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Most people who receive a heart failure diagnosis can manage the disease and continue enjoying their lives, says says Nina Asrani, M.D., a cardiologist with Texas Health Heart & Vascular Specialists, a Texas Health Physicians Group practice in Fort Worth.
“People hear the words ‘heart failure’ and they think the worst,” she says. “Sometimes the best thing to do involves taking a deep breath and a step back. It’s so important not to lose hope and stay motivated to do what you can do.”
When detected early, heart failure is often treatable with medication and lifestyle changes, Asrani says — a promising prospect for the 1 million people each year who are newly diagnosed with heart failure.
What is Heart Failure?
In heart failure, the heart muscle does not pump blood efficiently enough to meet the body’s needs. It can involve the left ventricle, right ventricle or both sides of the heart. However, heart failure often starts with the left ventricle, which is the heart’s main pumping chamber.
This pumping malfunction causes several common symptoms, including unusual fatigue, shortness of breath during exertion or while sleeping, rapid or irregular heartbeats, and swelling of ankles or legs due to fluid retention (edema). These symptoms all provide doctors with clues and may require more evaluation to determine a heart failure diagnosis.
Heart failure can be diagnosed in several ways:
- History and Physical exam that includes medical history review, blood pressure screening, weight measurement, and listening to the heart and lungs.
- Lab work, which will likely include blood tests.
- Chest X-ray that may reveal an enlarged heart or congested lungs.
- Electrocardiogram (ECG) to determine whether there has been damage to the heart or if the heart rhythm is abnormal.
- Echocardiogram (echo) to evaluate the function of the heart muscle and valves with ultrasound
- Stress test to determine how the heart responds when put under stress and assess for underlying heart disease
“Even though no one wants a heart failure diagnosis, sometimes having a diagnosis is a relief in the sense that there’s a reason why someone hasn’t been feeling well,” Asrani says. “I love that I get to go on this diagnostic journey with patients. There’s a lot we can do to help them have a higher quality of life.”
Care Options for Heart Failure
Damage to the heart caused by heart failure may improve, and prognosis often depends on the cause. Managing heart failure through a variety of treatment options is important, Asrani says. Generally, treatment focuses on reducing symptoms — often with medication — which Asrani says helps control the condition in the “vast majority of patients.” Some medications actually prolong life in heart failure patients, so they are critically important.
For others, specialized treatment depends on the disease’s progression. One procedure is the implanting of a defibrillator, which is similar to a pacemaker. Asrani calls it “an insurance policy” that can monitor and correct dangerous heart rhythms. For those with advanced heart failure, therapies include heart valve surgery; implanting an LVAD (left ventricular assist device), which is a mechanical pump that helps maintain the pumping ability of the heart; or a heart transplant, usually only done when other options fail.
Asrani stresses that symptoms and outcomes vary, so a heart failure diagnosis means different things for each person.
“It’s not just a recipe where you follow the plan and you know what you’re going to end up with,” she says. “What makes cardiology interesting is taking a look at all the variables and personalizing treatment for each patient.”
Family History and Heart Failure
With one in five people expected to have heart failure during their lifetime, more research is needed to pinpoint at-risk populations. Researchers know genetics plays an important role in the onset of the disease. That’s why doctors often ask about instances of sudden cardiac death and other heart failure symptoms within a patient’s family. A patient’s medical history also may help uncover genetic causes of heart failure and identify other family members who may be at risk.
However, knowing which heart failure syndromes are acquired and which are inherited isn’t always easy to determine, Asrani says. One reason is because multiple conditions may be present, making it difficult to determine the root cause. For instance, the heart muscle may have been damaged because of infection or alcohol or drug abuse. Disorders like diabetes, hypertension, obesity and kidney disease also could stress the heart. Since heart disease risk increases with age, several age-related conditions may play a role in overall health, Asrani says.
Regardless of the cause, Asrani encourages a healthy lifestyle for everyone to either help delay heart failure or to prolong life after diagnosis. These lifestyle choices include getting regular checkups, managing blood pressure, getting enough sleep and managing stress. She also notes the importance of following a heart-healthy diet and engaging in regular physical activity.
Asrani says she can empathize with the fear and anxiety brought on by visiting a cardiologist. But she advises patients to seek reliable information about their condition and feel comfortable communicating with their doctors.
When she was in medical school, Asrani’s father was diagnosed with heart disease. That’s a big reason why she picked cardiology as her specialty.
Now, she uses her expertise to support patients, caregivers and families through her practice and by volunteering for organizations like the American Heart Association.
“Getting out into the community lets me reach so many more people who I otherwise wouldn’t get to see in my office,” Asrani says. “This lets me educate more people about the importance of taking care of their hearts, and it lets me give them hope that there’s so much cardiologists can do to help them.”
Texas Health Physicians Group providers are employed by Texas Health Physicians Group and are not employees or agents of Texas Health Resources hospitals.
Doctors on the medical staffs practice independently and are not employees or agents of Texas Health hospitals or Texas Health Resources.