Trio to tackle queries related to heart health

Heart failure is becoming an epidemic in the United States, with more than 5 million Americans already affected. That number is expected to more than double over the next three decades.

It's the most common hospital discharge diagnosis in those older than 65 — and someone with that diagnosis is 6 to 9 times more likely to die from heart trouble than the general population.

"The burden is not only a health one but economic," said Dr. A.G. Kfoury, cardiologist and medical director of the cardiac transplant program at LDS Hospital. About $30 billion is spent on heart failure each year nationwide.

Kfoury, advanced practice registered nurse Judith Sampson and Amy Whipple, clinical cardiac transplant nurse coordinator, both from the hospital's heart failure program, will be featured on Saturday's Deseret Morning News/Intermountain Health Care Hotline. From 10 a.m. to noon, they will take phoned-in questions about heart failure, prevention, treatments and how to recognize symptoms.

The human and economic toll have led not only to better treatments but to attempts to understand what can be done to prevent it and how to recognize it early, Kfoury said.

Common causes of heart failure, which basically means the heart muscle is too weak to pump efficiently, include coronary artery disease, hypertension, diabetes and damage from a heart attack. There are also cases where the exact cause simply isn't known, but it is believed that many of those are sparked by an unknown virus. There are genetic cases, too.

In the past 10 years to 15 years, Kfoury said, a number of medications have been developed to treat heart failure. The cornerstone drugs — "drugs we know without question save lives," he said — are ACE inhibitors and beta blockers.

There are also several new classes of medications that have reached the market recently, "so it's very good news for patients. We have many options for medical management of the disease," he said. "But it has also made the treatment a little trickier."

The goal of treatment is to relieve the symptoms of congestion that go with heart failure — shortness of breath, inability to exercise and difficulty breathing when lying down — to reduce the heart's workload and to try to make the heart pump a little harder.

Diuretics are typically used to relieve the congestion. One hallmark of heart failure is water retention, either in the ankles or around the belly, Sampson said.

One effect of beta blockers and ACE inhibitors is to reduce blood pressure so the heart needn't work as hard to get blood out to the body.