Five million Americans suffer from a potentially life-threatening condition. It has claimed the lives of Henry Fonda, Ella Fitzgerald, Wilt Chamberlain, Roy Rogers and Dale Evans.
Even though half a million patients are diagnosed with congestive heart failure (CHF) each year, most people know very little about this disorder.
If you ask the average person about heart failure, he may well confuse it with heart disease and blame it on high cholesterol and clogged coronary arteries. But people with low cholesterol and clean blood vessels can develop heart failure too.
Cardiologists frequently describe CHF as a pump problem. The heart muscle needs to fill up with blood and then push it out through the body. If the heart is stiff and can’t fill up well, or large and weak so it can’t pump effectively, the result is heart failure.
Symptoms can include shortness of breath or nighttime cough from fluid retention in the lungs, or fatigue from simple activities like walking up stairs or making a bed. The general nature of these symptoms means that many people may go undiagnosed for years.
Heart failure is the leading cause of hospitalization for people over 65. But it is not restricted to older people. Even those in their twenties or thirties can develop CHF.
Leading causes include uncontrolled high blood pressure or a previous heart attack. Faulty heart valves can also contribute. But some people develop heart failure without a previous heart attack or artery blockage.
In recent years, the diagnosis and treatment of CHF have changed. A relatively recent technology, the echocardiogram, uses sound waves as part of the work-up for heart failure.
In the past, doctors were cautioned not to prescribe beta-blocker drugs for heart failure patients, but in recent years research has shown beta-blockers can be quite effective. One in particular, Coreg (carvedilol), is extremely helpful. Other medications called ACE inhibitors (drugs such as Accupril, captopril, enalapril or lisinopril) are also a mainstay of heart failure treatment.
Another new development involves an old drug. Spironolactone is a diuretic that has been around for more than 30 years. Recently, a study showed that it can dramatically improve survival in CHF patients. Caution is required, however, because this water pill can interact dangerously with ACE inhibitors to raise potassium too high.
With appropriate treatment, many patients with CHF can thrive as well as survive. But some experts estimate that half are not getting optimal treatment. Patients and families need to become knowledgeable and assertive about this mysterious ailment.
We recently discussed these complex issues on our radio show with two expert cardiologists. For a one-hour CD of this up-to-date overview, you may send $15 to: People’s Pharmacy, CD# A-91, P. O. Box 52027, Durham, NC 27717.
Those who do not have heart failure have a chance to prevent it. Keeping the heart healthy with exercise and sensible diet is a good first step. Controlling blood pressure with a low-salt diet and medicine when necessary is also valuable. Those who have been diagnosed with CHF need a team approach to achieve the very best modern medicine can offer.
