"Ask the Doctor": Heart Failure

February 14, 2000

The Houston Chronicle presents "Ask the Doctor" with Dr. Stainback who discusses health issues concerning heart failure, the heart, cholesterol, blood pressure, the arteries, heart attacks, and diet.

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HoustonChronicle: Welcome to Ask the Doctor! The purpose of the Ask The Doctor chats are to provide general information and is in no way intended to be construed as medical advice for any visitors' specific disease or condition. The intent is to increase a participant's knowledge about a general disease or condition. For treatment of your specific condition please see your personal physician. This forum is not intended to be used in emergency situations. If you are uncertain of the urgency of your problem or condition, contact your personal physician or the nearest hospital for assistance. HoustonChronicle.com, St. Luke's Episcopal Hospital - Houston and the Talk City Network are proud to present our special guest for today, Dr. Stainback of the Texas Heart Institute at St. Luke's Episcopa l Hospital. Welcome, Dr. Stainback!

Dr Stainback: Hello, it's Happy Valentine's Day to everyone out there, it's a pleasure to be a part of this chat session and to answer your questions about heart failure.

Mimi: What is heart failure?

Dr Stainback: Heart failure is a condition in which the heart cannot supply enough oxygenated blood to the body to meet the body's energy demands. There are a number of conditions that can cause this problem. The most com mon is weakening of the heart muscle by damage from heart attacks.

Siggie: What are the symptoms of heart failure?

Dr Stainback: The most common symptoms of heart failure are feelings of fatigue and shortness of breath or exhaustion during physical exertion. Sometimes people with heart failure can have a persistent cough, or a feeling of being short of breath even at rest. If the condition is advanced, sometimes people with heart failure experience breathing problems only when lying down at night. Other symptoms might include abdominal bloating, a fee ling that you're not hungry, and some patients with heart failure notice that they have swelling in the ankles or abdomen, particularly at the end of the day.

Sun-moon-stars: What percentage of persons who have had a cardiac event will experience heart failure at a later date?

Dr Stainback: Now we have better treatments for heart attacks, and this has been one of the big advances in cardiology over the last several years. Currently, it is uncommon for people with mild heart attacks to experienc e heart failure symptoms in the near future if they have had rapid and effective medical treatment, and it can be many years or decades before heart failure symptoms might occur. Some patients who have very large heart at tacks, however, might still go on to have heart failure symptoms soon after the event. But there are many advances that can help with these symptoms and prolong life.

RubyRose: What does the St. Luke's Heart Failure program consist of?

Dr Stainback: The Heart Failure Program at St. Luke's is an organization of physicians, nurses, nurse practitioners, dieticians, social workers, and a part of the hospital that has offices and exam rooms and a secretarial staff. This core group has access to all of the facilities of St. Luke's Episcopal Hospital, and the Texas Heart Institute. Therefore, it is possible for a patient who is referred here for further evaluation to have a co mprehensive assessment of their condition and ongoing care that is appropriate for their particular needs. Whether it be further diagnostic testing, review of existing data, improvement of medical management with dietary and exercise recommendations, or even referral for more advanced treatments of heart failures.

Gypsywoman: What are the benefits of participating in a heart failure program?

Dr Stainback: A heart failure program, first of all, offers the benefit of insuring that a patient knows about or is treated with therapies that are known to improve lifestyle and longevity. The Heart Failure Center is up to date with regards to the latest medical and surgical treatments for heart failure. And can help a patient or the referring physician decide upon treatment options. Many patients with advanced heart failure are provide d with a great deal of benefit by having frequent phone or heart failure clinic follow ups, with an experienced nurse, with backup physician help, without having to keep numerous doctor appointments. This can be very bene ficial for patients with heart failure, since medication dosages frequently have to be adjusted by trial and error. It is important for a patient to know that he or she has a central place to call to notify a caregiver of positive or negative experiences from medication changes. Also, the Heart Failure Center has experience with issues regarding exercise, diet, and emotional support needs in patients with such a life-changing diagnosis. W e find that many patients in the Heart Failure Center benefit from sharing their experiences with other patients, and from talking to caregivers here that understand the physical and emotional impact of this illness upon not only the patient but on his or her loved ones.

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