What Does Congestive Heart Failure Mean?
Congestive Heart Failure does not mean your heart is going to stop TODAY! Over 5 million Americans are living with Heart Failure, and 500,000 are diagnosed yearly. All people can develop heart failure. Some “famous” people with heart failure are Shelly Winters, Liz Taylor, Dick Cheney, Frank Sinatra, Dwight Eisenhower, Jack Lord, Ansel Adams, George Carlin, George Montgomery, Donald O’Connor, LBJ, Rutherford Hayes, Calvin Coolidge.
One million people are admitted to the hospital with CHF yearly. Upon discharge, 30% are readmitted within the first thirty days with the majority of these within the first week. With each hospitalization, the chance of survival decreases by 30%. If hospitalized four times in 1 year the mortality is 60%. Fifty percent of those diagnosed with CHF will die within five years. One in three dies within one year of diagnosis.
The American Heart Association & American College of Cardiology, both recommend one week follow up that has shown to reduce hospitalization and set up close follow up for improvement in patient outcomes. These one week follow visits help reduce the rate of rehospitalization. Most rehospitalizations are due to confusion regarding discharge instructions such as medications: what and when to take meds, drug interactions and side effects, NOT taking meds prescribed upon discharge, and not adhering to fluid and sodium restrictions.
What is the cause of Congestive Heart Failure?
Anything that damages the heart muscle, or impairs its ability to fill with or pump blood properly can cause the heart to fail. This can include high BP, diabetes, coronary artery disease, MI (heart attack), overactive thyroid, myocarditis (infections such as viruses like the flu or bacteria), trauma, COPD, stress, birth defects, heart valve disorders, abnormal heart rhythms, cancers, drugs, alcohol, chemo, radiation and “idiopathic”causes- which is a fancy word meaning we don’t know the cause.
Heart disease is a vicious cycle. Anything that impairs the heart’s ability to pump will cause alarm in the body, particularly the brain and kidneys. This alarm causes hormones to be released similar to the “flight or fight” reaction. The fluid is retained to keep the BP up in case you need to flee. Remember- the body cannot tell if the house is burning down, a tiger is chasing you, your mate just left you or your child was just killed in an accident- the response is the same. The heart pumps harder and faster and starts to change shape or (remodel). This changing in shape impairs the hearts pumping ability. The heart responds by beating harder, and faster; thus causing more damage. This cascade of events usually prompts your first visit into the healthcare system: ER, cardiologist or your primary care provider.
Next month we will discuss the diagnosis and treatment of heart failure.
We have a class on Congestive Heart Failure taught every other month at South Denver Cardiology Associates. Next class is May 21 from 1:30- 2:30, is free and open to the public. You can sign up at www.southdenver.com.