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FEBRUARY IS AMERICAN HEART MONTH HEART FAILURE: WHAT YOU NEED TO KNOW NOW
Over 6 million American adults suffer from heart failure, and that number is expected to grow to 8 million by 2030 according to the American Heart Association. What is heart failure? What causes it? How can it be managed? And is there a linkage between COVID-19 and heart failure? Interventional cardiologist Ankit Mehra, MD, answers these and other frequently asked questions about heart failure. Dr. Mehra is an assistant professor of interventional cardiology at McGovern Medical School at UTHealth Houston and is affiliated withMemorial Hermann Health System. He sees patients at the Center for Advanced Cardiology at Memorial Hermann Sugar Land Hospital. What is heart failure? The main function of the heart is to supply blood to every organ of our body. Heart failure means that the heart is not pumping enough blood to satisfy the body’s demand, due to reduced pump function or increased stiffness of heart muscle. Depending on the cause, it can develop acutely (suddenly) or gradually over a period of weeks, months or years. Is heart failure the same as heart attack? Heart attack is different from heart failure, but a heart attack can lead to heart failure. The heart itself is a muscle requiring its own blood supply. A blockage or impairment of blood f low to the heart muscle (coronary artery disease) can lead to a heart attack. As a consequence, the heart muscle can be damaged, which can lead to poor pumping action of the heart, or heart failure. What are the symptoms? Initial symptoms might be as vague as increased heart rate and/or fatigue, weakness and tiredness. Individuals may experience swelling of the legs and ankles or shortness of breath on exertion. Advanced- stage patients may be unable to lie f lat at night, due to a buildup of f luid in the lungs. These symptoms can result from a gradual worsening of underlying health problems, such as type 2 diabetes or high blood pressure, some of which don’t cause symptoms. That’s why it’s important to understand your risk factors and monitor your overall health with the help of your primary care physician. What are the causes? The main cause of heart failure is underlying coronary artery disease. Heart attack, as discussed earlier, can also
cause heart failure, as can other heart conditions, including heart rhythm and valve disorders, and some congenital (present at birth) heart diseases. Some medications and viruses can cause heart failure. And underlying health conditions, like hypertension (high blood pressure), high cholesterol, type 2 diabetes and obesity, can also lead to heart failure. How is it diagnosed? Your physician will perform a physical examination, examining your legs and lungs for f luid retention or buildup, and will listen to your heart for the presence of an irregular heartbeat, a valve issue or blockage. Based on the physical examination, your physician might order bloodwork and/or additional tests, including a stress test, echocardiogram (an ultrasound of the heart, used to measure the pump action of the heart and the thickness of the heart muscle, and to detect the presence of a leaky valve), coronary angiography, a cardiac CT, cardiac MRI and, in rare instances, a cardiac biopsy. How can I prevent getting heart failure? To prevent heart failure, you should be aggressive in screening for cardiovascular risk factors and control them, especially if you have a family history of heart failure. For individuals who have been diagnosed with heart failure, even early-stage heart failure, the goal is to prevent the worsening of symptoms and hospitalizations. Weigh yourself daily, as sudden weight gain could indicate a buildup of f luid in your system. Follow your doctor’s salt intake advice, limit your alcohol consumption, take your prescribed medications and get regular exercise. Is there a link between COVID-19 and heart failure? So far, we have limited data on the COVID-19 virus. But we have seen people coming in with heart attacks and blood clots in the lungs, even one month post recovery from this infection. A clot in the lung can cause right-sided heart failure. And the virus itself can affect the heart muscle, causing weakness of t he hea r t musc le , ca l led cardiomyopathy. Whether that’s temporary or permanent is yet to be determined. What treatments are available for heart failure at Memorial Hermann Sugar Land? The Center for Advanced Cardiology at Memorial Hermann
Sugar Land is very well equipped to diagnose and treat patients with heart failure. We offer all of the aforementioned diagnostic tests and advanced t reatment s , including minimally invasive and invasive procedures, like cardiac catheter i zat ion, pacemaker, implantable cardiac defibrillators and thrombolytic therapies for pa t i ent s w i t h pu lmona r y embolism (clot in lungs).
Ankit Mehra, MD Interventional Cardiologist
For patients with advanced heart failure for whom these therapies have proven ineffective, we work closely with the Center for Advanced Heart Failure at Memorial Hermann-Texas Medical Center, which offers advanced treatments, including left ventricular assist devices (LVAD) and heart transplant. These patients can be transported by Memorial Hermann Life Flight® air ambulance. If needed, the heart failure team at Memorial Hermann-TMC can f ly to Memorial Hermann Sugar Land to perform emergent procedures, like extracorporeal membrane oxygenation (ECMO), which can help stabilize patients with acute heart failure. Are there any new advancements on the horizon at Memorial Hermann to treat heart failure? Yes, Memorial Hermann is involved in numerous multicenter clinical trials for the management of heart failure and heart failure symptoms. One exciting study underway is looking at remote monitoring of people with heart failure, to identify the buildup of f luid in patients at home and adjust their medication to prevent worsening of symptoms and reduce hospitalization. There is also exciting research underway in the area of minimally invasive valve repair, specifically right-sided valve repair to prevent right-sided heart failure, which is more difficult to treat than left-sided. If you or a loved one is experiencing symptoms of heart attack, seek immediate emergency medical attention. If you believe you are at risk for—or are experiencing symptoms of—heart failure, talk to your primary care physician or a cardiologist right away. Early diagnosis and treatment can extend and improve your quality of life.
To learn more, or to schedule an appointment with a Memorial Hermann affiliated physician, visit memorialhermann.org/heart
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SUGAR LAND MISSOURI CITY EDITION • FEBRUARY 2022
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