LiveWorld Transcripts

Houston Chronicle presents

Dr. Reynolds Delgado
"Ask the Doctor": Heart Failure

February 8, 2000

Dr. Reynolds Delgado of the Texas Heart Institute at St. Luke's Episcopal Hospital answers audience health questions.

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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. Reynolds Delgado of the Texas Heart Institute at St. Luke's Episcopal Hospital. Welcome Dr. Delgado!

Dr. Delgado: Thank you!

EZGuest999: I'm a 21 year-old female with Aortic and Pulmonary Stenosis. My mom and I would like to know if there are any preventative measures that can be taken prior to becoming symptomatic?

Dr. Delgado: Well, I think the important thing in your case is to have regular follow-up with a cardiologist specialized in congenital heart disease. Usually this would be a pediatric cardiologist in a large center, and th ey should surveillance you with heart tests to determine when the stenoses are becoming important.

Pepsigirl: What research is being done in the field of prevention of heart failure?

Dr. Delgado: The most important things being done to prevent heart failure are those being done to prevent coronary disease, and heart attacks. That is now, by far, the leading cause of heart failure. So if we can prevent heart attacks, we can prevent heart failure. And of course, there's lots of research in this area, particularly in regards to lowering cholesterol.

EZGuest999: If the muscle in the heart's growing thicker, can exercise make it thicker?

Dr. Delgado: I don't quite understand that either, but thickening of the walls of the heart is known as hypertrophy. This is always an abnormal thing, and it's important that the doctor try to reverse it with medicines. Unfortunately, exercise doesn't do much to reverse this; in fact, certain types of exercise like weightlifting can make it worse.

EZGuest999: Right now, my heart has a pressure gradient of 61 mg. and I'm facing surgery. Which procedure would you recommend?

Dr. Delgado: It depends on where the gradient is in your heart. In general, that is a high gradient, and probably needs to be corrected. I would get the advice of your doctor, and perhaps a second opinion from another hear t specialist prior to doing anything as important as surgery.

Mimi: What is heart failure?

Dr. Delgado: Heart failure is when your heart weakens and cannot pump blood to the body normally. Most commonly, this is caused by coronary disease, or blockages of the coronary arteries. It can be caused by other things, like a viral infection, and other rare disorders. It can happen in young children and elderly adults--any age really. It can be mild, moderate, or very severe. Sometimes it requires transplantation. Most of the time, it c an be made better with medicines.

EZGuest999: Would I be able to notice a difference when doing strenuous activity after heart surgery? Would I be able to run without shortness of breath, etc.?

Dr. Delgado: Most patients who undergo open heart surgery can expect an improvement in their symptoms, whether it's done to correct a valve problem or to bypass blocked coronary arteries. Of course, this is not always the case--and often, it will take as long as two to three months before those improved symptoms are realized.

EZGuest999: What kinds of medicine could reverse the thickness of the muscle? My doctor says that's one of my main problems.

Dr. Delgado: There are two main types of medicines that reverse hypertrophy or thickening--one is known as beta blockers, and the other is known as calcium channel blockers. There are many examples of each type, and your d octor can prescribe the ones that best suit your personal needs. You should be on them for around 4-6 months before a real improvement will occur.

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