Many treatments are now available for heart failure

Heart failure has become an "epidemic." But with proper monitoring and care, including self-care, it doesn't have to be a death sentence.

"Patients are surviving their heart attacks and are being treated better for diabetes and hypertension," says Dr. A.G. Kfoury, a cardiologist in the LDS Hospital Heart Failure Prevention and Treatment Program. As more people survive, the number who live with heart failure grows — it's now estimated that 5 million Americans have heart failure and the number will double over the next 30 years.

Kfoury and nurse practitioner Jennifer Connolly will discuss heart failure during the Deseret Morning News/Intermountain Healthcare Hotline Saturday from 10 a.m. to noon.

He says that heart failure is more a syndrome — a collection of symptoms — than a distinct clinical condition and many things can lead to it. The heart muscle weakens and does not pump adequately to circulate blood.

Symptoms include shortness of breath with activity and a dangerous retention of water in the body. Fatigue is common, as well. The pump itself simply isn't working well, he says.

The real news in heart failure is the number and variety of treatments, from medications and use of pacemakers and defibrillators to devices that help the heart pump better to heart transplant, say Connolly and Kfoury.

Among the most effective tools are the things the patient can do to help his or her own heart, including careful monitoring of weight (which balloons with fluid retention), closely following a prescribed diet and salt restrictions and knowing when things aren't right and professional care is needed.

"Those all help you stay out of the hospital," Kfoury says.

Heart transplants have improved greatly over the years, and there is now a 50-50 chance that a transplant recipient will be alive 13 years later. So have mechanical circulation support devices. What's limiting there, he says, is not the procedure but the longevity of the mechanical pump, which can wear out. As they last longer, patients live longer. New-generation left-assist ventricular devices with no touching parts seem to promise great advances, but they're still in testing phases.

The other exciting thing on the horizon is the use of stem-cell-based therapies and genetic manipulation to counter heart diseases early to prevent damage and progression.

Unfortunately, it's unlikely those therapies will be available for several years.