Is Early Heart Failure Detectable?

[KimC]

My question for the research hounds out there:

Are today's tests able to detect early or mild heart failure?

The reason why I ask is that the nurse at my cardio's office called concerned about my asthma diagnosis. She wanted the PFT results.

Now I'm all worried. I don't see my cardio again until mid-January.

Thanks,

 

[Nancy]

There is a very good site for CHF.

Here are some links:

http://www.chfpatients.com/index.html

http://www.chfpatients.com/CHF.htm

http://www.chfpatients.com/CHF.htm#diagnosing

There is also a blood test BNP which can diagnose CHF. Most hospitals use it, but not all. Ask about it.

 

[bvdr]

Kim,

I was told that because of early chronic CHF the blood vessels in my chest have "cephalization"....meaning the size and fullness in the upper vessels is greater than those in the lower.

I really like how your doctor is doing some research for you. Mid-January is right around the corner. Try to enjoy the holidays between now and then and it will be here before you know it.

 

[Kim]

Hi Kim,

I have always wondered if an ejection fraction at 50 and below automatically meant early stages of CHF (when there are no symptoms). Or would there need to be other symptoms for a diagnosis of CHF in addition to a comprismised EF. My EF is 45-50%, but my cardiologist has me on lopressor, digoxin, aspirn, and of course, Coumadin. He has never used the words CHF, but I think because he knows how I worry, he just chooses not to tell me everything!

 

[KimC]

Nancy, Betty & Kim: thank you and HAPPY HOLIDAYS!


I'd like to share the reply I received from WebMD re: the same question:

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I have moderate AI and TI, plus hypothyroidism and was recently diagnosed w/ asthma. (I am four 1/2 months postpartum from a very difficult pregnancy and labor. I was originally diagnosed w/ peripartum cardiomyopathy but recent echoes showed high but normal chamber sizes).

According to the research I've read and my docs, my condition(s) should not be causing heart failure, yet I either coincidentally have a lot of similar symptoms to or may have early heart failure.

How can I be sure that my symptoms, (SOB and chest pain w/ heavy exertion, palps and fatigue) aren't related to heart failure?

What would my diagnostics show besides EF%? (I will see my cardio again in a few weeks and plan to ask the same questions).

Thanks for your help --

KKG

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Re: Is Mild Heart Failure Detectable?
by TooBreathless, on 12/19/2003 11:17:25 PM NEW!

Hi

I had a Stress Cardiac Pet scan a few months ago to see why I was having simliar heart failure symtoms even though my EF was almost normal. The test showed that my heart was enlarging approximately 25% under stress above the size that it was when I was at rest. No other test was capable of detecting that problem. My problem was caused by ischemia but yours might have a different cause. Prior to this test I did not know your heart could expand and go into heart failure in that way. Perhaps you could ask about a similiar test to see what is going on with your heart.

Good luck

Larry

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REPLY to this Post | MORE POSTS by TooBreathless


Heart failure detection/diagnosis general info......plus
by CardiostarUSA, on 12/20/2003 10:03:21 AM NEW!

Hi KKG:


Sorry to hear that you had a difficult pregnancy. I hope the baby is doing ok.

You would think that at any stage (or level, severity) of heart failure (systolic, diastolic, right-sided, left-sided) it should be/would be detectable, but depending on the competency of the particular technologist (technician) and doctor, plus the diagnostics chosen (e.g., echocardiography, Cardiac MRI, etc.), sometimes, subtle or mild cases may/can be missed.

Noteworthy is that one can actually have heart failure with a normal left ventricular ejection fraction (LVEF) as in diastolic heart failure in which there is a problem with the heart filling up with blood during diastole (the heart's resting phase).

My elderly mom was diagnosed with this (early stage, as it said on the cardiac echo report back then) specific condition a few years ago.

The trouble all began for her with swelling (edema, fluid retention) of the ankles that would come 'n go, and then it became chronic and eventually affected her legs, even causing slight "weeping edema" at one point where clear fluid was trickling (seeping) out of a teeny tiny red spot on one leg.

Heart failure has been called an "American epidemic" and it is estimated that more than 2.5 million individuals with heart failure symptoms have diastolic heart failure (diastolic dysfunction, DD).

Back in mid 2002, researchers at Columbia University announced that they had developed a new non-invasive measurement technique (method) called myocardial contraction fraction (MCF) to help solve the problem of diagnosing (confirming) diastolic heart failure which was first tested in 140 individuals.

Myocardial contraction fraction requires hi-tech 3D echocardiography which takes a series of cross-sectional pictures or "slices" that allows
for reconstruction of clear and concise images of the complete Engine of Life (heart).

The researchers compared the amount of blood the heart pumps out with the amount of heart muscle (myocardium) mass (HMM).

Standard ejection fraction measurement utilizes 2D echocardiography which does not measure muscle mass.

Some conditions are being detected that weren't before such as reported last year in the Journal of Nuclear Cardiology where Prinzmetal's angina (coronary artery spasms) was detected by exercise (not resting) Tc-99m tetrofosmin (Myoview?) w/gated-SPECT scan.

As I posted about a while back, several clinical trials are now in progress (Phase III) using echocardiography and specialized microbubble contrast agents (e.g., Definity®, AI 700 and CARDIOsphere?, which acts as a tracer in the blood) to evaluate myocardial perfusion (blood flow to the heart muscle) to detect coronary artery disease (CAD).

Contrast agents such as CARDIOsphere? are used in conjunction with gated-harmonic power doppler (HPD) ultrasound imaging, a modality purported as being highly qualified (and matched) for the assessment of myocardial perfusion.

Myocardial perfusion imaging is something that is routinely done in nuclear cardiology, but never thought possible before using plain 'ol harmless sound waves and contrast media.

I've supplied below some priority-selected URLs to general info that I hope you find helpful.

I hope the upcoming holidays are pleasant for you and your family and that the coming New Year is kinder and gentler to you.

Best of luck when you see your cardiologist next. Don't leave the office until any concerns have been properly addressed and
all your questions have been answered to your complete satisfaction.

Don't hesitate to seek additional professional opinions as necessary.

Take good care


C-Star*














General info


American Family Physician

American Academy of Family Physicians


Essentials of the Diagnosis of Heart Failure - Circa March 1, 2000

DIRECT address:

http://www.aafp.org/afp/20000301/1319.html




Mayo Clinic, Rochester

Diagnosis of Congestive Heart Failure

DIRECT address:

http://www.mayoclinic.org/congestiveheartfailure-rst/diagnosis.html




NASPE

Heart Failure

DIRECT address:

http://www.naspe-patients.org/patients/heart_disorders/heart_failure




�?

According to statistics from the American Heart Association, approximately 550,000 new cases of heart failure are diagnosed in the United States every year, including 10 out of every 1,000 individuals over the age of 65

�?



MEDLINEplus Health Information

Aortic insufficiency (AI)

[Regurgitation]

DIRECT address:

http://www.nlm.nih.gov/medlineplus/ency/article/000179.htm



Tricuspid Insufficiency (TI)

[Regurgitation]

DIRECT address:

http://www.nlm.nih.gov/medlineplus/ency/article/000169.htm





CCF

The Cleveland Clinic

Aortic Valve Disease
Management

DIRECT address:

http://www.clevelandclinicmeded.com/diseasemanagement/cardiology/aortic_valve/aortic_valve.htm



Valve Disease: Tricuspid Valve Disease

DIRECT address:

http://www.clevelandclinic.org/heartcenter/pub/guide/disease/valve/tricuspid.htm



HHS

Hendrick Health System

Hypothyroidism

DIRECT address:

http://www.ehendrick.org/healthy/000726.htm




American Lung Association

Asthma - Index

DIRECT address:

http://www.lungusa.org/asthma




PulmonologyChannel

Asthma - Index

DIRECT address:

http://www.pulmonologychannel.com/asthma




---?Women who are pregnant or are planning on starting a family should read the following patient guides

? Pregnancy & the Heart Disease

? Pregnant Heart Patients

? Gestational Heart Related Problems

at HeartCenterOnline For Patients -


[Free membership]


DIRECT address:

http://www.heartcenteronline.com/myheartdr/home/splash1.cfm?sp_id=276&T_Id=1169&