WELCOME
22
Cardiologist John P. Everett, M.D.
Q
:
My doctor told me I have congestive
heart failure. What do I do now?
A
:
When a doctor tells a patient that he or she
has congestive heart failure (CHF) oftentimes
that patient assumes it is due to a weak heart resulting
from a heart attack or some other condition that at-
tacked or weakened the heart muscle. Sadly, once they
have a diagnosis of CHF, many people also assume
that their life is nearly over. Some believe they’ll be
too weak to do anything during the time they have left.
Both of these assumptions are frequently wrong.
A weak heart, which contracts poorly, is the most
common form of CHF in younger
patients. However, for elderly
patients diagnosed with CHF,
50 percent of them have
normal or even super-
normal squeezing function
of their hearts. The heart
failure is not due to the
squeeze function
being weak, but
TAKE CHARGE OF YOUR HEALTH
John P. Everett, M.D., is a cardiologist with
Heart Clinics Northwest, a division of Kootenai
Health. To make an appointment with Dr. Everett,
contact their Spokane office at
(509) 489-7504
, or for
more information you can contact the Coeur d’Alene
office at
(208) 676-9913
.
ASK THE EXPERT
it is due to the heart being stiff and unable to relax. A
well-functioning heart has to quickly relax in order to
fill up with blood for the next cardiac cycle.
When the heart is stiff, it is like a brand-new party
balloon that was really hard to blow up the very first
time it was used. Just as it was difficult to fill the
brand-new party balloon with air, it is difficult to fill
the stiff heart with blood. Unlike a party balloon, a stiff
heart does not loosen up over time. Eventually, the
stiffness in the heart becomes so bad that the blood
will back up behind the heart into the lungs and cause
congestive heart failure.
Figuring out which type of heart failure a patient has
is difficult. Usually, a patient with CHF gets an ultra-
sound of his or her heart, which helps determine what
type of heart failure is present. An echocardiogram will
also help determine the next steps in the diagnosis of
what caused the CHF and the best medical therapy to
treat it.
Regardless of whether heart failure is due to a heart
being weak and unable to squeeze properly, or the CHF
is due to the heart being stiff, the treatment goals are
the same: Patients need to be compliant with medica-
tions, limit their fluid and sodium intake, and keep
track of their weight.
Total fluid consumption of any kind (not just wa-
ter) should be limited to 8 to 10 cups per day. Salt
consumption should be limited to less than 2,000 mil-
ligrams, and patients should weigh themselves several
days per week. An abrupt weight gain of 2 or 3 pounds
is often a sign of congestive heart failure developing,
and if it is treated early you may avoid hospitalization.
Restricting fluid consumption will help prevent
swelling and shortness of breath at night. Properly
prescribed medications can help restore heart func-
tion if heart function is weak and may potentially help
improve the stiffness in CHF patients with normal
squeeze function. With medication compliance, watch-
ing fluid and salt intake, and looking for early signs of
fluid retention by using a scale at least several days per
week, most patients with congestive heart failure can
live a long time with good quality of life.
