The call came in early October 2016. Dave Tough had been admitted to a hospital in Nashville for congestive heart failure. He’d turned 40 only months before – it didn’t seem possible.
By all accounts, Dave was in good health. He ran and worked out at a gym on a regular basis, didn’t smoke and drank alcohol in moderation. But he was also a self-described “workaholic.” As an associate professor of audio engineering at Belmont University, composer and a working musician, Dave rarely let himself rest. Plus, he’d recently gone through a divorce. Was it possible that stress caused his heart to fail?
When Dave checked into the emergency room, his heart was beating wildly. It wasn’t unusual for him to have a fast heartbeat, he’d been feeling anxious for months. But for the two weeks prior to going to the ER he’d also had shortness of breath, he was sweating and he had weight that he couldn’t seem to shed.
The signs were there
Dave was experiencing the classic symptoms of heart failure, but he didn’t believe it. He’d survived non-Hodgkin lymphoma nine years earlier and after chemotherapy, Dave wore a heart monitor for a week. The results showed his heart was healthy.
Providence cardiologist Lori Tam, M.D., said symptoms of heart failure, like the ones Dave experienced, can sneak up. Maybe a 30-minute run on the treadmill starts to feel like a marathon, or lying down to sleep becomes difficult because of shortness of breath.
Symptoms of heart failure can sneak up. Maybe a 30-minute run on the treadmill starts to feel like a marathon, or lying down to sleep becomes difficult because of shortness of breath.
It’s easy to ignore symptoms that cause gradual changes in the body, but that’s a mistake. “It’s important to be aware,” said Dr. Tam.
What is heart failure?
Congestive heart failure is not cardiac arrest, which is when the heart malfunctions and stops beating. Dave’s heart was beating quickly but it wasn’t pumping well enough to keep up with his body's demand for oxygen-rich blood. A normal heart pumps 50% to 70% of the total amount of blood in the left ventricle with each heartbeat.
Dave’s heart was only pumping 10% to 15% of the normal rate. His heart was severely damaged and irreparable. He needed a left ventricular assist device, or LVAD, to help keep his heart pumping, but that would be a temporary fix. For the long-term, Dave needed a new heart.
The heart can be damaged
There are many ways a heart can be damaged. In some cases, genetics cause abnormal scar tissue in the heart, and some viruses can have a similar effect. Hypothyroidism can cause a slow heart rate, a rise in cholesterol and an increase in fluid around the heart.
Unhealthy lifestyle choices also have a long-lasting effect on the heart. Too much alcohol, smoking and illicit drug use can cause damage to the heart and arteries. Lack of exercise, obesity and an unhealthy diet–one high in saturated fats, trans fat and cholesterol–have been linked to heart disease, as well.
It’s not clear what caused Dave’s heart failure. He wonders if his busy lifestyle contributed, or maybe he had broken heart syndrome.
Broken heart syndrome is often triggered by severe emotional distress that temporarily stuns the heart and causes decreased heart pumping function and congestive heart failure.
“Broken heart syndrome is also known as takotsubo cardiomyopathy or stress cardiomyopathy and is usually a passing form of congestive heart failure,” said Dr. Tam. “It’s often triggered by severe emotional distress that temporarily stuns the heart and causes decreased heart pumping function and congestive heart failure. But it tends to have a good prognosis for complete recovery – especially if treated with appropriate medications.”
Whatever the cause, Dave believes he brushed aside the signs for too long.
A happy heart
To say Dave is lucky is an understatement. Within a month of being admitted to the hospital, he received a heart transplant. Two weeks later, he was taking walks around his neighborhood.
He feels like a new man. He can breathe deep and walk up the stairs in his house without stopping. He says he’s calmer—more “Zen-like.” Perhaps it’s his new life perspective, or maybe it’s because his heart isn’t racing anymore.
Don’t ignore the signs
“If you notice a difference in how much you can do, shortness of breath, have swelling or unexpected weight gain, make sure you see a provider early,” said Dr. Tam.
Everyone should try to maintain a healthy lifestyle with at least 30 minutes of cardiovascular exercise, five days per week. “Eat a well-balanced diet and especially avoid excessive sodium. It can cause congestive heart failure patients to retain fluid and worsen their symptoms,” she said.
The most common signs of heart failure are:
- Extreme fatigue
- Decreased tolerance for exercise
- Shortness of breath, especially while lying down
- Swelling in legs and/or torso
- Unexpected weight gain
Find a doctor
If you feel unwell and would like to consult your doctor, Providence Express Care Virtual connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a doctor, you can use our provider directory or search for one in your area.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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