Heart Failure: A Growing, Deadlier Condition That Needs More Attention

The condition known as “heart failure” ismisunderstood and often under-diagnosed. Much of the confusion comes from thename. Heart failure does not mean the heart stops. It means the heart is tooweak to pump blood through the body as it normally should. The heart keepsworking, but the body’s need for blood and oxygen isn’t being met.

Fueled in part by the prevalence of obesity and diabetes,more U.S. adults are dying from heart failure, compared to even a decade ago,recent studies have indicated. And this trend is evident not just in theelderly, which is expected, but in middle-aged and young adults as well.

The most common cause of heart failure is coronary arterydisease (CAD), which occurs when arteries that supply blood to the heart musclebecome narrowed by buildups of fatty deposits called plaque. Obesity, diabetesand high blood pressure are major risk factors for heart disease. But thoseconditions can be modified and treated.

Faulty heart valves, damage to the heart muscles, and abnormal heart rhythm are other key risk factors. Survivors of heart attacks can also develop heart failure, which can be misdiagnosed or overlooked after the patient returns to his or her normal life. Heart Failure Awareness Week is observed Feb. 9-15 to help increase education about the severity of this disease.

“Because some risk factors like obesity, diabetes, andhypertension are increasing, then we are going to see more patients with heartfailure,” says Sandra Chaparro, M.D., cardiologist and director of theAdvanced Heart Failure program at MiamiCardiac & Vascular Institute. “Another factor is ourgrowing population of elderly patients, and those patients tend to developheart failure as well.  Because of advancesin treating acute coronary syndrome, more patients are surviving heart attacks,but they can end up with damage that can lead to heart failure. So we’re goingto see an surge in those patients as well.”

Advanced HeartFailure

Of the more than 6 million Americans living with heart failure, about 10 percent have advanced heart failure. When the condition is advanced, conventional heart therapies or treatments no longer work. Neither are strategies to manage symptoms — such as shortness of breath; fatigue; weakness; swelling in the legs, ankles and feet; and rapid or irregular heartbeat.

Someone with advanced heart failure feels shortness ofbreath and other symptoms even at rest. The U.S. Centers for Disease Controland Prevention (CDC) states that about half of people who develop heart failurewill die within five years of diagnosis.

“Yes, and that’s something that we need to emphasizebecause even some doctors in the community don’t know those numbers and somemay underestimate the scope of the problem,” says Dr. Chaparro. “Overfive years, prognosis for heart failure is similar to some cancers. So, we needto underscore all the things that we can do to keep heart failure patientsstable, like education, risk factor modifications and compliance withmedications.”

As part of a major study released last year, researchersexamined data from the CDC on deaths from heart failure between 1999 and 2017among adults 35 to 84 years old.

Between 1999 and 2012, annual heart failure death ratesdropped from 78.7 per 100,000 people to 53.7 per 100,000, the researchersfound. But after 2012, a reversal occurred, with rates starting to climb,reaching 59.3 fatalities for every 100,000 people by the end of the studyperiod.

Common Signs andSymptoms

“It’s also important to recognize that the presentationof heart failure is not like the typical heart attack, where you may have chestpain and a lot of people recognize that,” says Dr. Chaparro.“Sometimes, heart failure is much more subtle. We need to do a better jobof educating the public and the medical community. “

By themselves, any one sign of heart failure may not because for alarm, says the American Heart Association (AHA). But if you havemore than one of these symptoms, even if you haven’t been diagnosed with anyheart problems, report them to a healthcare professional.

Here are common signs and symptoms of heart failure,according to the AHA:

• Shortness of breath (also called dyspnea)
• Persistent coughing or wheezing
• Buildup of excess fluid in body tissues (edema)
• Tiredness, fatigue
• Lack of appetite, nausea
• Confusion, impaired thinking
• Increased heart rate