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Ask An Expert: The Basics of Heart Failure

Ask An Expert: The Basics of Heart Failure

With Sarasota Memorial Cardiologist Thomas Archer, MD

It’s estimated that nearly 6.5 million adults in the United States are living with heart failure. And it contributes to nearly 400,000 deaths every year. But as widespread as this condition is, heart failure is also very preventable and highly treatable.

We spoke with SMH Cardiologist Thomas Archer, MD, to learn more about the fundamentals of heart failure.

What is heart failure?

Heart failure is defined as the heart not being able to keep up with the oxygen demands of the body, whether at rest or with activity.

What are the most common symptoms of heart failure?

The most common symptoms are shortness of breath, fatigue, and weakness, over and above what would be considered normal for the activity. Also, having difficulty lying flat at night. Patients may find themselves short of breath, waking up coughing in the middle of the night. Another sign of heart failure could be swelling in the legs. There are lots of causes of swelling, but if it shows up without any other clear explanation, that's a concern.

How common is heart failure?

It's very common. More common than people realize, particularly as the population ages. They're projecting by 2030 there will be more than 8 million patients with heart failure in the United States.

How is heart failure diagnosed?

It's a clinical diagnosis. There's not one test that confirms it. First and foremost, it's looking at signs and symptoms and conducting a physical examination. Then, probably the single most helpful test for a cardiologist is an ultrasound of your heart, or what's referred to as an echocardiogram. All of that together helps us know exactly what is happening and to define the type of heart failure.

Are there different types of heart failure?

There are primarily two types of heart failure. One is where the heart is weak; it's not able to keep up. As a result, blood backs up and causes congestion in the lungs. The other type of heart failure is where the heart is stiff, and that's more common in people that are elderly. Again, fluid backs up and causes symptoms. We refer to these two types, heart muscle weakness and heart muscle stiffness, as systolic heart failure and diastolic heart failure.

What are the most common treatments for heart failure?

The first thing is to treat the symptoms, meaning reducing the congestion in the lungs. So diuretics are probably what people benefit from the most early on, particularly in the hospital.

To address the heart failure process itself, there are four medications that we use—beta blockers, an aldosterone antagonist, an SGLT2 inhibitor, and an ace inhibitor. We call these the Core Four. Those four medicines really help to counteract the heart failure process, such as by controlling blood pressure. And people don't realize, but the kidneys play a big role, releasing certain chemicals that progress heart failure. By blocking those chemicals, oftentimes patients do much better.

And I like to spend a lot of time with my patients to make them understand why we're using all these medicines, because nobody likes to take medicines.

Reduce Your Risk!

Worried about your heart health? Following these simple steps for a healthier lifestyle can go a long way in preventing heart failure.

  • No smoking (this includes vaping)
  • Exercise daily (just 20 minutes a day works wonders!)
  • Eat a balanced diet (cut down on the salt and don’t forget your fruits and veggies!)
  • Moderate alcohol intake

How do you help patients through those concerns?

Sometimes it takes several office visits to walk people through it and help them to understand the importance of the medicines. And that’s OK. They all have a different action; they all have different potential side effects. It’s a lot to take in.

What about someone who has more advanced heart failure?

That’s always an unfortunate situation, and always a challenge. If they get the right care, many do very well. But we have to look at more advanced therapies. Sometimes, that might be a referral to a center that can provide a transplant.

Can heart failure be cured or does it require lifelong treatment?

I would like to say that we could cure it. There are patients who respond tremendously to treatment, but as much as I'd like to say yes, we really feel that there should be at least a baseline of certain medications to keep the heart failure from coming back.

Hear more from Dr. Archer on heart failure and advancements in the treatment of heart failure in his recent appearance on SMH Healthcasts.

Advancements in the Treatment of Heart Failure | HealthCasts Season 6, Episode 4 from SMHCS on Vimeo.

Learn More

To learn more about cardiac services at Sarasota Memorial, click here.

To request an appointment with Dr. Archer, click here.

Posted: Mar 19, 2024,
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