The Washington Post

Congestive heart failure felled Elizabeth Taylor. What is it?

Film legend and notable activist Elizabeth Taylor has died at age 79 of congestive heart failure (CHF). Though her death was not entirely unexpected, as she’d been ill for some time, it is of course very sad. And it has many people, including me, wondering what exactly is “congestive heart failure,” anyway?

I asked Mario Garcia, chief of cardiology at the Montefiore-Einstein Center for Heart and Vascular Care in the Bronx, New York.

“Congestive heart failure is a syndrome, the end-stage of many different potential processes that can affect the heart,” Garcia explains. The most common of these processes – the one responsible for some 60 percent of cases of CHF -- is having a heart attack or myocardial infarction, he says. That’s when an artery is blocked, which keeps blood from being delivered to the heart, which leads death and/or enlargement of the heart muscle.

“The heart tries to compensate, but over time it becomes weaker,” Garcia says. That means it can’t pump blood efficiently, which affects the kidneys, blood vessels and other body parts. Fluid retention may ensue; when your lungs are full of fluid, you’ll feel out of breath.

This pump failure, Garcia notes, “is a slow and very painful death.”

There are medical treatments that can “improve the quality of life and retard the process” in people with CHF. (Treatments may vary for people whose CHF is caused by other conditions, which include alcoholic cardiomyopathy and viral infection.) The only cure is a heart transplant, but there aren’t enough hearts available for all the people suffering from CHF – some 5 million to 6 million in the U.S., Garcia estimates, with half a million people newly diagnosed each year.

Fifty percent of those diagnosed, Garcia adds, will die within five years.

“It’s scary,” Garcia says.

Part of the equation, Garcia says, is that “As we get better at treating heart attacks, people are surviving but living long enough to develop [congestive heart failure]. It’s an unfortunate consequence.”

To avoid CHS, the best thing to do is to take steps to avoid a heart attack. That means avoiding obesity, high blood pressure and diabetes and treating high cholesterol if you have it. If you do have a heart attack, he says, immediate treatment, including having your arteries opened with stents, is key. “The sooner you treat heart attack, the less chance heart muscle will die,” Garcia says.

Here’s the really scary part, though. Garcia says, “You can get heart failure no matter your physical condition.” Still, he says, “Your chances are much less when you’re fitter...If you’re healthy and fit, even if you develop a heart condition you can have a better outcome, better quality of life.”

“Left untreated, this condition is fatal,” Garcia says. But with “discipline and good medical care,” he says, “It’s a bad problem to have, but it can be treated.”

Read more here and here.


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