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(Compiled and reviewed by the Regional Cardiac Education Committee, Education Committee, clinical staff and physicians in Providence Health & Services' Portland Service Area.)
Like so many diagnoses, the words pack an emotional wallop.
Congestive heart failure.
While the phrase may sound like a death sentence, the good news is that many people whose hearts are considered to be failing can make a virtually complete recovery.
“It is a scary term,” agrees Scott Werden, D.O., a cardiology specialist who practices in Olympia and Shelton, Washington, with Providence Medical Group Cardiology Associates. But, he said, “You can have an absolutely complete recovery from heart failure.”
Dr. Werden says full recovery depends on a variety of things, such as how well a patient responds to medication. A minority of people with congestive heart failure require surgery, and some will never enjoy the high quality of life they did before their hearts failed. But many others will return to very nearly normal life and levels of activity, he says.
The phrase “congestive heart failure” is not a pronouncement of imminent death, but a clinical term to describe poor functioning of the mechanics of the heart, Dr. Werden says. As the American College of Cardiology puts it, it is “a problem with how your heart pumps.”
What it means
Heart “failure” occurs when the heart becomes unable to pump or accommodate a flow of blood sufficient to recirculate to the body. The two types of heart failure — systolic and diastolic — describe whether the heart’s main chamber is too weak or too stiff to keep up with the task.
People whose hearts are failing often struggle to draw a breath when doing the simplest sort of exercise, such as walking to the mailbox. They also may feel weak, extremely fatigued, or suffer from swollen legs or joints.
Sometimes heart failure is caused by an acute, dramatic event, such as a blocked artery. Often it occurs gradually, and it is caused by a combination of factors such as elevated blood pressure, carrying too much weight, diabetes, kidney problems and drinking too much alcohol.
Heart failure is a very common diagnosis, affecting about 5.7 million Americans a year, according to the National Heart, Lung and Blood Institute. It strikes men and women, old and young, and is the leading cause of hospitalization for people 65 and older, leading to more than $30 billion in medical costs each year.
Survivability and recovery
Heart failure is a leading or contributing cause of death for one in nine Americans, according to the U.S. Centers for Disease Control and Prevention. About half the people who are diagnosed with heart failure die within five years.
Dr. Werden says that proportion largely reflects those who don’t take medications or make other adjustments after their diagnoses. For many of the rest, life can return virtually to normal without dramatic intervention, such as surgically inserting a heart stent or a pump.
Recently updated guidelines for the clinical treatment of heart failure describe an array of medications that providers can prescribe to help patients return to a normal life. They include enzyme inhibitors, beta blockers and diuretics, or water pills, the combination of which may be determined by the severity of the heart failure and the patient’s response to treatment. Generally, as the dosages are increased, so does a patient’s survivability, says Dr. Werden.
In addition, health care providers usually recommend lifestyle changes, especially getting more exercise. Dr. Werden advises patients to limit their intake of salt to less than two grams a day — about four-tenths of a teaspoon. And he encourages them to check their weight daily, adjusting the volume of diuretics to match.
Many of his patients start to feel significantly better as soon as three days after treatment begins, Dr. Werden says. And after three months, he says, “they are closer to their baseline.”
If you’re feeling weak, extremely tired, experiencing swollen legs or having trouble breathing, see your provider as soon as possible. You can find a Providence provider near you in our online directory.
California: Providence Saint John’s Health Center
Montana: International Heart Institute
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.