The Tired Heart

BFP Magazine

Cardio-vascular Health

Congestive Heart Failure, CHF

The Tired Heart

By Dr. W. Gifford Jones

June 18, 2000

How would you like to move the muscles of your arm 100,000 times every day to push 5,000 gallons of blood through 60,000 miles of blood vessels? And to know you have to do it 2.5 billion times without failing? Faced with this momentous task your arm muscles would last only a few minutes.

Your heart, day after day without any holiday, pumps 10 pints of blood a minute to keep you alive and functioning. The heart itself weighs only 11 ounces! It's no wonder that the human heart finally gets tired and quits!

Today over three million North Americans have what's called "Congestive Heart Failure" (CHF). And each year 450,000 new cases are diagnosed.

A report from Johns Hopkins medical centre shows that the extent of the problem. Between 1979 and 1992 the number of patients admitted to U.S. hospitals with CHF jumped from 377,000 to 822,000!

It's the one disease of the heart that's on the rise. And it's estimated that the cost of treating this condition in North America is 10 billion dollars or more.

The term "heart failure" is an ominous term. It need not imply imminent death from heart disease. But although much progress has been made in treating cardiac failure, about 50 percent of those diagnosed with congestive failure die within five years.

The primary symptoms of heart failure are breathlessness, fatigue and swelling of the ankles. Initially shortness of breath only occurs during exertion. But as time passes the ability to perform normal activities may be severely limited. In extreme cases even moving from the bed to a chair can be an exhausting experience.

The reason for this huge increase in patients suffering from CHF is ironic. The prompt treatment of heart attack victims has saved many from death.

Some owe their lives to the prompt use of cardio©pulmonary resuscitation (CPR). Others to the use of drugs which quickly dissolve a blood clot blocking the supply of blood to the heart muscle.

But the downside is that this has left many people with a heart muscle that's been permanently damaged and no longer capable of pumping blood to the rest of the body. Ô 0*0*0* Hypertension is another major cause of congestive heart failure. People with high blood pressure are twice as likely to develop CHF. Hypertension forces the heart to pump against greater arterial resistance. The higher the pressure the greater the risk of CHF.

Patients with diabetes are two to four times more likely to develop CHF than non©diabetics. And for reasons that are not known this risk is higher in women than men.

A report from The Harvard Medical School shows that high cholesterol also doubles the risk of CHF. And it should not come as a surprise to anyone that cigarette smokers also double the risk of CHF.

Other conditions such as prolonged drug addiction, alcoholism, bacterial and viral infections can also destroy the heart muscle. Heart valves damaged by rheumatic fever or atherosclerosis can set the stage for CHF as well.

There are several clues that point to congestive heart failure. Some patients wake during the night and feel they're not getting enough air. Or start to need two pillows to sleep.

Others may notice their shoes getting tighter. Or suddenly find themselves gaining an pound a day due to the accumulation of fluid in the tissues.

Once CHF has developed it's not normally reversible. But there are several ways to slow or even stop the progression.

ACE (angiotensin©converting enzyme) inhibitors such as Capoten and Vasotec help to prolong life. They relieve the symptoms and increase the ability to exercise by causing blood vessels to dilate.

Digoxin (Lanoxin) is used to increase the force of the heart's contractions. By ejecting more blood the heart achieves increased efficiency. And diuretics such as Diuril or Lasix force the kidneys to excrete more sodium and water. This reduces the total volume of fluid in the body reducing the heart's work load.

Several studies show that Coenzyme Q10 aids failing hearts. CO©Q10 is a vitamin©like substance which helps to control the rate that oxygen flows into cells. CO©Q10 boosts the performance of the heart and also decreases blood pressure.

Studies show that regular exercise, preferably walking, along with drugs can relieve symptoms and increase endurance. We know that regular exercise can slow down the heart rate. Tennis player, Bjorn Borg, in his prime at 20 years of age had a resting heart rate of only 35 beats per minute! That should motivate all of us to get moving.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He's been a ship's surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: He can be reached at

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