Dear doctors: I am 71 years old and have been diagnosed with chronic heart failure. In October of last year, I had triple-bypass surgery, but now I'm in good health. Some things I have read about chronic heart failure are unnerving. Will you give me your take on what lies ahead for me?
S.T.
Heart failure, chronic heart failure and congestive heart failure are the same condition. It's one of the most common reasons why older people are hospitalized. The basic problem is that the heart has become so weak that it circulates blood poorly. Such poor circulation permits fluid to ooze out of blood vessels and "congest" tissues in the feet, ankles and lower legs.
The lungs fill with fluid, which brings on heart failure's cardinal feature - gasping for breath.
Other signs of heart failure are breathlessness when lying in bed, heart enlargement, seen on X-rays, and the doctor's discovery of lung sounds that indicate the lungs have fluid in them.
Numerous conditions lead to heart failure. At the top of the list is coronary artery disease, blockage of heart arteries that often brings on a heart attack.
This must be why your heart failed. You did have surgery to correct blocked heart arteries, but they did their damage well before surgery took place. Heart valve problems, high blood pressure and atrial fibrillation are other causes of heart failure.
Medicines usually can get the heart beating with greater vigour and can lessen or abolish most symptoms.
Dear doctors: I am 84 and have heart failure, diagnosed four years ago. I had a pacemaker put in for atrial fibrillation. I take a number of medicines. My heart doctor says I might need a stent in my heart artery. I am anemic and take vitamin B-12 shots. Why am I tired a lot of the time? Why am I out of breath often? Would it do me any good to lose weight? I am 170 centimetres tall and weigh 175 pounds.
J.B.
What I said in the former letter also applies to you. Your ane-mia can make you tired and short of breath. You are under treatment for anemia (pernicious anemia) with the B-12 shots. I don't know how long you've been taking the shots, but they should correct the anemia shortly. Your symptoms should improve then.
You don't need to lose weight. Your body mass index is 27.4, which means you are only slightly overweight.
The doctors regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors at P.O. Box 536475, Orlando, Florida 32853-6475. Readers can order health newsletters from rbmamall.com.
