Is Heart Failure a Death Sentence?

HYANNIS – Last year, Orleans resident Paul Peloquin’s health was failing. Over a six-week period, the 72-year-old experienced worsening shortness of breath and swelling from fluid retention in his extremities and lungs. Unable to walk across the room, he went to the Emergency Center at Cape Cod Hospital for help.

Peloquin was diagnosed with congestive heart failure and was admitted for treatment.

According to the American Heart Association, he joins more than six million Americans who are living with congestive heart failure today. It is one of the most common reasons people age 65 and older go to the hospital. About half of those diagnosed with heart failure will die within five years of diagnosis, according to the Centers of Disease Control and Prevention (CDC).

But, the outcome isn’t always dire. Peloquin is living proof that disease management strategies, when followed carefully, can help extend both the quality and quantity of life.

What It Is

Congestive heart failure (CHF) is a chronic, progressive condition where the heart’s ability to pump enough oxygenated blood to meet the body’s need is diminished. Congestive heart failure is a type of heart failure that requires immediate attention.

The hallmark symptom of congestive heart failure is the collection of fluid, or ‘congestion’ in the lungs and tissue of the body.

“When he presented to us initially, Mr. Peloquin required oxygen therapy to come into the office and he had significant fluid retention, shortness of breath just getting on to the exam table, and quite abnormal labs, with poor renal function and electrolyte disturbances,” said Shannon List, a nurse practitioner at the Cape Cod Heart Failure Clinic in Hyannis.

The tests performed during his hospital stay revealed the while he had normal “squeezing” function of the heart (ejection fraction), his heart failure was probably due to a combination of diastolic dysfunction (stiffening of the heart that doesn’t relax well), high blood pressure, diabetes, chronic kidney disease and most likely sleep apnea, according to List.

Over the next nine months, Peloquin was seen multiple times by specialists in cardiology, pulmonology, nephrology, as well as his primary care doctor.

“We saw him weekly initially,” said List.

Heeding a sobering warning from Elissa Thompson, MD, cardiologist and medical director of the Clinic, Peloquin embraced the support and care from his team and was determined to turn his life around.

In nine months time, Peloquin lost 50 pounds and his kidney function normalized. He no longer requires supplemental oxygen or the use of diuretics. During a recent appointment, he had no shortness of breath with activities, no swelling, no cough and felt “ better than he had in years.”

The Risk Factors

According to the American Heart Association, the biggest risk factor for developing congestive heart failure is coronary artery disease.

Other risk factors include:

High blood pressure
Having a previous heart attack
Congenital heart defects
Heart valve disease
Diseases of the heart muscle
Infection of the heart and/or heart valves
Abnormal heart rhythms (arrhythmias)
Being overweight
Thyroid problems
Alcohol or drug abuse
Certain types of chemotherapy.
Many of these diseases develop as a result of longstanding poor lifestyle habits. When someone is diagnosed with heart failure, hospitalization is just the starting point for recovery, explained Dr. Thompson. It takes as long to reverse the situation as it did to create it in the first place.

“The heart failure clinic is so important because we are able to see high-risk patients every day, if need be, and make sure they are heading in the right direction,” she said.

Patients are closely monitored and are advised on ways to improve their health.

“It’s very simple lifestyle changes. Because, it is the lifestyle that contributed to the illness in the first place,” she added.

New to the Cape Cod Healthcare Heart Failure Clinic is heart failure specialist Amy French, MD. She is already working with patients at the Hyannis clinic.

Mr. Peloquin attributes his success to the straight talk of Dr. Thompson and the care team at the Clinic. He cites, in particular, the home visit from the pharmacist who helped him sort out his medications.

His diligence in changing his lifestyle is probably the key factor in his recovery, said List. And it comes with a big reward. He has not been hospitalized since starting the program.

By CLAUDIA DOLPHIN, Cape Cod Health News

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