What do you know about heart failure?

What do you know about heart failure?

If you’re like most people, not enough.

In fact, it is believed that most people who have heart failure are not even aware of it. It’s estimated 30 per cent of those who have heart failure, but are not aware of it, will go on to develop full blown symptoms requiring urgent medical care within the next three years.

The overall one-year mortality rate (risk of dying) for patients diagnosed with heart failure is 30 per cent. The risk is higher with those with three or more other chronic health conditions (up to 50 per cent) and higher still in the elderly (up to 61 per cent).

But patients who are informed and engaged in self-management in partnership with their family physicians have much better outcomes — slower disease progression and fewer hospitalizations.

Your heart is a muscular organ that acts as a pump. The right side of the heart receives blood returning from the body through veins and pumps this oxygen-depleted blood to the lungs. Oxygen-rich blood then returns to the left side of the heart, which delivers it to the rest of the body (including the brain) through the arteries.

Congestive heart failure is due to the decline in the pumping ability of the heart. This results in shortness of breath when blood backs up into the lungs, edema (or fluid retention), particularly in the legs and feet when blood backs up into the extremities, and fatigue because less blood is getting to the brain, muscles and organs.

The most common causes of heart failure are high blood pressure and atherosclerosis (narrowing of the arteries). Because the effects of these chronic conditions accumulate over time, the onset of symptoms is often gradual, unrecognized or mistaken for normal aging or deconditioning.

Other causes for heart failure include irregular heart rhythms, smoking, obesity, thyroid disease and excessive alcohol. Less common causes include disease of the heart muscle following viral infections, as side effects of medications (including some types of chemotherapy) or due to metabolic conditions such as hemochromatosis (iron overload).

In addition to the symptoms of fatigue, fluid retention and shortness of breath with physical activity, another classical symptom is shortness of breath when lying flat. In patients with worsening heart failure, blood fills the lungs unless they are sitting upright.

Several classes of medications have been shown to improve both the survival and quality of life in heart failure. These include beta blockers and ACE inhibitors. The condition requires close medical follow-up and regular monitoring.

Individuals with heart failure can maintain their health with diligent self-care and lifestyle management, monitoring their weight to pick up on fluid retention that may indicate a sudden worsening of their condition, limiting salt, alcohol and fluid intake and maintaining regular appropriate exercise.   

To learn more attend my next free public lecture, “What you Should Know About Heart Disease,” on behalf of the Burnaby Division of Family Practice’s Empowering Patients series.

You’ll learn if you’re at increased risk, practical tips to reduce your risks and how to maintain your best health in spite of heart disease.
I’ll be speaking Wednesday, March 30 at 7 p.m. at the Alan Emmott Centre at 6650 Southoaks Cres. in South Burnaby. Register online with lcullen@divisionsbc.ca or call Leona at 604-259-4450.

Davidicus Wong is a family physician and his Healthwise columns appear regularly in this paper. For more on achieving your positive potential in health, see his website at davidicuswong.wordpress.com.

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