"Ask the Doctor": Heart Failure

February 9, 2000

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Blue-Heart31: Is chest pain always related to heart problems?

Dr. Delgado: No. In fact, most of the time it is not. The most common cause of chest pain is esophageal problems that are related to acid reflux into the esophagus. Also, chest wall or lung lining problems can lead to chest pain. So usually, the heart is not the culprit.

ContestCensus: I have pain in my chest and I'm tired 24/7. My legs, hands, and ankles are swollen, and as soon as I move I have problems breathing. Should I check my heart?

Dr. Delgado: Yes, these symptoms suggest congestive heart failure, and I think it would be smart to see your doctor about them. I can't really say anymore based on what you tell me, because it could certainly be other things.

JJTJ: How can I prevent a heart attack when I have a family history of heart disorders?

Dr. Delgado: Unfortunately, a family history is one risk factor that you cannot do away with. Therefore, it's important to address all the other risk factors that you can modify, such as high cholesterol, smoking, etc. Also, someone with a strong family history should have routine screening for heart disease done by his or her doctor.

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

Dr. Delgado: This is a specialized clinic for people who have congestive heart failure. We have the best new treatment options available to manage these patients. In this clinic, we can best determine which of the modern therapies is best for people, including transplantation, if necessary, or new study drugs.

Parodeis: What age group does the heart failure program most benefit?

Dr. Delgado: Heart failure is most common as people get older. In general, we benefit people who are over age 50. However, it can occur in any age group, including children.

Veggiehead: What is a left ventricular assist device?

Dr. Delgado: Basically, it is a modern day artificial heart. It is a machine that pumps blood through the body the way the heart is supposed to but can't. In the old days, we took the heart out, and put the machine in. The LVAD is put in with the heart still intact, to assist the heart, rather than replace it. And it works much better this way.

Tintman 1: What is your opinion on the low carbohydrate diets, such as Dr. Robert Atkins' diet?

Dr. Delgado: I think that any diet that helps overweight people lose weight is a benefit, because just achieving an ideal body weight will lower your heart risk. However, we have to be concerned about dietary fats and cholesterol as well, because this is clearly one of the most important risk factors for stroke and heart attack.

Dragonlvr: How important is diet in preventing future heart failure occurrences?

Dr. Delgado: Diet is important because lowering cholesterol lowers the risk of heart attacks. And less heart attacks means less heart failure. So it's indirectly important in preventing heart failure. Once you have heart failure, though, it's very important to do away with salt in your diet. Salt will make the heart failure worse.

Bob: We always hear that we should obtain a physical before starting an exercise program. What should the primary care doctor be performing in such an exam?

Dr. Delgado: If someone who is at risk for heart disease wants to engage in some physical activity that may be stressful, I think a reasonable approach would be to do a simple stress test. This is a test that can be done in most primary care doctor's offices. And it's a good screening tool to determine if the heart will do okay under exercise stress. Other than this, a simple electrocardiogram and physical examination will probably suffice.

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