About 6.5 million people in the United States have heart failure and about 960,000 are diagnosed for the first time each year, according to the Heart Failure Society of America. Increasing awareness and preventing heart failure could go a long way toward lowering health care costs since it is the primary reason for 12 to 15 million office visits and 6.5 million hospital days each year.
“Identifying and aggressively treating risks, such as high blood pressure and diabetes, before any structural abnormalities develop in the heart is necessary to prevent progression toward heart failure,” says Mark J. Friedman, MD, professor of medicine in the UA College of Medicine – Tucson, Division of Cardiology and the UA Sarver Heart Center’s Thomas and Sabina Sullivan, Sr. Endowed Chair for the Prevention and Treatment of Heart Failure.
Cardiologists use the following classification system approved by the American College of Cardiology to determine the best course of treatment for people who are at risk of progressing from heart disease toward heart failure. “The goal is to avoid progressing because you can never go back to an earlier stage,” says Dr. Friedman.
You don’t have heart failure, but you are at high risk because of high blood pressure, diabetes, obesity or coronary artery disease. “At this stage, many people are treated by their primary care doctors, but people should be evaluated by a cardiologist to make sure they are being treated as aggressively as possible,” recommends Dr. Friedman. “I advise my patients to monitor their weight and blood pressure regularly, eat a heart-healthy Mediterranean diet, participate in aerobic exercise, take their prescribed medications as instructed and get regular follow-up care with their physician,” he adds.
Because of these risks, your heart has been damaged, possibly by a heart attack or blockages in the coronary artery that reduce blood flow. Heart failure symptoms have not developed yet. “The good news is that improved technology now allows many heart conditions to be treated with catheter techniques, such as implant of a coronary artery stent or aortic valve replacement with a balloon expandable prosthetic aortic valve. In the past, these conditions required cardiothoracic surgery,” explains Dr. Friedman.
Your heart is damaged and you are experiencing heart failure symptoms, such as chest pain, shortness of breath, fainting, unable to lie flat, rapid heart rate, rapid weight gain, pain or swelling in the abdomen, legs or ankles, fatigue and chronic coughing. “Many of the medications are the same as for high blood pressure – ace inhibitors, diuretics, Beta blockers – but the goals are different. With heart failure, the goal is to improve function and increase the chance for survival,” says Dr. Friedman. He also recommends a no-salt-added diet and checking weight everyday to watch for aggressive fluid buildup.
Many people benefit from cardiac rehab three times a week where the patient receives supervised exercise, education about their condition, nutrition and lifestyle changes, such as smoking cessation.
You have severe heart failure that requires specialized care. These patients need to be seen and followed by a cardiologist who is specially trained in management of advanced heart failure and cardiac transplant.
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