February 23, 2019

Don’t Fail Your Heart – What You Need to Know about CHF


This year, close to 1 million Americans will be diagnosed with congestive heart failure (CHF). Unlike a heart attack where the heart suddenly stops working, CHF is a chronic health condition that builds up when the heart doesn’t pump enough blood and oxygen to the body. The shortness of breath, persistent cough, fluid build-up, and fatigue that patients experience as a result of poor circulation is what cardiologist Dr. Hana Smith describes as CHF.

You may be surprised to learn that the heart’s failure to pump properly is not the most common cause of CHF. The majority of CHF patients seen by Dr. Smith and the cardiology team at Guthrie Cortland Medical Center have symptoms related to heart muscle relaxation. “Every time your heart contracts, it also must relax to accumulate blood for the next pumping action. As we age, the heart muscle, like other muscles, stiffens, and this alters the relaxation pattern. Cardiologists call this diastolic dysfunction,” explains Dr. Smith.

While aging is a factor in developing CHF – it is the number one cause of hospitalization in those over age 65 – many people who develop CHF have other heart-related issues. High blood pressure, diabetes, smoking, and diets high in fat and sodium and low in fiber are “additional insults to a weakened heart” that Dr. Smith says may result in acute CHF.

“There are several less frequent but also important causes of CHF, such as narrowed or leaky valves, true systolic (failure to pump) heart muscle dysfunction, rapid heart rates for prolonged periods, and other rare conditions,” Dr. Smith says.

Cardiologists use laboratory tests, imaging, and electrocardiograms (ECG) to diagnose CHF, but Dr. Smith says a patient history and general physical exam are no less important in determining the root cause of a patient’s symptoms. “Patients may already have several issues with their heart as well as other illnesses, and it’s detective work to find out what threw them off balance and made the symptoms worse,” she says.

Treatment, says Dr. Smith, “needs to be focused on the underlying cause of CHF. This may be as simple as controlling blood pressure and changing up diet or as complicated as open-heart surgery to unclog blocked arteries.” CHF prevention includes an overall heart-healthy lifestyle including a low-salt, high-fiber diet, regular exercise, no smoking, and weight control.

Because CHF symptoms can be mistaken for many other health conditions, Dr. Smith says she and her Guthrie Cortland colleagues tell their CHF patients to keep an eye out for rapid weight gain, leg swelling, new or worsening breathing issues, waking at night short of breath, or having difficulties when laying down in bed. She encourages her patients to call during office hours even when issues don’t appear to be urgent.

“We often can prevent a hospital admission with a quick in-office visit and altering their medication or administering certain medications right in the office,” she says. “We would never encourage patients to delay care.”

Dr. Smith is available to consult on your heart issues with a referral from your primary care physician. For questions or to schedule an appointment, call Guthrie Cortland Cardiology at 607-756-3561. Click here to visit the Cardiac and Vascular Center webpage.

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