GETTING TO THE HEART OF THE MATTER WITH DR. FONTANET
April 28, 2005

Dr. Hector Fontanet, born and raised in Puerto Rico, brought his knowledge in cardiology to Florida Medical Clinic in November of 2004.  A graduate of the University of Puerto Rico, Dr. Fontanet was originally interested in agriculture and had great plans to feed the world.  As time progressed and interests changed, he ultimately fell in love with the inner workings of the heart- the relation of the heart to function, emotions and most importantly, the immense impact on patient’s lives following treatment and healing cardiac procedures. 

One of Dr. Fontanet’s passions is studying failing hearts.  According to the Heart Failure Society of America, heart failure is the only major cardiovascular disease on the rise.  Heart failure is a serious chronic medical condition that develops slowly due to underlying coronary artery disease, valvular disease and longstanding hypertension.  It weakens the heart muscle so that it cannot pump blood adequately through the body.  Some symptoms of heart failure include shortness of breath, fatigue and swelling.  Even with the use of medical therapy, heart failure is life threatening.  Approximately 250,000 Americans die from heart failure each year.  One of the most dangerous complications of heart failure is the development of irregular heart rhythm.  When heart rhythm becomes rapid or chaotic, the heart suddenly stops beating which is known as sudden cardiac death.   The estimated cardiac arrest survival rate is approximately 5%. Studies show that sudden cardiac death is the terminal event in 30-50% of patients with heart failure.

For the five million Americans who live with heart failure there is a new implantable cardioverter-defibrillator (ICD) therapy that has shown a significant decrease in the risk of sudden cardiac death. An ICD is an electronic device that is implanted surgically (similar to a pacemaker) that monitors heart rhythm and can also deliver powerful shocks to the heart to correct life threatening abnormal rhythms. Until recently ICD’s were implanted only in the highest-risk patients who have survived an episode of sudden cardiac death.  In January of this year, The New England Journal of Medicine published the results of a clinical trial, which showed that ICD implant therapy reduces all-cause mortality in heart failure patients by 23% when compared to placebo.

Living with heart failure requires modification in lifestyle and careful monitoring by a physician.  Because of nighttime sleep interruptions due to shortness of breath and coughing, patients must plan rest times during the day.  Close attention must be paid to changes in condition such as sudden weight gain of 3-5 pounds per day, increased swelling, pain in the abdomen, rapid heart beat or loss of appetite.  These changes are usually due to water retention around the heart and can be prevented by moderate exercise, avoiding stress, taking prescribed medications faithfully and following up with a physician regularly.

Comprehensive Heart Care Clinics such as the one at Florida Medical Clinic have been developed to improve quality of life. Dr. Fontanet and his cardiology staff help patients manage their heart failure, have shorter hospital stays and can often avoid hospital admissions by offering treatment in a more comfortable out-patient setting. Dr. Fontanet’s patients often comment on the confidence they feel at the end of their first visit and, more importantly over the years of developing a professional relationship, patients observe a strong sense of becoming a part of Dr. Fontanet’s extended family.

Dr. Fontanet is board certified in Cardiovascular Diseases, Echocardiography and Nuclear Cardiology.  For more information on heart failure you can call Dr. Fontanet’s office at 813-788-5575.

Additional Stories:
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Living with Heart Failure
GETTING TO THE HEART OF THE MATTER WITH DR. FONTANET
May 26, 2005
Hector Fontanet, MD, FACC
Marie Cheine, Medical Writer

When a heart’s pumping power is reduced by a heart attack, untreated blood pressure, or other abnormal heart conditions, a syndrome known as congestive heart failure (CHF) exists. Heart failure is a progressive condition in which the heart muscle cannot pump enough blood through the body to supply the necessary amount of oxygen. Heart failure cannot be cured. However, physicians have many options for treatment aimed at reducing symptoms and need for hospitalization, preventing progression of the disease and improving one’s quality of life.

Unfortunately, many do not realize they have heart failure. This is because some of the key symptoms -- fatigue, shortness of breath and inability to exercise can be viewed as signs of being out of shape or normal aging. Some compensate for symptoms by taking an elevator instead of climbing the stairs, sleeping with extra pillows or cutting back on usual daily activities. Often the symptoms necessitate an emergency room visit where the condition is first diagnosed. Early detection and treatment can be lifesaving.

The choice of treatment for heart failure differs from patient to patient, depending upon the degree to which the heart failure has progressed and the underlying cause of heart failure. Two classes of medications, ACE inhibitors and Beta Blockers have shown to improve survival, overall well being and exercise capacity and in some instances, normalize heart function. Only a physician can determine the best treatment options for a patient. In addition to medication, life style changes and inotropic infusions, there are implantable devices that, along with optimal medical therapy, can improve the heart’s ability to supply blood and oxygen to the body.

As many as 50% of patients with heart failure have abnormalities in their hearts that cause inefficient and uncoordinated beats of the heart (www.Mayoclinic.com.)  A special device known as a cardiac resynchronization therapy pacemaker (CRT-P) is a special pacemaker that is implanted to help the lower heart chambers (ventricles) to beat together (in synchrony) and reduce the symptoms of heart failure. This special pacemaker is also known as a biventricular pacemaker.

Cardiac resynchronization therapy (CRT) is a clinically proven treatment option that improves the quality of life, increases the ability to exercise and improves the functional class of many patients with heart failure. Candidates for this implantable therapy are patients diagnosed with moderate to severe heart failure and who remain symptomatic on optimal medical treatment.

There have been numerous advances in the treatment of heart failure. Today, medications, device and surgical treatments can not only relieve its symptoms but also slow the progression of this condition. Only a physician can determine if you have heart failure by taking a detailed medical history, performing a physical examination, and performing painless diagnostic tests such as an echocardiogram. If you or your loved one is experiencing any of the key symptoms of heart failure or has been diagnosed with heart failure or have suffered from heart attack in the past, seek the advice of a primary care physician or a cardiologist.

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