep
- A balanced diet is what you should be eating.
- limiting the amount of alcohol consumed.
Researchers are trying to understand the outlook for people with high-output heart failure.
In one retrospective analysis, people with high-output heart failure had a higher 3-year mortality rate compared with people in the healthy control group. But this differed based on the underlying condition. Of the types of high-output heart failure, “It’s obese.”-related high-output heart failure had a lower 5-year mortality rate, while high-output heart failure caused by liver disease and arteriovenous shunts had the highest.
“High-output heart failure is a rare form of heart failure. We don’t fully understand why obese people are more likely to die.”
With the growing rate of “It’s obese.” in the United States, doctors are caring for more people with high-output heart failure.
There are no short-term medical therapies for high-output heart failure that have been shown to be safe and effective in clinical trials.
If you have been diagnosed with high-output heart failure, you should talk to your doctor about the underlying cause and treatment options. If you suddenly have a problem with your heart, you should talk to a doctor.
