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Heart Disorders Message Board

Heart Disorders Board Index

Hey Steven,

I know the "heart failure" label is a very scary one to hear, but it IS MANAGEABLE! As a generally acceptable rule, an EF less than 45 indicates treatment for Congestive Heart Failure. In simplest terms, CHF means that your heart isn't effectively clearing the blood from the chambers in your heart, thus not getting it to the rest of your body. With certain CHF (There are various different types - try searching Diastolic and Systolic disfunction) the "fluid" or blood begins to back up with in the system. This can lead to an increase in fluid in your extremities (Peripheral edema - swollen legs) or pulmonary edema (can cough up pink, frothy sputum). I am interested if you have any other symptoms besides the shortness of breath. Do you wake up short of breath? Is it worse after even a little exertion? Do your legs and feet swell to the point where if you placed your finger tip onto your skin, the prints remains for a few seconds after you remove it? These are just a few symptoms of CHF.

I'm sure your docs are great and it is good to trust them, but they have LOTS of patients and now a days, patients must be their own best advocates. A simple test can rule out (or in) CHF. Ask your doctors for a TEE (Trans-esophageal echocardiogram). You have probably had one or two of these before and after your CABG (By-pass). This is like a fancy ultrasound of your heart. It can check for ventricular remodeling, accurately measure your EF and show if there is any fluid accumulating around the heart. Additionally, ask for a BNP (Brain Neuro peptide). This is a simple blood test. While ranges for normal vary, a result above 100 indicates CHF, but can be as high as 1000!

Worst case scenerio is that you may be suffering from CHF. The good news is that while 55,000 Americans are diagnosed with CHF each year, new drugs and treatments are becoming more widely availible, and clinicians (like I'm studying to become) are becoming more aware of options. I can't officially offer definitive advice, just suggestions, but I can offer support and encouragement. I see folks everyday who have done just what you have - researched their problems, advocate for a better quality of life and GET IT! Simple changes in medications can often times reslove this problem. Are you on any diuretics like Lasix, spironolactone, or hydrochlorothiazide. These are frontline drugs for CHF and generally have remarkable results. Also, you mentioned two beta-blockers, while this is unusual, it is not unheard of. Generally cardiologists will begin post-CABG treatment with an ACE (Angiotensin Converting Enzyme) Inhibitor. Are you taking an ACE Inhibitor? These are just a few suggestions and I hope they help! GOod luck!

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