Health and Fitness for Saturday April 16, 2011

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Lifelong Health: Congestive Heart Failure Has Many Causes The death of Elizabeth Taylor brought great sadness to her millions of fans worldwide. After a long battle with congestive heart failure, she succumbed to a disease that annually claims more than 300,000 lives. About 2.2 percent of the population has heart failure with 1.1 million admitted to hospitals each year. Its prevalence has doubled in the past 15 years, and the annual cost of dealing with the disease is more than $50 billion annually and climbing. Congestive heart failure is a complicated illness with varying causes and presentations. The most common causes are coronary artery disease and high blood pressure. Long-standing high blood pressure causes the heart muscle to hypertrophy and enlarge, which eventually impedes the heart from pumping adequate amounts of blood, and heart failure ultimately follows. Other causes of congestive heart failure include a very slow or rapid heart rate, a chronic irregular heart rhythm (atrial fibrillation), and damage to heart valves due to rheumatic fever, congenital abnormalities or other causes. Cardiomyopathy, or damage to the heart muscle, can also lead to heart failure. This illness can occur from cardiac infections, other inflammatory conditions that damage the heart, or for no known reason. Finally, heart failure can occur as a consequence of severe lung disease. To understand congestive heart disease, first consider the mechanics of your heart. The heart consists of four chambers: a left and right atrium and a left and right ventricle. Deoxygenated blood from your body flows to the right side of your heart, which is then pumped into the lungs to receive oxygen, back into the left heart, and then finally out again to the body. When the left side fails, blood backs up in the lungs, causing shortness of breath on exertion and difficulty sleeping when lying down. When the right side of the heart fails, blood backs up in the veins that drain blood back to the heart. This causes veins in the neck to swell, the liver to fill with blood, enlarge and become painful, and significant swelling of the legs. This leads to a condition called peripheral edema. Identifying the cause and type of heart failure determines the way the disease is treated. One of the most important tests used to assess heart function is the echocardiogram, which evaluates the heart valves and the way in which the heart fills with blood and pumps it out. After pumping blood out of the heart (a period called systole), the heart relaxes and fills with blood (diastole). A strong heart will pump more than 60 percent of blood out of its chambers with each contraction, but in a weak or diseased heart, less than 20 percent may leave with each beat. This condition is referred to as systolic dysfunction. In another form of heart failure, diastolic dysfunction, the percentage of blood pumped out of the heart during systole is normal, but the volume is reduced. The heart can become very rigid, causing relaxation to be impaired. Depending on the cause of the heart failure, treatment may focus on diet, rest and a supervised activity program. The main goal of treatment is to make it easier for the heart to function by reducing blood pressure, relaxing blood vessels and removing excess fluids. Common medications used are called ACE inhibitors, beta-blockers, digitalis, diuretics (water pills), and medications that dilate arteries. With appropriate treatment, patients can have a good quality of life for many years. However, failing to comply with treatment can result in sudden heart failure -- as can a sudden and inexplicable onset of a fast or very slow heart rate, a new heart attack, failure to comply with diet, and any illness such as bronchitis or an urinary infection. If symptoms worsen, it is important to see a doctor immediately or get to an emergency room. Men and women are affected by congestive heart failure, but for reasons not well understood, it is decreasing in men and increasing in women. Fortunately, many incidences of heart disease can be prevented. By living a healthy lifestyle, exercising, eating well and identifying and treating the conditions that can lead to heart failure, you can avoid the deadly consequences of congestive heart failure. ======== Dr. David Lipschitz is the author of the books "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com. Copyright 2011 Creators Syndicate Inc.
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