Symptoms of aortic stenosis
If the aortic stenosis is mild, there may be no symptoms at all, or tiredness may be the only symptom. If the stenosis is greater, other symptoms may include chest pain and/or breathlessness during exertion, palpitations, dizziness and fainting, especially during exertion.
Heart failure may develop, causing symptoms that include tiredness, breathlessness and fluid retention in the legs, for example.
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?
Compare your options
||Get a pacemaker
||Don’t get a pacemaker
|What is usually involved?
- The doctor will numb the area so you won’t feel pain. (This is not open-chest surgery.)
- It can take up to 2 to 3 hours to place the pacemaker.
- You may spend the night in the hospital to make sure that the device is working and that there are no problems.
- You will need regular checkups to make sure that the pacemaker is working and to adjust the pacing, if needed.
- You still need to take medicines for heart failure.
- You still have to eat healthy foods and exercise as your doctor advises. You also may need to limit salt and fluids.
- You take medicines for heart failure. Your doctor may change the type or dose of your medicines.
- You have to eat healthy foods and exercise as your doctor advises. You also may need to limit salt and fluids.
- You may have to see your doctor often to check your symptoms and how your medicine is working.
|What are the benefits?
- A pacemaker can help you feel better so you can be more active.
- It can help keep you out of the hospital and help you live longer.
- It can help your heart pump better by changing the shape of your heart. In heart failure, the left ventricle often gets too big as it tries to make up for not pumping well.
- You won’t have the risk of infection or other problems from the surgery.
|What are the risks and side effects?
||The risks from surgery are usually low. But they may be different for each person. Here are some possible risks:4
- A lead could tear the heart.
- A lung could collapse from a buildup of air in the space between the lung and the chest wall.
- You could get an infection in the chest.
- The doctor might not be able to place the pacemaker. For example, a vein could be too small to place a lead.
After surgery, you may have some other risks:
- You will need surgery to replace the battery, which lasts 8 to 10 years.
- If a lead breaks or the pacemaker stops working, you may need another surgery to fix the problem.
- Some devices with strong magnetic or electrical fields could stop the pacemaker from working. You need to avoid MRI machines, battery-powered cordless power tools, and CB or ham radios. But most everyday appliances and electronic devices are safe.
- Your symptoms could get worse. This would limit your ability to do your daily activities.
- If your heart failure gets worse, you may have to go into the hospital a lot.
- You might not live as long as you could if you had a pacemaker.2
Heart failure usually gets worse over time. But there are many things you can do to feel better, stay healthy longer, and avoid the hospital.
Self-care means managing your health by doing certain things every day, like weighing yourself. It’s about knowing which symptoms to watch for so you can avoid getting worse. When you practice good self-care, you know when it’s time to call your doctor and when your heart failure has turned into an emergency. The lists below can help.
Top 5 self-care tips for every day
- Take your medicines as prescribed. This gives them the best chance of helping you.
- Watch for signs that you’re getting worse. Weighing yourself every day is one of the best ways to do this. Weight gain may be a sign that your body is holding on to too much fluid. Weigh yourself at the same time each day, using the same scale, on a hard, flat surface. The best time is in the morning after you go to the bathroom and before you eat or drink anything.
- Find out what your triggers are, and learn to avoid them. Triggers are things that make your heart failure worse, often suddenly. A trigger may be eating too much salt, missing a dose of your medicine, or exercising too hard.
- Limit salt (sodium). This helps keep fluid from building up and makes it easier for your heart to pump. Your doctor may want you to eat less than 2,000 mg of salt each day. That’s less than 1 teaspoon. You can stay under this number by limiting the salt you eat at home and by watching for “hidden” sodium when you eat out or shop for food.
- Try to exercise throughout the week. Exercise makes your heart stronger and can help you avoid symptoms. Walking is a great way to get exercise. If your doctor says it’s safe, start out with some short walks, and then slowly build up to longer ones.
When to act
Try to become familiar with signs that mean your heart failure is getting worse. If you need help, talk with your doctor about making a personal plan.
Here are some things to watch for as you practice your daily self-care. Call your doctor if:
- You gain 3 pounds or more over 2 to 3 days. (Or your doctor may tell you how much weight to watch for.)
- You have new or worse swelling in your feet, ankles, or legs.
- Your breathing gets worse. Activities that did not make you short of breath before are hard for you now.
- Your breathing when you lie down is worse than usual, or you wake up at night needing to catch your breath.
Be sure to make and go to all of your follow-up appointments. And it’s always a good idea to call your doctor anytime you have a sudden change in symptoms.
When it’s an emergency
Sometimes the symptoms get worse very quickly. This is called sudden heart failure. It causes fluid to build up in your lungs.
Sudden heart failure is an emergency. If you have any of these symptoms, you need care right away. Call 911 if:
- You have severe shortness of breath.
- You have an irregular or fast heartbeat.
- You cough up foamy, pink mucus.
Other tips to help you stay healthy
There are other things you can do to take care of your body and your heart. These things will help you feel better. And they will also reduce your risk of heart attack and stroke.
- Try to stay at a healthy weight. Eat a healthy diet with lots of fresh fruit, vegetables, and whole grains.
- If you smoke, quit.
- Limit the amount of alcohol you drink.
- Keep high blood pressure and diabetes under control. If you need help, talk with your doctor.
Also let your doctor know if:
- You’re having trouble sleeping. Sleep is important to your well-being. It also helps your heart work the way it’s supposed to. Your doctor can help you decide if you need treatment for sleep problems.
- You’re feeling sad and hopeless much of the time, or you are worried and anxious. Heart failure can be hard on your emotions. Treatment with counseling and medicine can help. And when you feel better, you’re more likely to take care of yourself.