From Deseret News archives:

Heart failure now treatable

To avoid disease, nurse says 'know your numbers'

Published: Friday, Feb. 8, 2008 12:34 a.m. MST
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Heart failure used to be a death sentence. Now with tools like medication, lifestyle modification and mechanical devices, it often can be managed as a chronic disease. With a heart transplant, it can be cured.

Heart failure is the subject of the Deseret Morning News/Intermountain Healthcare Hotline Saturday. People who call 800-925-8177 can ask questions of Dr. Patrick Fisher, a cardiologist who specializes in the condition, and Kismet Rasmusson, a family nurse practitioner, both of Intermountain Medical Center, from 10 a.m. to noon.

Rasmusson says that while it's more common in the elderly, heart failure can happen at any age. Causes in adults include coronary artery disease or heart attack, high blood pressure, heart valve disease or alcohol or drug abuse. Often, the cause is unknown. For children, it's often congenital or from muscle disease.

A failing heart doesn't pump blood well. The body tries to compensate but makes things worse. The heart beats too fast and becomes enlarged and even less efficient. Fluid accumulates in tissues and symptoms appear. Shortness of breath, a persistent cough, the need to sleep propped on pillows, decreased ability to be active, weight gain, abdominal bloating or swollen legs should prompt a visit to a health-care provider. It could be heart failure.

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Experts hope to find patients early, when they have risk factors, rather than symptoms. High blood pressure, diabetes, obesity, sedentary lifestyle and a family history of cardiomyopathy are among risk factors.

Lifestyle changes, like diet and exercise, better control of diabetes and high blood pressure, can limit the risk. But though it sounds simple, Fisher says some find it quite difficult to make needed changes.

It's more common to see patients when they have clear symptoms. At advanced stages, a heart transplant or mechanical heart assistance may be needed. Those not eligible for devices or transplants may be given palliative care and hospice services.

Rasmusson tells people to "know your numbers:" blood pressure, blood sugar and cholesterol profile. Waist circumference is tied to risk of heart disease. Smoking poses a huge risk.

Primary care providers should know the stages of heart failure, risk factors and how to manage the disease because they provide most of the care. And they need to know when to refer patients for more advanced therapies.


Tomorrow: Treating heart failure


E-mail: lois@desnews.com

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Dr. Patrick Fisher, a cardiologist with the Intermountain Medical Center, specializes in diagnosing and treating heart failure.

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