Frequently Asked Questions
I have been told I have heart failure – what should I expect?
Heart failure is said to occur when the heart is incapable of keeping up with
the body’s needs. When patients
have heart failure, the heart muscle usually has become weak for some reason.
Common causes of heart failure include heart attacks (in which a portion
of the heart muscle dies due to coronary artery disease), valvular heart disease
(in which the heart muscle weakens over time in response to a valve that is
chronically too leaky or too tight), or cardiomyopathy (a primary disorder of
the heart muscle itself.)
The most common symptoms of heart failure include shortness of breath, edema (swelling), and fatigue. Heart failure is often progressive, and tends to worsen over time.
The ultimate outcome for a patient with heart failure depends on what is causing the heart failure, how advanced it is, and on whether optimal therapy is instituted.
A vitally important, and unfortunately frequently overlooked, part of treating heart failure is to identify the cause of heart failure, and to reverse it if possible. (In other words, too many doctors think of heart failure as a final diagnosis instead of as a problem that needs to be fully evaluated.) Aggressively treating underlying coronary artery disease, or valvular heart disease, or metabolic conditions (like hyperthyroidism) can greatly improve the patient’s outcome.
The medical treatment of heart failure has advanced significantly over the past few years. It is now known that the use of certain drugs like ACE inhibitors and beta blockers can significantly improve the symptoms and the prognosis of many patients with heart failure. The use of disease management programs (newer methods of actively monitoring patients with certain chronic illnesses, and aggressively intervening when the illness begins to worsen) has proven effective in reducing the frequency and severity of acute illness in patients with heart failure. Further, a lot has been learned about how to prevent sudden death from cardiac arrhythmias in heart failure. Finally, several exciting new experimental therapies are about to bear fruit (including resynchronization pacing therapy, and for patients with the most severe cardiac disease, artificial hearts). Studies have consistently shown, however, that many doctors have not kept up with significant recent advances in the treatment of heart failure, and that their patients are suffering the consequences.
For this reason patients with heart failure should consider getting themselves “plugged in,” when possible, to medical centers that have displayed a specific interest in treating patients with heart failure. Or alternatively, patients with heart failure - and their loved ones - should make a concerted effort to stay abreast of these advances themselves. The Internet offers an excellent means of doing so.
Click here for a more detailed discussion of heart failure – its causes, its consequences, and its treatments.
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