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Old 08-26-2007, 07:51 PM   #1
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Congestive Heart Failure

I wondered if anyone here has congestive heart failure and would mind sharing their experiences with medication, treatments and lifestyle changes that may ease your symptoms. Thanks for your input.

 
Old 08-27-2007, 09:17 AM   #2
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Re: Congestive Heart Failure

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Originally Posted by goldyfm View Post
I wondered if anyone here has congestive heart failure and would mind sharing their experiences with medication, treatments and lifestyle changes that may ease your symptoms. Thanks for your input.
Gldyfm, if one is in CHF, the protocol would be a diuretic to reduce fluids in lungs due to the heart's left-side contraction impairment, and sometimes the right side is involved causing edema to peripherals. That was my experience.

Causation was a low EF (below 29%) indicating about 71% of the blood remained in the left chamber with each heart beat resulting with less blood pumped out than received and blood/fluids backed up in the lungs causing edema.

An overworked heart will increase in size. An enlarged heart will reduce the strength of contractions. To reduce heart size (dilated type) the medication would be to lighten the heart's workload. Mediation to dilate blood vessels (ACE inhibitor) and a beta blocker to help dilate blood vessels and slow the heart rate. Sometimes medication to increase the heart's contractions.

After 3 1/2 years, with medication my heart has returned to normal size and pumping efficiency... has increased to normal (EF 60%). I still have MVR (mitral valve regurgitation) and no symptoms.

 
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Old 08-27-2007, 03:26 PM   #3
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Re: Congestive Heart Failure

Ken I am happy for your turn around, thats great to see someone go from real bad CHF to where you are today. I wish the same good luck to goldy!!

 
Old 08-28-2007, 08:28 AM   #4
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Re: Congestive Heart Failure

Lutheran, thanks for the kind thoughts.

 
Old 08-28-2007, 10:42 AM   #5
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Re: Congestive Heart Failure

Thanks so much for the info and well wishes. I have 4 incompetent valves and I was put on a low dose Ace Inhibitor as I have low blood pressure. I can't tell if it is helping at this time. I am not to return to cardiologist until November for a followup echo. I really feel uninformed as I do not know if the valves are structurally damaged or if it is from a vegetation of some sort. He did not say I had CHF but from all the literature I have read on valvular disease, it is the outcome. I have a call in to his office and am requesting a copy of the results of the TEE. I think I could understand more of my prognosis if I could see the report. I had some nursing classes and I do believe I could understand if given the opportunity. I just think 3 months of waiting to ask questions and get some idea of my condition is asking too much of a patient.

 
Old 08-30-2007, 10:50 AM   #6
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Re: Congestive Heart Failure

Goldy, yes you are really uninformed without the actual echocardiogram. Not the summation sent to your PCP or maybe yourself. You need the actual test data. There is so much information on an echo data sheet. It is your current heart status and is unadulterated.

This information is sometimes withheld on purpose, because the doctors do not want you to be worried about anything abnormal on the test. They try to contain your emotions and limit your worry and stress. That is all well and good for some patients, but you are proactive and take responsibility for your health.

I have diastolic dysfunction with preserved ejection fraction, which means that my left ventricle does not fill properly during the diastolic phase. My left ventricle end fill pressure is high (LVEDP). A cardiac cath 3 months ago showed an LVEDP of 24 mmhg. Diastolic dysfunction is diagnosed when the LVEDP is > 20 mmhg.

I believe it is diastolic failure, but my cardio corrected me....Due to these excessive fill pressures, my left atria has enlarged as shown on my last echocardiogram, about 3 weeks ago. I have mild reverse blood flow (MVR, or mitral valve regurgitation) into my pulmonary vein i.e. blood from my pulmonary vein is fresh, oxygenated blood that should be going to and through and being pumped by my LV and onto my body. Of course this reverse flow volume is to low to cause me to pass out or otherwise check out, but it flows against the fresh blood coming from my lungs and causes pulmonary edema, due to turbulent, regurgitant blood flow. The pressure in my PV is also elevated due to my high LVEDP. I take Lasix for the PE.

CHF can be caused by either right or left sided heart failure and either condition, after an extended period of time and not responsive to treatment, will cause both sides of the heart fail.

I have shortness of breath, zero energy and my legs, ankles and feet ache and swell. Ankle/leg edema is more often associated with right sided heart failure. I do not understand it unless it is venous insufficiency or PAD.

If I piddle pretty hard for a day, it takes 2 or 3 days to get over it. I am also having lots of muscular pain, but I have FM and CFS....I think I told you earlier that I am having MID-CAB bypass surgery evaluation 9/21. Maybe this will get me going. I found out yesterday that I have early stage macular degeneration. Smoking and a way too stressful job wrecked me.

I wish you the best

Andy

Last edited by huckfinn; 08-30-2007 at 10:58 AM.

 
Old 08-30-2007, 02:23 PM   #7
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Re: Congestive Heart Failure

Goldyfm,
I have two bad valves, one from birth and the other damaged since, and my heart started failing with a enlarged left ventricle. I take Altace to lower my bp and atenolol to ease the strain on my heart. Have gotten back to about 45% EF and stopped there. The doctor is trying to figure out if the lack of progress is due to muscle damage or valve damage. So I would say the main thing is to get a good sense of your heart's condition and what can be done about the valves.
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Old 08-30-2007, 03:46 PM   #8
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Re: Congestive Heart Failure

Hi Andy,

Quote:
I have shortness of breath, zero energy and my legs, ankles and feet ache and swell. Ankle/leg edema is more often associated with right sided heart failure. I do not understand it unless it is venous insufficiency or PAD.
Just wanted to tell you how much I enjoy reading your posts. So, thanks for sharing. How severe is your SOB? I was put on asthma meds for mine and they are not helping one bit. It's pretty bad. I wonder if it can get much worse. I suppose it can. I don't know the reason for mine. No one does. The cardio told me months ago I should not be having any SOB. Well, I am! He is also the one who told me that beta blockers do not cause shortness of breath. We all know better than that! Especially when they are taken in maximum doses. Anyway, mine were stopped in May. My SOB is worse than ever.

Quote:
I found out yesterday that I have early stage macular degeneration. Smoking and a way too stressful job wrecked me.
You know, it could be a result of high blood pressure. That's how I got mine. I was not even sent for baseline tests. The doc said none would be needed. What does that tell you? I know that mine was caused by an uncontrolled very high blood pressure and happened over a long period of time (years).

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Old 08-30-2007, 04:41 PM   #9
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Re: Congestive Heart Failure

If I got my right side upper and lower chamber paced, then I'll never be getting edema? I've a puffy hand but after wake up it strinks. How can I prevent to go into CHF? I also very SOB.

 
Old 08-30-2007, 04:53 PM   #10
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Re: Congestive Heart Failure

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Originally Posted by Gojoe View Post
Goldyfm,
I have two bad valves, one from birth and the other damaged since, and my heart started failing with a enlarged left ventricle. I take Altace to lower my bp and atenolol to ease the strain on my heart. Have gotten back to about 45% EF and stopped there. The doctor is trying to figure out if the lack of progress is due to muscle damage or valve damage. So I would say the main thing is to get a good sense of your heart's condition and what can be done about the valves.
Gojoe, I would think an EF at 45% would be due to left ventricle muscle impairment (scarred from previous MI, inflammation, etc.) and easily observed with an echo. I saw mine on the echo monitor as well as valve regurgitation.

If you have an EF of 45% and valve problems, the quantity of blood pumped into circulation with each heartbeat is going to be less due to some blood back flow into the left atrium. I have an EF at 60% and mitral valve regurgitation that reduces cardiac output a few points.:

As you probably know the heart enlarges (LV) regularily to increase contractions and this compensation helps maintain a balance of blood flow between the right and left side. However, a pathological enlargement (over compensation) the size reaches a point that breaks down the muscle fibers and contractions are weak enough to compromise cardiac output causing heart failure. Do you still have an enlarged heart? That may be the cause for an EF of 45%.

Last edited by started04; 08-30-2007 at 04:58 PM.

 
Old 08-30-2007, 07:50 PM   #11
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Re: Congestive Heart Failure

Thanks for the replies all. Andy, I also have FM, so I know what a double whammy it is to have cardiac problems as well. My previous echocardiogram in July had an estimated LVEF of "aproximately 55-65% LV diastolic filling pattern impairment of relaxation to suggest mild diastolic dysfunction with no significant aortic stenosis but at least moderate regurgitaion. All 4 chambers appear grossly normal in size and thickness, normal L and R systolic function" I have requested the TEE and should have it in a couple of days.

I also want to thank whoever mentioned the Cleveland Clinic, I am investigating the possibility of going there for a second opinion once I see the doctor again. I was very impressed with their information on their website and even though we are supposed to have some great cardiac surgical units in Alabama, not a one of them made the US News and World Reports Top Hospital List. Cleveland Clinic was number 1 in one poll I saw and ranked 4th in the other.

I do have lots of questions and I doubt I will wait til November to talk with the doctor, as I have already had to change the ACE Inhibitor (now on Cozaar) due to worsening cough and chest tightness. I do want to have a chance to see the TEE report as that may answer some of my questions or give me some more to mull over.

I suppose I join the ranks of the smoked way too much and stressed too much on the job.

 
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