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GLENN ELLIS' STRATEGIES FOR WELL BEING: Understanding Heart Failure

(March 16, 2006)
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    The term "heart failure" sounds pretty scary — as if the heart has "failed" or stopped beating. Actually, the term means that the heart isn't pumping as well as it should be. Usually the heart has been weakened over time by an underlying problem, such as clogged arteries, high blood pressure, a defect in its muscular walls or valves, or some other medical condition.

    Your body depends on the heart's pumping action to deliver oxygen- and nutrient-rich blood. That supplies all the body's cells with nourishment so the body can function normally. In people with heart failure, the body doesn't get enough blood. As a result, they tend to feel weak, fatigued or short of breath. Everyday activities such as walking, climbing stairs, carrying groceries and doing yard work can become quite difficult.

    About 5 million Americans are living with this condition, with 550,000 new cases diagnosed each year. Congestive heart failure affects people of all ages. However, it's more common among older people. Therefore, as the older population grows over the next few decades, so will the number of people living with congestive heart failure or caring for a loved one who has it.

     All of us lose some blood-pumping ability in our hearts as we age. But the more serious loss that we call heart failure results from the added stress of health conditions that either damage the heart or make it work too hard. In fact, all of the behaviors that you probably associate with heart disease or heart attack — such as smoking, being overweight, eating foods high in fat and cholesterol, and not exercising — can also cause heart failure. In some cases, though, behavior has absolutely nothing to do with heart failure. For instance, some people who develop heart failure were born with structural heart defects, while in others a virus damaged the heart muscle.

    If you have heart failure, chances are you have (or had) one or more of the following health conditions. Some of these can be present without you even knowing it:

Coronary artery disease
    When cholesterol and fatty deposits build up in the heart's arteries, less blood reaches the heart muscle. This damages the muscle, and the healthy heart tissue that remains has to work harder.

Past heart attacks (myocardial infarction)
    A heart attack occurs when an artery that supplies blood to the heart gets blocked. The loss of oxygen and nutrients damages the heart's muscle tissue — part of it essentially "dies." The remaining healthy tissue has to pump even harder to keep up.

High blood pressure (hypertension)
    Uncontrolled high blood pressure increases a person's risk of developing heart failure by two to three times. When pressure in the blood vessels is too high, the heart has to pump harder than normal to keep the blood circulating. This takes a toll on the heart, and over time the chambers get larger and weaker.

Abnormal heart valves
    Heart valve problems can result from disease, infection (endocarditis) or a defect present at birth. When the valves don't open or close completely during each heartbeat, the heart muscle has to pump harder to keep the blood moving. If the workload becomes too great, heart failure results.

    Heart muscle disease (cardiomyopathy) or inflammation (myocarditis)
Any damage to the heart muscle — whether because of drug or alcohol use, viral infections or unknown reasons — increases the risk of heart failure.

Heart defects present at birth (congenital heart disease)
    If the heart and its chambers don't form correctly, the healthy parts have to work harder to make up for it.

Severe lung disease
    When the lungs don't work properly, the heart has to work harder to get available oxygen to the rest of the body.

Diabetes
    Diabetes puts extra strain on the heart, increasing risk for heart failure. People with diabetes also tend to be overweight and have high blood pressure and high cholesterol — all of which make the heart work harder.

   
    Typically these conditions cause the "wear and tear" that leads to heart failure. A combination of any of the above factors dramatically increases risk.

    Less commonly, an otherwise healthy heart may become temporarily unable to keep up with the body's needs. This can happen in people who have:
 
Low red blood cell count (severe anemia)
    When there aren't enough red blood cells to carry oxygen, the heart tries to move the small number of cells at a faster heart rate. It can become overtaxed from the effort.

An overactive thyroid gland (hyperthyroidism)
    This condition causes the body to work at a faster pace, and the heart can be overworked trying to keep up.

Abnormal heart rhythm (arrhythmia or dysrhythmia)
    When the heart beats too fast, too slow or irregularly, it may not be able to pump enough blood to meet all the body's needs.

    In these cases, the person may experience heart failure symptoms until the underlying problem is identified and treated.

    Heart failure is a serious condition, and there's usually no cure. But we deliberately use the phrase "living with heart failure" because that's what people who have it learn to do. In most cases, heart failure can be managed by taking medications and making healthy changes in habits such as diet and exercise. The help of families and friends can be beneficial, too. These changes are often the key to leading a full, enjoyable life.
 
Remember, I’m not a doctor. I just sound like one.
TAKE GOOD CARE OF YOURSELF AND LIVE THE BEST LIFE POSSIBLE!
 
 
Glenn Ellis, author of Which Doctor?, is a syndicated health columnist and radio commentator who lectures around the country on health issues relevant to the African-American community.
E-mail me at glenn@glennellis.com
For good health information, visit: www.glennellis.com
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