Heart “failure” remains an imprecise way to describe a heart muscle that’s falling down on the job, because it’s not a conclusion of a process but an ongoing one: the body’s main pump is failing, in a dynamic pattern that is almost always part of a changing disease condition.
“All types of heart diseases end up in heart failure,” said Geurys Rojas-Marte, MD. “If left untreated, heart failure is the end result of almost all cardiac diseases.”
The list of issues that can weigh on the heart includes but is not limited to hypertension, coronary artery disease, heart attack, birth defects of the heart, lung disease, obesity, diabetes and even sleep apnea. Getting those underlying conditions treated is Job One, because the hardy heart can only compensate for so long before it starts to give out.
The struggle causes the heart to pump inefficiently “or at the expense of high pressure inside the heart,” Dr. Rojas-Marte explained. “That high pressure is what causes symptoms such as shortness of breath, fatigue, and fluid buildup.” Lack of blood to organ systems throughout the body can strain them as well and result in even more illness.
Recognizing the wide-ranging implications of heart failure, a new international consensus published this summer reframes heart failure as a condition that can change over time, with more emphasis on early detection and precision treatment.
That precision affects the language of heart failure. Instead of “systolic” or “diastolic,” the preferred terms are Heart Failure with Preserved Ejection Fraction (HFpEF) and Heart Failure with Reduced Ejection Fraction (HFrEF). More language to learn: pacemakers or implantable defibrillators fall under the category of Cardiac Resynchronization Therapy (CRT), and there’s news to share about them. Therapies for other conditions such as GLP-1 weight loss medications and extracorporeal membrane oxygenation (ECMO) are now treating heart failure, and clinical trials are enrolling patients to investigate and confirm the efficacy of new techniques, devices and procedures.
KYW’s Rasa Kaye discusses all of it with Dr. Rojas-Marte.
Geurys Rojas-Marte, MD
Geurys Rojas-Marte, MD
