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.
