Efin­ing “heart fail­ure”

Wellness Update - - Meet Our Doctors -

D“Heart fail­ure oc­curs when the heart is un­able to pump enough blood out of the heart, and ei­ther through leak­age of the valves or the heart not squeez­ing nor­mally, the con­di­tion raises the pres­sure in the lungs,” says Win­ston Gandy, M.D., a car­di­ol­o­gist at Pied­mont Hospi­tal. “This cre­ates a sen­sa­tion of short­ness of breath.” Dr. Gandy says that “heart fail­ure” does not nec­es­sar­ily mean the heart is fail­ing; it is rather a con­stel­la­tion of symp­toms that cause the heart to not pump as well as it should.

Sys­tolic vs. Di­as­tolic Func­tion of the Heart

“The squeez­ing com­po­nent [of heart func­tion] is the sys­tolic func­tion and the re­lax­ing com­po­nent is the di­as­tolic func­tion,” says Dr. Gandy. To de­ter­mine a per­son’s blood pres­sure, physi­cians look at both of th­ese func­tions. “When the heart squeezes, that will gen­er­ate the top num­ber, when the heart re­laxes, that will re­sult in the bot­tom num­ber.”

Di­as­tolic Dys­func­tion

A study from the Cleve­land Clinic looked at out­pa­tients who had echocar­dio­grams, or ul­tra­sound imag­ing of the heart, for var­i­ous rea­sons. “Re­searchers looked at the flow pat­terns when the heart’s pump­ing cham­ber was be­ing filled,” says Dr. Gandy. “What they no­ticed was a cer­tain pat­tern that they termed ‘di­as­tolic dys­func­tion.’ It turned out that a large group of in­di­vid­u­als, the ma­jor­ity of pa­tients, have some type of ab­nor­mal­ity with that in­flow.” In this par­tic­u­lar study, in those pa­tients who had mod­er­ate and se­vere di­as­tolic dys­func­tion, there was an in­crease in the in­ci­dence of heart fail­ure events.

Who is at risk for di­as­tolic dys­func­tion?

“Those with long­stand­ing high blood pres­sure are at risk,” says Dr. Gandy. Pa­tients who suf­fer from coronary heart disease are also at risk, as are some di­a­bet­ics be­cause they can ex­pe­ri­ence dif­fused disease that causes scar­ing in the heart over time.

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