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Demystifying Heart Failure: Clearing up misconceptions

The second post in the Demystifying Heart Failure series, co-authored by cardiologist Fatima Rodriguez, addresses misconceptions about heart failure.

Heart failure can be frightening, and for many, it may seem like a hopeless diagnosis. However the term covers a broad range of heart conditions with many types, origins, and severities. By focusing on key health behaviors and taking the right drugs, patients can successfully manage the condition and enjoy an active and fulfilling life.

Heart failure does not always mean that the heart will eventually stop working completely. When a patient we'll call Ms. M first heard the term "heart failure," she was shocked and thought that it meant her heart would soon stop working. She was 64 and knew she had high blood pressure, but had been unaware of her heart condition.

Ms. M was diagnosed with systolic heart failure, a condition where a chamber in her heart known as the left ventricle is unable to contract normally. Her heart can only pump out about half of the blood it contains each time it squeezes. The other half of the blood remains in the left ventricle. In a healthy individual, only about 30%-45% of the blood is left behind.

Fortunately, Ms. M does not have any severe symptoms. With a careful diet and regular exercise routine, she is able to live a relatively normal life with few physical limitations.

Common misconceptions about heart failure can interfere with treatment.

  • The most common misunderstanding about heart failure is that the heart will soon stop beating. This is not true. The word "failure" is used to indicate the heart is weak and can no longer pump the needed amount of blood to the body.

    "Heart failure is not a death sentence. It can be managed as a chronic disease with appropriate use of medications and lifestyle changes," says Fatima Rodriguez, MD.
  • Another frequent misconception is that heart failure is the same as a heart attack, or myocardial infraction. A heart attack happens when a blood vessel supplying the heart with oxygen and nutrients is blocked, usually by a plaque.

    Often causing severe chest pain, a heart attack can cause permanent damage to the heart muscle that deprived of blood during the attack. Scar tissue can then replace the damaged muscle. This can sometimes result in heart failure. Along with long-standing high blood pressure, heart attacks are one of the leading causes of heart failure.
  • Furthermore, some people may think that they cannot be physically active. On the contrary, a healthy routine is a critical part of living with heart failure. Physical activity or movement is an important treatment strategy. Those with heart failure should consult their physicians about how to carefully and gradually ease into a consistent physical activity routine. Your doctor can also refer you to a cardiac rehabilitation programs and facilities for patients with congestive heart failure, which can help you start an exercise routine in a monitored environment.

    Ms. M, who has mild heart failure, tries to get at 30 minutes of aerobic exercise five days a week.
  • Finally, there is the perception that heart failure is an irreversible form of heart damage and that nothing can be done. However, heart failure can be successfully managed, reversed, or have its progression halted through both medications and healthy lifestyle behaviors.

    Randall Stafford, MD, PhD, an internal medicine physician, has identified some health behaviors that can both prevent and treat heart failure:
  1. Eat healthy foods, such as a Mediterranean or mostly plant-based diet
  2. Reduce sodium intake
  3. Consistently engage in physical activity
  4. Avoid high blood pressure
  5. Get adequate sleep
  6. Don't smoke
  7. Reduce stress levels
  8. Maintain a healthy weight
  9. Watch your cholesterol level
  10. Limit alcohol intake

Many of the misconceptions about heart failure are unnecessarily frightening to patients. Growing knowledge and science about heart failure make it a much more manageable and less alarming diagnosis compared to a few decades ago.

This is the second in a series of blog posts, Demystifying Heart Failure, to help patients and family members better understand and help mitigate heart failure. The next blog will focus on explaining left-sided heart failure.

Min Joo Kim is a master's degree student in Community Health and Prevention Research at Stanford studying the patient experience for those with chronic conditions and identifying barriers to treatment. Fatima Rodriguez, MD, focuses on strategies to prevent heart disease, while researching disparities in health practices and outcomes by gender, race, and ethnicity.

Photo by Natalie Grainger

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