Demystifying heart failure: A Q&A with Sara Kalantari, MD

Millions of people in the United States suffer from heart failure. While the name of their condition might sound dire, many heart failure patients can have a good quality of life for the long term. They’re able to do this in part with changes to their diet, medical treatment and in some cases, surgery.

In short, a diagnosis of heart failure means the heart isn’t pumping like it should. As a cardiologist, and heart failure expert at the University of Chicago Medicine, many patients seen by Sara Kalantari, MD, suffer from this condition and are often frightened by the diagnosis. Here are some of the common questions she addresses with heart failure patients.

Who gets heart failure?

Heart failure can affect people of all ages and backgrounds. In some patients, ischemic heart disease – or blockages to blood flow to the heart – and high blood pressure are the main causes of heart failure. In younger patients, viruses, genetic risks and complications related to pregnancy or other life events can be more common factors.

What are symptoms of heart failure?

The most common symptom of heart failure is shortness of breath. Additionally, if someone has swelling in their legs or has a bloated or distended abdomen, they should get evaluated by a physician. One of the main problems with heart failure is the retention of fluids in the body, which causes this swelling. In addition, someone should also be evaluated if they experience decreased energy, fatigue or a cough when they lie down.

What causes heart failure?

Patients commonly ask me why and how they developed this disease. Sometimes there is a clear cause but, unfortunately, in many cases there is not an obvious answer. Testing allows us to discover any potential reversible causes of their heart failure.

How is heart failure treated?

There are three general types of treatment: lifestyle changes, medical treatment and surgery. All heart failure patients are told to change their diet by reducing the amount of salt and fluid they take in. We also encourage people to stop using alcohol and tobacco as quickly as possible.

One of the primary issues for patients is that they’re holding onto too much fluid. To help with this, we give medications called diuretics, which are aimed at getting rid of fluid through the kidneys. Other medications help the heart get stronger over the long term. Most of the medications we use are not designed to change symptoms immediately but to help over time.

Medical treatments like this are the mainstay, and the vast majority of patients remain on medications throughout their lives. About 5% of heart failure patients progress to advanced heart failure. For those patients, if they are eligible, we can offer them surgery like heart transplantation or the placement of a mechanical assist device to help their heart pump correctly.

How long can you live with heart failure?

Patients are interested in knowing how the disease will affect their quality of life and survival. With advances in medical treatment, many patients can live a normal and full life. I think people hear that their heart is failing and think it is irreversible, but that’s not true. Even in patients who have more advanced diseases requiring surgery, outcomes with transplant and mechanical devices have improved tremendously.

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