Congestive heart failure is serious

Posted 9/16/22

Untreated, congestive heart failure has the same 5 year survival as pancreas cancer.  Not good.

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Congestive heart failure is serious


Untreated, congestive heart failure has the same 5 year survival as pancreas cancer.  Not good. There are two different types of heart failure.  Systolic heart failure means the heart muscle is weak.  Diastolic heart failure means the heart is stiff and slow to fill kind of like a stiff balloon.  You can have both types of heart failure.

The good news is that its usually treatable and often reversible.  In systolic heart failure it turns out its not the weak heart that kills you, its the chemicals your body produces in response to the weak heart that kills you.  

There are three classes of medications that have been shown to double expected life span for systolic heart failure and cut hospitalizations in half.  Beta blockers such as Toprol (long acting metoprolol succinate) and carvedilol.  The aldosterone inhibitor spironolactone is used as well.  ACE inhibitors or ARB’s are another medication that can turn around heart failure.  Entresto is a new medication that takes the place of an ACE inhibitor or ARB.  Some diabetic medication like Farxiga has been shown to improved heart failure as well.  Maximum doses give the maximum benefit - if tolerated.

Diastolic heart failure often responds to beta blockers.  By slowing the heart rate the heart has more time to fill the stiff heart.  Entresto has been shown to help with diastolic heart failure as well.

The major symptoms of heart failure are fatigue, swelling, shortness of breath, inability to lay flat, rapid heart beat or cough.  Sometimes the abdomen can swell also.

Heart failure is caused by undertreated high blood pressure, viral infections, coronary artery disease, heart valve disease and sometimes genetics. 

A healthy heart pumps out 55-75% of the blood with each heartbeat.  50% is normal in the older population.  If its 35% or lower the patient is at risk of sudden death from a rhythm disturbance.  These individuals need an implantable defibrillator.

The medications require regular lab work, usually every 3 months.  An echocardiogram (sound waves of the heart) is often done annually to follow the progression of the disease.  A patient with significant heart failure should check their weight daily and if up by 3 pounds take a water pill.

With the right medications and monitoring, individuals with heart failure can usually live very active lives.

heart failure, Okeechobee Family Practice