Ask the adult general public what heart failure is and the answers will range from a heart attack to sudden death.
At the final Sarver Heart Center lecture of the season last week, Dr. Elizabeth Juneman defined heart failure as “any damage to the heart.”
As cardiologist and Associate Professor of Medicine at Sarver Heart Center at Banner University Medical Center, Juneman’s talk attracted an audience of more than 100. Many had questions while a line of others stayed after to ask one-on-one questions about their personal health.
“Heart failure is when the body is unable to move blood effectively out of the heart and into the body. It’s a weakness of heart muscle to move blood, a weakness of the heart muscle to relax causing breathlessness, ankle swelling and fatigue,” Juneman said, adding that many signs can be resolved quickly with diuretic therapy.
Heart failure is common and affects about five million people in the U.S. annually. Common as it is, it’s also serious, causing an estimated 250,000 deaths in the U.S. each year.
Juneman gave what appeared to be an alarming statistic and explained its cause: there are more deaths now from heart disease than in the 1900s. It’s because Americans are now living longer.
In the 1900s, there were more deaths from smoking; there was no treatment for high blood pressure and there was less physical activity. Americans died younger. Today, there are fewer massive heart attacks. People are living longer and dying from heart failure.
Of $28.8 billion spent on heart failure in the U.S. annually, $17.1 billion is spent on hospital and nursing care.
Irreversible risk factors are those that can’t be changed. They include advanced age, being male, and family history.
Reversible risk factors, those that can be changed, include high cholesterol, smoking, high blood pressure, hormones, physical inactivity, obesity and stress.
“Inactivity is a tremendous risk factor,” Juneman said, and listed other risks: diabetes, heart murmurs, having an enlarged heart and having a prior heart attack.
Knowing the signs of heart failure enables you to seek medical help promptly. Signs include ankle swelling, shortness of breath, coughing, unable to lie flat (need two pillows to elevate head), sudden weight gain, being cold to the touch (especially limbs), and being tired and lethargic.
Juneman suggests knowing your blood pressure and heart rate and checking your weight daily. Baseline weight should be checked early in the morning, without clothing and before eating.
She explained what is included in an initial clinical evaluation of a heart-failure patient. Beyond medical history and physical evaluation there are diagnostic tests, lab tests for liver, kidney and thyroid function, blood count, urine analysis and non-invasive cardiac imaging.
A physician will go through a lifestyle checklist that includes current medications, maintaining follow-up appointments, monitoring weight, proper diet, daily exercise, limiting alcohol and caffeine and avoiding tobacco.
Six surgeries are available to improve heart failure. They include an Auto Implantable Cardioverter Defibrillator, Cardiac Resynchronization Therapy, a Left Ventricle Assistive Device, Bypass Surgery, Heart Valve Surgery and Cardiac Transplant.
How to improve
Juneman said one cup of coffee a day is OK. So is one small glass of wine — after exercising.
Take two grams of fish oil pills daily, maintain a low-salt diet, and monitor daily weight. And exercise.
People with heart failure who exercise do better. It’s important to remember anything you eat out will have a lot of salt.
“Heart failure is a chronic disease. It will never go away no matter how good you feel. But it can be treated so that you can continue to live your life.
“It’s a serious diagnosis, but we can help you to feel better.”
Contact Green Valley freelance reporter Ellen Sussman at email@example.com.