In February, we're all thinking about sweethearts — both the ones we love and the candy versions — so what better time of year to talk about heart health?
Congestive heart failure is one of the main reasons for hospitalization in people older than 65, but it's not just a concern for seniors. According to the Centers for Disease Control and Prevention, about 5.1 million people in the United States have heart failure, and one in nine deaths in 2009 included heart failure as a contributing cause. The total cost of health care services, medications and missed days of work because of heart failure in the United States is about $32 billion each year.
Heart failure does not mean that your heart has stopped working. It simply means that the heart's pumping power has degenerated or weakened as a result of a number of possible factors or conditions.
There are two main types of congestive heart failure: diastolic and systolic. In diastolic heart failure, the heart has become stiff and can't properly fill with blood during the resting period between each beat. Systolic heart failure is also known as pump failure, in which the heart muscle has been weakened and can't pump with enough force to push the amount of blood your body needs into circulation.
In either type, the symptoms of heart failure may include shortness of breath, fatigue, swelling/fluid buildup in the extremities, difficulty breathing when lying flat, persistent coughing or nausea.
In some cases of heart failure, especially in younger patients, the condition is caused by a congenital heart defect, such as an abnormal valve, that is detected early in life. According to the American Heart Association, about one percent of all infants are born with some type of structural heart defect. Heart failure in people under age 65 also may be a result of diabetes, which predisposes patients to many heart-related conditions.
You may be at risk for heart failure if you've experienced wear and tear on your heart as a result of coronary artery disease, which is a buildup of plaque in the heart's arteries that often leads to a heart attack.
Damage from a past heart attack, high blood pressure/hypertension, severe lung disease, heart muscle inflammation or kidney disease could also be contributing causes of heart failure in both young and older patients. Lifestyle choices heavily contribute to the risk of heart failure, including smoking, alcohol abuse, high cholesterol related to a poor diet, obesity and lack of exercise.
Congestive heart failure is a highly preventable condition. Simple healthy lifestyle changes and appropriate management of underlying conditions are essential ways to minimize your risk. Proper management of hypertension, for example, has been shown to stop the progression of congestive heart failure. Routine checkups that can detect possible issues like high cholesterol or abnormal valve function may help ensure the prevention of heart failure.
Prevention is the best treatment, but if you are diagnosed with heart failure, there are a wide variety of medications and treatments available that could stop further heart muscle degeneration. Medications known as angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels, and beta blockers have been shown to reduce heart rate and blood pressure by dilating blood vessels.
Surgical options to treat heart failure range from bypass surgery, which creates a new route for blood and oxygen to reach your heart, to valve reconstruction and replacement (that now can be done in a minimally invasive fashion in high-risk patients). Another option may be the placement of stents, which are tubes that hold arteries open. Patients who are in the advanced stages of heart failure may benefit from defibrillators or pacemakers that treat heart rhythm problems.
The best therapy for heart failure is a multidisciplinary approach to patient care that involves both primary care providers and specialists, and takes into consideration all aspects of an individual's lifestyle, underlying conditions, medications, family situation and mental health.
If you're concerned about your risk for congestive heart failure or would like to learn more about treatment options, make an appointment with your primary care provider for a routine checkup.
Dr. Nezar Falluji is with Cardiology Associates, part of KentuckyOne Health.