Head off heart failure risk with exercise

Cardiac patients like Sharon Kindall of Lawrence gain strength and confidence exercising in the medically-supervised environment of the Cardiac and Pulmonary Rehabilitation program at Lawrence Memorial Hospital.

Cardiac patients like Sharon Kindall of Lawrence gain strength and confidence exercising in the medically-supervised environment of the Cardiac and Pulmonary Rehabilitation program at Lawrence Memorial Hospital.

The heart is a muscle, and it’s clearly the most important muscle in your body. Composed of a special type of tissue found nowhere else in the body, the heart muscle is made to beat powerfully and continuously minute after minute, day after day, without rest, for your entire life.

It should not weaken, but when it does, for any reason, the result is heart failure. Cardiologist Roger Dreiling of Cardiovascular Specialists of Lawrence explains that the term “congestive heart failure” sounds ominous, but it does not mean that the heart has failed or has stopped working. “It’s simply not pumping as effectively as it should to get blood and oxygen to the cells of the body,” he said.

This is a serious matter. Heart failure is the leading cause of hospitalization for Americans age 65 and older, and statistics show half of these patients die within five years.

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Symptoms of heart failure include fatigue, weakness and shortness of breath with just a little amount of work; difficulty climbing stairs or getting from point A to point B without frequent rests; and swelling in the feet, ankles and other parts of the body.

Heart failure often occurs as an after effect of a heart attack. Damage to the heart muscle makes it less efficient at pumping blood. Or heart failure can develop gradually as a result of an infection of disease of the heart.

Dr. Dreiling explains that congestive heart failure results from a lack of forward flow of blood from the heart, which acts as a pump, to such an extent that it does not meet the demands of the body.

When the left side of the heart fails to pump with enough force, fluid may collect in the lungs, making it more difficult to breathe and causing shortness of breath, particularly during exercise or while lying in bed. When backups occur on the right side, fluid begins to collect in the lower part of the body, leading to puffy legs and feet.

“So if lack of forward flow is such that you don’t get enough kidney blood flow, then the kidneys recognize that, and the kidneys start retaining salt and water,” Dr. Dreiling said. “Your volume in your intravascular space starts filling up to the point that you can’t contain it all, so it has to be stored somewhere, and frequently it’s stored in the lungs. The lungs become heavy, and the air sacs start filling with water and they can’t fill up with air, so your oxygen level goes down, which further exacerbates your feeling of shortness of breath.”

Probably the most common sign of heart failure is a reduced ability to exercise, but exercise is the most important thing you can do to prevent heart failure and to head off the most serious consequences once you do have the disorder.

Dr. Dreiling says because the heart is a muscle, exercise strengthens it, just as it does other muscles in the body, by stressing it in a controlled way. Exercise also boosts circulation, strengthens the cardiovascular system, lowers blood pressure and cholesterol and helps cells use oxygen more efficiently.

For those who already have heart failure, exercise becomes increasingly difficult. Patients with severe symptoms usually need a supervised exercise program to make sure they work out at the right level of intensity. The American Heart Association and the American College of Cardiology recommend exercise-based cardiac rehabilitation as a safe and effective part of therapy. Always consult with your doctor before beginning an exercise program.

The key is to start exercising early in life, long before the symptoms of heart failure appear, and make it a lifelong habit. Exercise costs you nothing but time and effort. Yet it offers better prevention and treatment for the heart. With aging and certain medical conditions, heart failure can occur, even in previously fit persons. In such cases, exercise becomes more difficult and may need to be more moderate and controlled in intensity.

Lawrence Memorial Hospital offers a medically-supervised Cardiac and Pulmonary Rehabilitation program and a Congestive Heart Failure Clinic for ongoing disease management and education to help keep cardiac patients out of the hospital. For more information, visit the hospital’s website at lmh.org/heart. You can also watch a video featuring Dr. Dreiling explaining the difference between a heart attack and congestive heart failure on that page.

You can learn more about the risks, diagnosis and treatment of heart disease at the LMH Healthy Hearts Fair on Feb. 20, an annual event focused on screenings and information about cardiovascular disease and its prevention and treatment. For more information, click Wellness Resources on the LMH website and search the Classes and Events tab.

— Aynsley Anderson Sosinski, MA, RN, is Community Education Coordinator at Lawrence Memorial Hospital, a major sponsor of WellCommons. She is a Mayo Clinic Certified Wellness Coach. She can be reached at aynsley.anderson@lmh.org.

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