Heart Failure Archive

Paying attention to changes in your body can help prevent a recurrence of heart failure.

Q. My 69-year-old husband has had cardiomyopathy and diabetes for several years. Lately, his ankles are always swollen. At his last doctor's visit, my husband's cardiologist said his heart has leaky valves and his ejection fraction is 10%. What would be the best plan for him?

A. The combination of leaking valves and a low ejection fraction is serious indeed. Your husband needs to work very closely with his physicians to make sure he is getting optimal care. The ideal scenario would be if he can work with a team that specializes in caring for people with heart failure.

Although heart failure seems to have little in common with broken bones, accumulating evidence suggests they are somehow tied to each other.

Mayo Clinic researchers followed the health of nearly 1,000 men and women newly diagnosed with heart failure and an equal number without it, matched for age and gender. The investigators tracked their health for at least seven years and sometimes for as long as 20 years. Those with heart failure had more broken bones — mostly broken hips — both before and after the onset of heart failure than those without failing hearts (American Journal of Medicine, May 2011).

When the heart suddenly stops beating, an event known as a cardiac arrest, the combination of cardiopulmonary resuscitation (CPR) and a shock from an automated external defibrillator offers an arrest victim the best chance of survival. If the cardiac arrest is seen by someone, and CPR is started right away, there's no need for mouth-to-mouth breathing. Doing this hands-only form of CPR means pushing hard on the chest about 100 times a minute without stopping.

Preparing the arrest victim to receive a shock from the defibrillator sometimes temporarily stops CPR. The shorter the pause, the better. A study of more than 800 victims of cardiac arrest showed that stopping chest compressions for 20 seconds before delivering the shock reduced the odds of surviving by 50% (Circulation, July 5, 2011).

Positive markers mean better heart health, less disease.

In 2010, the American Heart Association (AHA) added a new page to its playbook against the leading causes of death and disability in the United States. Instead of focusing solely on cardiovascular disease, the AHA is broadening its mission to include improving cardiovascular health.

It's a timely shift. The impressive decline in death rates from heart disease since 1970 is threatened by climbing rates of obesity and diabetes, the aging of the population, and early signs of heart disease in adolescents.

Many people say they would shy away from using a defibrillator.

If you were in a public place and saw someone suddenly collapse, would you use a nearby defibrillator to revive him or her? In a survey of 1,000 adults, more than half answered "no."

Women tend to develop heart disease about 10 years later than men — in part, it's believed, because of the heart-protective effects of ovarian estrogens, which are around until menopause. But the female advantage seems to end there. Because women develop heart disease later, they're more likely to have coexisting conditions, like diabetes, which can complicate treatment and recovery. And because they have smaller hearts and coronary vessels, surgery can be more difficult for them. Women are more likely to die after procedures such as bypass surgery and angioplasty.

But now a study suggests that one treatment for heart failure actually works better in women than men (Journal of the American College of Cardiology, Feb. 15, 2011).

They can shock a heart back into rhythm and save a life. But are too many of these heart devices being implanted?

Each month, about 10,000 Americans have implantable cardioverter-defibrillators (ICDs) put into their bodies. The main function of these devices is to sense fast or irregular heart rhythms that can be potentially fatal and then to shock the ventricles, the heart's two main pumping chambers, back into a regular, healthy heartbeat. The shock can be quite painful and may feel like a hard punch or kick in the chest. In essence, the ICD is an automated, in-the-body version of the defibrillator paddles used in cardiac emergencies.

High-quality chocolate may lower the risk of heart failure in middle-aged and older women when eaten once or twice a week — but not when eaten more than that. That's the conclusion of a study published online, Aug. 16, 2010, in Circulation: Heart Failure. Cocoa beans are rich in flavonoids — plant chemicals known to lower blood pressure and improve cholesterol levels and coronary artery function. Cocoa and dark chocolate are already associated with a reduced risk for heart attacks, strokes, and death from heart disease.

The study. Researchers at Harvard Medical School and Sweden's Karolinska Institute followed 31,823 Swedish women ages 48 to 83 for nine years, tracking their chocolate intake with food questionnaires completed as part of the Swedish Mammography Cohort study. At the start of the study, none of the women had a history of diabetes, heart failure, or heart attack. According to the authors, most chocolate then consumed in Sweden had 30% cocoa solids — more than is typically found in chocolate in the United States. The average serving size ranged from 20 to 30 grams (about three-quarters to one full ounce).

The phrase "exercise in bed" conjures images of sex, a fine way to engage in a little physical activity. Miami-based Non-Invasive Monitoring Systems has a different idea, called whole-body periodic acceleration, that may help people who can't exercise in traditional ways.

Instead of moving yourself, whole-body periodic acceleration moves you — shakes you, really — using a special bed called the Exer-Rest that moves back and forth in the head-to-foot direction 140 times a minute. Your feet are strapped firmly to the foot of the bed, so you move with it. This motion mimics the effect of exercise on the arteries as they experience faster, stronger, quicker pulses of blood. Both exercise and whole-body periodic acceleration stimulate the inner lining of blood vessels to release nitric oxide, which tells blood vessels to relax. This improves blood flow throughout the body.