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Protecting Your Heart
A Longer Life for Your HeartNew medications can curb heart failure in the early stages
LVH on Leading Edge in Emergency Heart Attack CareLehigh Valley Hospital’s emergency departments (ED) at both Cedar Crest and I-78 and Muhlenberg have set the standard in the region for quick diagnosis and treatment of heart attacks, the number one killer of adults in the United States. People who come to the ED with chest pain get an EKG (electrocardiogram) within 10 minutes of arrival to determine if they’re having a heart attack. If so, the medical team activates a protocol named MI* Alert. The goal is to open the blocked vessel by angioplasty in 90 minutes or less. This rapid response — available all day, every day — is the “gold standard” set by the American Heart Association and the American College of Cardiology. Cardiac Rehab Earns National CertificationLehigh Valley Hospital’s cardiac rehabilitation program is the only program in the area to have earned certification by the American Association of Cardiovascular and Pulmonary Rehabilitation. The certification involved a rigorous review by a national board, whose members found that the hospital’s program meets high standards of care. “As medical director of this program for the past 24 years, I have always been proud to work with such experienced and dedicated nurses and exercise physiologists,” says James Pantano, M.D. “They are deeply supportive of their patients’ recovery. This certification reflects a quality that has always been there.” The cardiac rehab program is located at 1243 S. Cedar Crest Blvd., Allentown. * myocardial infarction, a medical term for heart attackColarusso of Neffs was only 54 when he started feeling out of breath. Through medications and lifestyle change, the retired painting contractor has improved his heart function dramatically. “I feel better than I have in a long time,” he says. Like 5 million other Americans, Colarusso had a heart that could no longer meet his body’s demands. Sometimes called congestive heart failure because of the fluids that can build up when the heart pumps insufficiently, the disease is usually the end result of coronary artery disease, past heart attack, high blood pressure, untreated diabetes or other conditions that affect heart function. Heart failure is a growing epidemic in the United States in men and women over age 65. “With today's advanced care, more people survive heart attacks and live long enough to develop chronic conditions,” says Donna Petruccelli, nurse practitioner who manages the heart failure clinic in Sandberg's group. The key to successful treatment is detecting heart failure early. But the most common early symptoms—fatigue, shortness of breath and/or swollen ankles—can be due to many other conditions, Sandberg says. “If you have past heart disease or a family history of heart failure, see your doctor regularly,” he advises. Cardiologists use an echocardiogram (ultrasound of the heart) to measure ejection fraction, or strength of the heart muscle. Normal ejection fraction is 60 to 70 percent; Colarusso’s was a low 15 percent at the time he was diagnosed. Anything below 40, Sandberg says, is a cue to begin medication to prevent the heart from deteriorating further. Thanks to aggressive treatment, Colarusso’s function is up to 40 now and he’s free of symptoms. The major classes of drugs that have made such a difference for people like Colarusso are ACE inhibitors (such as Vasotec and Zestril) and beta blockers (including Coreg and Toprol XL). ACE inhibitors and beta blockers often are used in combination. Both were first used for other heart-related problems, but research has proven their value in helping a weak heart as well, Petruccelli says. People with more advanced heart failure run a high risk for sudden cardiac death from heart rhythm irregularities. When they’re treated with an internal defibrillator (to shock the heart back into normal rhythm), it greatly reduces that risk, Petruccelli says. New devices that defibrillate and also pace the heart (called biventricular pacemakers or ICD devices) have made a dramatic difference in the lives of heart failure patients who could barely walk before treatment. If you’re concerned about heart failure, how can you help prevent the condition?
Want to Know More about coping with heart failure?
Call 610-402-CARE. This page last updated 3/30/08 03:16 PM
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