February 2010: The Impact of Heart Failure on the Individual and Health Care
31 Jan 2010
Dr. Amjad Sheikh serves as the Chairman, Department of Medicine, at Weiss Memorial Hospital. He is a board-certified cardiologist with a special interest in echocardiography and diagnosis and management of heart failure.
Dr. Amjad Sheikh
Weiss Memorial Hospital
Heart failure is the number one hospital medical diagnosis today and the number one reason for hospital readmissions. According to the American Heart Association, an estimated 5.7 million Americans are living with heart failure, and 670,000 new cases are diagnosed each year.
What causes heart failure?
There are several medical conditions that can lead to heart failure:
- High blood pressure. High blood pressure, or hypertension, is the most common cause of heart failure and matter of concern for many Americans. And to make matters worse, high blood pressure is often under-diagnosed and under-treated by doctors. High blood pressure leads to thickening of the heart muscle and dilation of the cavity of the heart, resulting in the weakening of the heart muscle. High blood pressure is particularly prevalent among African Americans.
- Ischemic heart disease (atherosclerosis). Ischemic heart disease occurs when the heart muscle is not receiving enough blood due to obstruction in coronary blood vessels, causing dysfunction and weakening of the heart muscle. High cholesterol in the arteries of the heart is one of the major factors that can lead to coronary artery disease which leads to ischemic heart disease.
- Valvular heart disease. Valve problems can be present at birth or caused by infections, heart attacks or heart disease or damage. Heart valves can malfunction—especially in the aging population—leading to heart muscle weakness.
- Cardiomyopathy, or primary heart muscle disease. Cardiomyopathy can be primary or inflammatory disease of the heart. Doctors often do not know the cause, but too much alcohol or a virus may be the culprit.
- Atrial Fibrillation. According to the American Heart Association, about 2.2 million Americans have atrial fibrillation. Age increases the likelihood of developing atrial fibrillation. With this condition, the heart’s two small upper chambers (the atria) quiver instead of beating effectively. In addition to its implication in heart failure, it can lead to a stroke if a blood clot in the atria leaves the heart and becomes lodged in a brain artery.
Can you reverse heart failure?
There is hope for people experiencing heart failure; in fact, it is treatable, manageable and potentially reversible. Most heart problems can be treated through proper diagnosis, disease management and aggressive control of underlying causes.
Medication is one important key to controlling heart conditions. Treatment of underlying conditions that have either caused or contributed to heart failure is crucial. Such conditions may be anemia, thyroid problems or high blood pressure.
Interventional and surgical management of heart failure can greatly slow down the progression of the disease and even reverse it. Stent deployment in coronary arteries and coronary bypass surgery can go a long way in optimizing heart function.
Exercise and dietary restrictions are also very important in the management of heart failure and the underlying conditions that are affecting the heart’s function and performance. Talk to your doctor about establishing a meal plan and an exercise routine that is right for you.
Ensuring successful outcomes
Preventing, treating and managing heart failure is a hot topic for not only health care providers, but for the hospitals and medical facilities that treat them, as well as the government. With the realization of the severity of the problem, hospital administrators, cardiologists and government officials are beginning to work together to better educate, treat and monitor patients, even after hospital discharge.
Many hospitals, including Weiss, are now developing mechanisms to follow patients, even at home. Like many other chronic diseases, follow up care is essential to preventing future problems and the resulting hospital readmissions. Home health organizations or nurse specialists with an expertise in heart failure are becoming a key component to the management of discharged patients. Their role is to keep patients on track with their medication, dietary restrictions and exercise programs. Through frequent follow up calls, they can troubleshoot problems patients may be experiencing, such as feet swelling and shortness of breath, and suggest ways to head off problems, often preventing a return to the hospital.
Additionally, part of this follow up care includes the use of home monitoring equipment. Today’s new pacemakers and implantable devices can monitor the heart and automatically send information back to the cardiologist for evaluation.
For more information
If you would like more information about heart failure, or would like an appointment, please call Weiss Cardiology at (773) 564-5912.