Congestive heart failure is perhaps the most challenging of all the conditions a cardiologist has to treat. Successful treatment requires time and patience, two commodities doctors often lack. As a result, patients often are treated and monitored inadequately.
Congestive heart failure is not really a disease, but the name given to symptoms that occur when your heart becomes too weak to pump the amount of blood your body needs. The body tries to compensate by producing a series of structural changes, a process called “remodeling.” This helps in the short run — but over time, it is harmful.
With remodeling, the heart is forced to hold more blood and it becomes enlarged. As a result, some of the blood backs up into the lungs, which causes congestion. When this happens, the body reduces the blood supply flowing to the kidneys, which regulate fluids. This causes excess fluid buildup, resulting in the swelling that is often seen in the legs and ankles of patients with heart failure.
The more fluid buildup there is, the harder the heart has to work — and that weakens it even further. It’s a vicious cycle.
Heart failure usually occurs in people older than 65. People with coronary artery disease, high blood pressure, diabetes, valvular disease, and arrhythmias also are at risk.
If you have heart failure, you need to know your “ejection fraction.” This is the all-important measurement of how well your heart pumps the blood within it. A healthy heart pumps out 50 percent to 70 percent of blood with each beat. If your heart can pump out only 36 percent to 49 percent, that’s below normal. A measurement of 35 percent to 40 percent may indicate heart failure.
If your ejection fraction is below 35 percent, you are in danger of developing a life-threatening irregular heartbeat. Know your ejection fraction and your doctor’s plans for monitoring it.
Your ejection fraction should be measured every six months to one year to determine how well your heart is functioning and whether any changes need to be made in your treatment regimen.
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