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New Directions - How Can You Mend a Broken Heart?

New Directions Winter 2013

How Can You Mend a Broken Heart?

Date: November 1, 2013

Nancy Davenport, M.D.
Nancy Davenport, M.D.

Romance aside, about six million Americans suffer from a “broken” heart. Roughly 670,000 people are diagnosed with congestive heart failure every year. It’s the top cause for hospitalization in people age 65 and older. Below we asked cardiologist Nancy Davenport, M.D., to answer some frequently asked questions about congestive heart failure. Dr. Davenport, who opened her practice in 1992, is board certified in cardiology. Her office is on the campus of Sibley Memorial Hospital in Washington, DC.

Q: What is congestive heart failure?

A: Heart failure does not mean your heart stops. But for various reasons it does not function normally. The word “congestive” in front of the term comes from the disease’s number one symptom: fluid build-up in the body, especially the lungs. If the heart fails, blood backs up into your veins in an attempt to carry oxygenated blood from the lungs to the heart. As fluid fills the lungs, it becomes difficult to breathe.

Heart failure is a chronic, long-term condition that gradually worsens. By the time most people visit a doctor, the heart has been failing for an extended period of time.

Q: What are the symptoms?

A: Shortness of breath when you lie flat or after mild exercise is the biggest symptom. Dizziness, fatigue, weakness and rapid or irregular heartbeats are also signs of a problem. There is no chest pain with heart failure (but a heart attack can cause a weak heart). Swollen feet are not a sure indicator. While water retention is a symptom, it is more so throughout your body, not necessarily just in your feet.

Q: Are there different kinds of heart failure?

A: There are two types of congestive heart failure: weak heart and stiff heart.

The heart is a pump that is at all times either empty or full. Weak heart/systolic heart failure occurs when the “pump” is ineffective and the heart can’t pump the blood out to the body.

Stiff heart/diastolic heart failure is the more common type of heart disease. As we age, our hearts get stiffer. The “squeeze” or pump OUT might be fine, but when it’s stiff, the full heart does not relax enough to fill with blood so it can circulate through the body.

Q: How is heart failure diagnosed?

A: If you have symptoms, your doctor may order an echocardiogram or ultrasound of the heart. Undergoing an EKG is not helpful when initially diagnosing heart failure.

Q: Does heart failure “run in the family”?

A: Not really. Just because a family member had heart disease doesn’t mean you will. It’s all about lifestyle choices. Get moving! Exercise is one of the best ways to say, “I love you,” to the essential pump that is your heart. Make activity part of your routine, even if it’s just walking up the stairs instead of taking the elevator. It is important to recognize and control predisposed familial conditions like coronary artery disease, diabetes, high blood pressure and obesity.

Q: Is congestive heart failure inevitable as we age?

A: People are living longer than ever, into their 80s and 90s. In the past 20 years doctors have recognized that the stiff heart is more prevalent than the weak heart. There is more data on the symptoms and treatments for a weak heart than a stiff heart. Currently, both types of heart disease are treated the same way, but studies are under way to learn how to better treat a stiff heart.

Q: What are the treatment options?

A: Many medicines are effective and inexpensive, but if prescribed, they must be taken without fail. The good news is these medications are tolerated by the body very well, are available in generic form, and even if uninsured, it’s about $10 for a three-month supply.

Q: What is the outlook for people with heart failure?

A: The outlook is very good for almost everybody. In addition to medications, there are options for treating a weak heart, such as a pacemaker or a left ventricular assist device. (There are no devices or invasive treatments for a stiff heart.) Heart transplant is the ultimate and usually final treatment for a weak heart. But the procedure is expensive, and there is a cost for monthly after-transplant medications.

Q: Are there any steps to prevent worsening heart failure?

A: Continue to take your medication even when feeling better. Once prescribed, these medications must be taken for the rest of your life. Exercising, reducing salt in your diet, maintaining a healthy weight, controlling high blood pressure, cholesterol levels and diabetes and taking prescribed medications are key to living the best life possible.

To Learn More | For a referral to a cardiologist, call 1-855-JHM-3939.