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January 30, 2007 > Seminar to Focus on Arrhythmias and Heart Failure

Seminar to Focus on Arrhythmias and Heart Failure

Coronary heart disease is America's number one killer. While heart attacks (myocardial infarctions) tend to gain the most attention because they are the most dramatic example, other conditions are actually more prevalent.

According to the American Heart Association, approximately 1.2 million Americans suffer a heart attack each year. That compares to 2.2 million Americans with atrial fibrillation - only one form of heart rhythm problems known as arrhythmias. And approximately five million Americans have been diagnosed with congestive heart failure, with 550,000 new cases diagnosed each year.

To help you gain a better understanding of the symptoms and treatment of both congestive heart failure and heart arrhythmias, Washington Hospital is sponsoring a special Health & Wellness seminar on these topics, featuring cardiologists Dr. Jeffrey Carlson and Dr. Thirupathi Reddy. The seminar, scheduled for Tuesday, February 6 from 1 to 3 p.m., will be held in the Conference Center adjacent to the Nakamura Clinic at 33077 Alvarado-Niles Road in Union City. Attendance is limited to 35 people. To register, please call (800) 963-7070.


"All of us have irregular heartbeats on occasion, and that tends to increase as we age," says Dr. Reddy. "Persistent arrhythmias, though, can cause the heart to work less effectively and indicate a serious medical problem."

Abnormal heartbeat rhythms can cause the heart to beat too rapidly (tachycardia), too slowly (bradycardia) or erratically.

"The abnormal rhythms can be caused by faulty electrical impulses that could be related to factors such as damage to the heart or electrolyte irregularities from kidney malfunction," Dr. Reddy explains. "When arrhythmias result in bradychardia, the heart may not pump enough blood to the body, resulting in fatigue, dizzy spells, lightheadedness and fainting spells. Symptoms of tachycardia can include heart palpitations, shortness of breath and chest pain, as well as dizziness, lightheadedness and fainting."

Diagnosing arrhythmias begins with blood tests to evaluate factors such as electrolyte levels and thyroid function, in conjunction with an electrocardiogram (EKG) to record the timing of heartbeats.

"When an EKG indicates irregular heartbeats, we may have the patient wear a Holter monitor for 24 hours to gauge the pattern and frequency of any arrhythmias," Dr. Reddy says. "Other diagnostic tools include a cardio event monitor that can be worn for a month, an echocardiogram - which is a sonogram of the heart - and a treadmill stress test. Sometimes those tests can't pinpoint the problem, so we would do an electrophysiology study using a catheter."

Treatment for arrhythmias varies widely, depending on the cause and severity of the problem. "Most irregular heart rhythms are benign and don't require any treatment other than making lifestyle changes such as avoiding caffeine, eating a heart-healthy diet and exercising," Dr. Reddy notes.

"For more serious cases of slow heart rates, we can implant an electronic pacemaker under the skin to speed up the heart rhythm," he adds. "In cases of a rapid heartbeat, we would start with medications such as beta blockers and calcium channel blockers. If those medications don't control the problem, we use alternative treatments such as an implantable defibrillator that delivers electrical shocks to control the heartbeat, or radiofrequency ablation, which uses a catheter to deliver radiofrequency energy that stops the extra electrical impulses causing the rapid heartbeats."

Congestive Heart Failure

With congestive heart failure, the heart can't pump enough blood to the body's other organs. Although the "failing" heart keeps working, it does not work as efficiently as it should.

"Congestive heart failure is defined as being unable to meet the body's demand for oxygen both during exercise and at rest," says Dr. Carlson. "At first, people with congestive heart failure experience shortness of breath when they are exercising, progressing to shortness of breath while at rest and then to problems breathing at night when they are lying down. Other common symptoms of congestive heart failure include fatigue, heart palpitations, weight gain and swelling of the feet and ankles."

Dr. Carlson notes that congestive heart failure is on the rise in the United States, in part because the population is aging. "After age 40, the lifetime risk for suffering congestive heart failure is one in five," he says. "That risk doubles for people with a blood pressure reading over 160/100. Congestive heart failure is five times more common in women with diabetes and two times more common for men with diabetes."

Diagnosing congestive heart failure entails taking a complete patient history and conducting a thorough physical exam.

"Just by listening to the patient's heart and lungs with a stethoscope, we can detect abnormal heart sounds and the sound of fluid in the lungs," Dr. Carlson explains. "We also would conduct blood tests for various proteins that indicate heart failure. A chest X-ray could reveal an enlarged heart, a sign that the heart muscle had to grow in order to pump enough blood. An EKG can also help determine if the heart is enlarged or if the patient has any arrhythmias or has suffered a previous heart attack. Other tests might include an echocardiogram, stress testing, angiogram, nuclear imaging or MRI."

People who are diagnosed with congestive heart failure are advised to follow a heart-healthy lifestyle, avoiding smoking and alcohol, eating a healthy diet, losing weight if they are overweight, exercising in moderation and getting plenty of rest. Various medications also can help control the condition, including:
* Diuretics to help reduce water and salt retention.
* ACE (angiotensin-converting enzyme) inhibitors and vasodilators to expand blood vessels.
* Hormone-altering drugs such as beta blockers to improve how well the heart pumps.
* Digitalis to increase the pumping action of the heart.

"Other treatments for congestive heart failure can include treatments for high blood pressure, surgical repair or replacement of faulty valves and angioplasty to clear blocked arteries," Dr. Carlson says. "If the heart is so damaged that it can't be repaired, however, the only remaining option would be a heart transplant."

If you suspect you have either heart arrhythmias or congestive heart failure, consult your regular physician or call Washington Hospital's Physician Referral service at (800) 963-7070 or visit Washington Hospital's Web site at and click on "Find a Physician".





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