Help for Failing Hearts
"Then over time, we realized that fluid accumulation is secondary to failure [of the heart pump], so we added agents that help the heart pump better. [But] as we did this, we realized patients were still getting worse and slowly dying," Vijay tells WebMD.
"Then we discovered that in addition to pump failure, all sorts of hormones are being released in the bodies of people with heart failure that continue to attack the heart muscle, weakening it and causing deterioration," he tells WebMD.
So more studies investigated whether blocking these hormones would slow disease progression. Enter beta-blockers and ACE inhibitors. Both block specific, heart-damaging hormones, or "little devils," as Vijay calls them.
Now that physicians better understand "some of the underlying mechanisms that occur with heart failure, [we] are targeting those mechanisms, and we are winning the game to some extent," he says.
Patients can help by recognizing the symptoms and getting the right care.
But some experts fear one of the hindrances to getting proper care may be the name -- heart failure.
"We struggle with [the name] all the time," says Packer.
"From a patient perception, the name heart failure sounds morbid so a lot of education is needed in terms of patient awareness, especially since a positive outlook can have a significant role in making quality of life better," Vijay says.
New names for the disease have been considered -- dysfunction, left ventricular dysfunction, cardiomyopathy, heart insufficiency -- but heart failure remains the moniker.
The bottom line is that "we have been scratching our heads and many people have given it considerable thought, but we have not come up with a name that's any better than congestive heart failure," Packer tells WebMD. "My own personal sense is that this situation is best served by keeping its name and educating people about the implications of the name."
Regardless of the name, "The first step," says Iliadis, "is to make the diagnosis and find out what is causing the heart failure. ... We have improved significantly the long-term outcome, and as newer techniques arrive, we will continue to chisel away at poor long-term outcome."