Q: What is heart failure and how can it be treated?
Dr. Anil Punjabi, cardiologist, Ohana Heart: Heart failure, also known as cardiomyopathy, is a medical term used to describe differing pathologies of the heart that prevent the heart from adequately and efficiently pumping blood out to the rest of the body. These conditions are commonly split into systolic and diastolic heart failure.
First, systolic heart failure is when the pumping function of the heart is lower than normal. The most common cause in the U.S. is blockages of the heart vessels, also known as coronary artery disease. Other causes include toxin (alcohol, cocaine, methamphetamine use) induced, leaky valves, chronic fast heart rates and sometimes genetic mutations also known as familial cardiomyopathy.
Secondly, diastolic heart failure is when the pumping function is normal, but the heart is stiffened and unable to relax and accept a large volume of blood back into the heart. The most common cause of this type of heart failure is due to the effects of long-standing high blood pressure.
Common symptoms of either systolic of diastolic heart failure include but are not limited to: shortness of breath at rest or worsening with exertion, increase in swelling in your legs and sometimes belly, weight gain, fatigue, cough and inability to breathe when lying down.
The most important way to prevent heart failure is to have routine checks with your doctor who can manage conditions like high blood pressure and diabetes and can discuss how to quit smoking and use of alcohol. If you suspect you or a loved one has heart failure, please consult with your doctor.
Depending on the cause, symptoms and longevity, doctors will usually treat heart failure with a combination of medications and discuss lifestyle interventions including reducing the amount of salt in your diet and monitoring your fluid intake and weight daily. In some cases, further diagnostic testing and possibly surgery is sometimes warranted.
Q: What causes heartburn?
Dr. David Crow, otolaryngologist, Advanced Pacific Ear, Nose and Throat: There’s a small band of muscle at the bottom of your esophagus, the tube that carries food from your mouth to your stomach. Normally, when you swallow, this muscle opens to allow food to pass through, then closes again behind it, like a trap door. When that little muscle fails to close properly, stomach acid can flow back up into the esophagus, causing an uncomfortable burning sensation in your chest. In some cases, the stomach acid and contents travel farther up into the throat. This can cause a bitter taste, voice changes, difficulty swallowing or a feeling of something stuck in the throat. Most people can control occasional heartburn with lifestyle changes, like avoiding caffeine, alcohol, tobacco or fatty foods that trigger the symptoms, avoiding lying down after eating a meal, and maintaining a healthy weight. Over-the-counter medications can also help.
But if your symptoms continue even with medication, or if your heartburn is especially severe and includes symptoms like nausea and vomiting, you should see a doctor. Treatment might include prescription medication or surgery.
Finally, if you are experiencing chest pain or pressure, especially in combination with other symptoms like difficulty breathing or pain in the arm or jaw, seek immediate help; it could be symptoms of a heart attack.
* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem .org/contact.