Don't Give In To Heart Failure
This column is the third in a series aimed at raising awareness on heart health during February, which is National Heart Month.
What are you doing to take care of your heart?
Every second of every day of your life, your heart is taking care of you, keeping your body supplied with a steady flow of oxygen-carrying blood. If your body is a machine, then your heart is the engine that powers every system and organ.
How we live our lives and the care we take of our bodies are critical to the health of our hearts. If we don’t take care of our bodies, our hearts feel the effects. Over time, that can prevent our hearts from functioning properly. This is called heart failure, and ultimately it is a life-threatening condition. Fortunately, it is largely treatable and even preventable, if you take the right precautions.
Your heart is a wonderfully sophisticated organ that does two things to accomplish its job: Squeeze and relax. The squeezing motion of the heart is called “systole” (sys-toll-ee). The relaxing motion is called “diastole” (die-as-tol-e). During systole, your heart squeezes in sequence to pump blood throughout your body. During diastole, it relaxes momentarily, which allows it to fill up with blood in time for the next squeeze.
When your heart can’t squeeze correctly, this is called systolic heart failure. When the heart can’t relax properly, this is called diastolic heart failure. They have different causes and effects, but both are serious problems because your whole body feels the effects when your heart isn’t working properly.
It’s also important to note that heart failure happens over time, not overnight. Because your heart never takes a break, it will keep trying to work through the problems. If this happens for a long enough time, the actual shape of the heart can change, which can negatively affect the way it functions and can cause serious, even deadly, problems.
Systolic Heart Failure
Systolic heart failure happens when the lower section of your heart, the ventricles, cannot pump effectively. This causes the heart to enlarge and weaken. This type of heart failure is most commonly caused by heart attacks, but also can be caused by abuse of drugs like methamphetamine or excessive drinking of alcohol.
Of the two heart failure types, systolic failure is the most well-known. Treatment of this type of heart failure can be traced back to the 1700s, with the use of a plant called foxglove (also known as digitalis). Today, we use a number of medications, which can help strengthen heart muscle and reverse the effects of systolic heart failure. We also have some surgical therapies such as mechanical assistance devices and specially designed pacemakers.
The news about systolic heart failure is mostly good. We continue to do a better job at treating it and are seeing fewer readmissions to the hospital. In combination with lifestyle modifications like improved diet, reduced salt intake and close adherence to doctors’ orders, patients with this diagnosis are living longer, healthier lives.
Diastolic Heart Failure
The other side of this coin is diastolic heart failure, which is less understood and more difficult to treat. Diastolic heart failure means the heart does not relax between beats, which prevents it from filling up with enough blood to pump on the next squeeze. What makes diastolic heart failure so dangerous is that we do not yet have really good drugs to treat it and improve survival.
When diastolic heart failure occurs, this can cause the upper chambers of the heart, or atria (each one is called an atrium), to enlarge. When an atrium enlarges, it can cause backup of fluid into the lungs, which causes breathing problems, especially at night. It can also cause very irregular heartbeats called atrial fibrillation. Atrial fibrillation is particularly dangerous, because it can cause formation of blood clots, which can then travel elsewhere in the body, such as the brain where they can cause strokes.
The risk factors for diastolic heart failure are especially troublesome because they are so common in this region: Diabetes, smoking, obesity and high blood pressure. A closely related problem is sleep apnea, which is a breathing disorder while you sleep. Over time, sleep apnea leads to high blood pressure, which is why it’s so closely tied to atrial fibrillation and stroke. This is why people who snore heavily and who experience pauses or gasps for breath in their sleep need to see a pulmonologist or sleep specialist as soon as possible.
Treatment of diastolic heart failure is not as advanced as for systolic heart failure. The best way to stop diastolic heart failure is to prevent it, or to limit it before it becomes advanced. Prevention or correction can be accomplished through weight control and management of blood pressure, diabetes or quitting smoking.
What You Can Do
For either type of heart failure, it’s important to minimize your risks. If you smoke, it’s important to quit. If you have high blood pressure, high cholesterol or diabetes, you need to manage these conditions. If you are overweight, shedding some pounds is one of the best ways to improve your heart health.
Talk to your primary care provider, or if you don’t have one, make an appointment. Not only do they do the simple, non-invasive tests that can easily detect the beginnings of heart problems (blood pressure check, diabetes screening and blood work), but they can give you resources and advice to help you. They can also refer you to a specialist like me so you can get the care you need.
Make it a priority to take care of your body. Your heart will thank you for it.
Dr. Peter Gregor is a board certified cardiologist with Owensboro Health’s One Health medical group. For more information or to request an appointment with Dr. Gregor, call 844-44-MY-ONE (844-446-9663).