What is Congetive Heart Failure?

Heart failure is a term used to describe a condition where the heart can no longer provide sufficient blood supply to all parts of the body. Though many people associate the word “failure” with a bad outcome, heart failure can often be managed quite well for long periods of time.

Are there different types of heart failure?

Yes. Heart failure can involve systolic or diastolic dysfunction, or a combination of both. Dysfunction means not working properly. Therefore, systolic dysfunction means the heart does not squeeze with enough force to send the blood out to the body at a normal level. Diastolic dysfunction means the heart does not relax properly between beats to fill with blood.

Who will most likely get heart failure?

To answer that question, we must first discuss the most common causes of heart failure. Most heart failure is caused by coronary artery disease, or blockages in the heart arteries. Therefore, people age 50 and over are more likely to develop coronary artery disease and subsequently heart failure. Diabetics have very high incidences of heart failure. One of the most alarming findings for me is that young diabetic women have an eight-fold risk of developing heart failure compared to a woman without diabetes. There are many causes of heart failure ­ high blood pressure, thyroid disease, chemotherapy agents, drug use, alcohol use, pregnancy, exposure to viruses, and heart valve disease are just a few.

How do you treat heart failure?

In order to treat heart failure, we must first try to determine the cause. If the cause is blockages, then open up the arteries. If the cause is valve disease, then fix the valves. If the cause is alcohol use, then abstain from all alcohol. If the cause is pregnancy, then do not have any more children. We must order numerous diagnostic tests initially to find the cause of heart failure so we can treat it. As we are trying to determine any reversible causes for the heart failure, we begin with standard medical therapy. There are certain medications that every heart failure patient should take, some that may help, and some that are harmful and should be avoided.

There are two major factors that will affect the outcome of heart failure ­ how well the patient can tolerate the medical therapy and how well the patient follows lifestyle changes.

Truly, no medication is as beneficial in managing heart failure as the patient who chooses to make the right lifestyle choices. It will not matter how many medications we prescribe if the person does not follow our recommendations to live healthier.

What types of lifestyle changes are we talking about?

This is the exciting part - because the person with heart failure has total control over this aspect of his recovery. The following recommendations are the major ones that I tell every patient I see:

• Low sodium diet - that means less than 2000 milligrams per day
• Fluid restriction - this is not always necessary. However, if you are on a fluid restriction, it is very important to measure all liquids. Anything that can be poured should be measured.
• Exercise - you may start off very weak, but it is important to slowly and steadily increase your activity level to a goal of 60 minutes of exercise at least 5 to 6 days a week
• Weight loss - if you are overweight, losing the extra pounds will help your heart by reducing its workload
• Don’t smoke
• Take all of your medications exactly as prescribed
• Don’t take medications that can be harmful
• Weigh yourself daily as sudden weight gain is most often the earliest sign of worsening heart failure

Are there any local support groups for heart failure patients and their families?

As a matter of fact, a local Mended Hearts support group was recently organized. They meet at 6 p.m. on the 3rd Wednesday of each month at TexSan Hospital. You can call TexSan Heart Hospital 210.736.6700. The President of the local chapter is Denise Ure, and you can call her at 210.922.1263 or 210.887.9175, or contact her by email at Dutheheartthing@yahoo.com