When the heart pumps normally but struggles


If you were diagnosed with heart failure in the hospital, I’m presuming that you were admitted with symptoms such as shortness of breath, fatigue, and difficulty doing everyday activities. Other common symptoms include swelling in your legs and feet and trouble breathing at night.

Heart failure means that the heart cannot pump well enough to meet the body’s need for blood. To diagnose the condition, doctors rely on several tests, including blood tests, an electrocardiogram (ECG), and a chest x-ray. An ultrasound of the heart (echocardiogram) shows how well the heart can pump. A measurement known as the ejection fraction, or EF, refers to the amount of blood pushed out (ejected) with each heartbeat. A normal EF is 50% to 70%.

An EF in the range of 41% to 49% is considered borderline low. An EF of 40% or lower suggests heart failure with reduced ejection fraction. This type of heart failure, which used to be called systolic heart failure, happens because the heart muscle doesn’t contract effectively. It can occur after a heart attack, but there are many other possible causes, including severe, untreated valve disease or a viral infection.

However, about half of people with chronic heart failure have a normal EF. Formerly known as diastolic heart failure, this condition is now referred to as heart failure with preserved ejection fraction. The heart contracts normally, but the lower chambers (ventricles) are stiff and thickened, so they do not relax and refill normally. This type of heart failure is more common in older people, especially women, as well as people who have high blood pressure or the irregular heart rhythm called atrial fibrillation.

People with either type of heart failure usually need to take blood pressure drugs known as diuretics (sometimes called water pills) to eliminate excess fluid from the body. Common examples include chlorothiazide (Diuril), chlorthalidone (Hygroton), and furosemide (Lasix). However, people like you who have a preserved ejection fraction need to be alert to dangerously low blood pressure, which can occur if your diuretic dose is too high. While other blood pressure drugs such as ACE inhibitors seem to help people with reduced ejection fraction, that’s not the case for those with preserved ejection fraction. But a number of clinical trials studying new therapies for heart failure with preserved ejection fraction are currently under way.

A healthy, low-salt diet appears to be important for people with heart failure. Losing weight (if needed) and avoiding alcohol can also help improve your symptoms. It’s also a good idea to engage in regular physical activity, but ask your doctor for advice on how much and how often you should exercise.

— by Deepak L. Bhatt, M.D., M.P.H.
Editor in Chief, Harvard Heart Letter

Below are spiritual recipe for health and wellness: Matthew E. McLaren

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. 1 Corinthians 13:4-5  NIV

Do everything in love. 1 Corinthians 16:14

Let the morning bring me word of your unfailing love, for I have put my trust in you. Show me the way I should go, for to you I entrust my life. Psalm 143:8 NIV

Let love and faithfulness never leave you; bind them around your neck, write them on the tablet of your heart. Then you will win favor and a good name in the sight of God and man. Proverbs 3:3-4 NIV

And over all these virtues put on love, which binds them all together in perfect unity. Colossians 3:14 NIV

I pray that out of his glorious riches he may strengthen you with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you, being rooted and established in love. Ephesians 3:16-17 NIV

And now these three remain: faith, hope and love. But the greatest of these is love. 1 Corinthians 13:13  NIV

And so we know and rely on the love God has for us. God is love. Whoever lives in love lives in God, and God in them. 1 John 4:16 NIV

Be completely humble and gentle; be patient, bearing with one another in love. Ephesians 4:2 NIV

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