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A Patient's Guide to Heart Surgery

What is Heart Failure?

Heart failure is a chronic syndrome that may present with the following signs and symptoms:

  • Shortness of breath, especially with activity (dyspnea)
  • Nighttime shortness of breath (orthopnea, paroxysmal nocturnal dyspnea)
  • Swelling of the feet, ankles, legs, hands, and abdomen from fluid buildup (edema)
  • Weight gain
  • Fatigue
  • Lightheadedness or fainting
  • Fluttering of the heart (palpitations)

Who has heart failure?

Approximately 4.9 million Americans, or 1-2% of the entire US population, have heart failure (HF). Each year, there are about 400,000-700,000 newly diagnosed cases of HF and nearly one million hospitalizations due to this illness.

It can affect the young, middle-aged, or elderly. Among the elderly, HF is the number one cause for hospital admissions.

What causes heart failure?

Among the many causes of heart failure, the more common ones are:

  • Heart attack
  • High blood pressure
  • Disease of the heart muscle (cardiomyopathy) from a virus, alcohol, drugs, etc.
  • Diabetes
  • Diseases of the heart valves
  • Diseases of the sack around the heart (the pericardium)
  • Continuous fast heart rates

Are there different types of heart failure?

Two types of heart dysfunction can lead to heart failure: "systolic" and "diastolic". They may be present together or separately.

"Systolic" heart dysfunction occurs when the heart is weak and enlarged. It is unable to pump enough blood to supply the needed amounts of oxygen and nutrients to the rest of the body. The walls of the left heart chamber are thinned and the chamber is dilated.

"Diastolic" heart dysfunction occurs when the heart becomes stiff and unable to relax such that the pressure in the heart is elevated and transmitted to the lungs. The walls of the heart are thickened and the size of the left heart chamber is normal to reduced.

Systolic cardiac dysfunction is more common (present in 70% of heart failure cases) compared to diastolic dysfunction as a cause of heart failure.

What are the goals of therapy?

Fortunately, we live in an era in which significant advances have been made in the understanding of the progression of heart failure. Effective therapies continue to be developed to:

  • Relieve symptoms and improve quality of life
  • Slow disease progression
  • Reduce the need for emergency room visits and hospitalization
  • Help people live longer

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