A historical perspective: More people today are surviving heart problems

More people are surviving heart attacks.

If you had a heart attack in the 1960s while admitted to a hospital, the likelihood you would die was 30 percent. Now imagine if, in that same era, you had a heart attack in your living room. The fatality rate probably jumped to 80 percent or 90 percent.

Today, the likelihood that you will die from a heart attack in a hospital is 2 percent.

This is a momentous accomplishment. People who, in the past, would have died of a heart attack are now surviving. However, there is a downside – these patients are now going home and living with a damaged heart. This condition is called heart failure.

A confusing term

Heart failure is a confusing term. It’s not the same as car failure – the heart doesn’t just stop beating and shut down. Heart failure occurs when the heart is unable to keep up with the demands of the body.

There are different levels of heart failure, but the condition typically worsens if it isn’t treated, and heart failure patients who aren’t being treated are usually on a downhill slope to bad things. In fact, the mortality rate of heart failure is several times that of breast cancer.

Treatments for heart failure

The good news is that heart failure can be treated in a number of ways, including the following:

Lifestyle changes

Simple changes can help you feel better and control heart failure. The sooner you make these changes, the better off you'll likely be.

  • Avoid smoking, excessive alcohol and caffeine, and stress
  • Reduce the amount of salt in your diet
  • Keep track of your weight

Medication

Heart failure medications can stabilize the function of your heart, slow down the progression of heart failure, and even improve heart function. Always stick to your medication plan unless you are instructed otherwise by your doctor.

Surgery

As heart failure worsens, lifestyle changes and medicines may no longer control your symptoms. You may need surgery or a medical procedure such as the following:

  • Angioplasty and stenting for patients with atherosclerotic blockage of their coronary arteries to promote normal blood flow
  • Pacemaker to improve the heart’s rhythm or assist both sides of the heart in contracting at the same time
  • An outpatient procedure in which catheters are inserted through arteries in the leg or arm to close a hole in the heart or repair valves

The connection between heart failure and heart disease

Heart failure is a frequent consequence of atherosclerotic heart disease, which occurs when plaque builds up and narrows arteries. In the United States, we’ve seen dramatic successes in the treatment of heart disease – so much so that the likelihood of dying from it has dropped 75 percent in the last 50 years. Over the same time, the likelihood of dying from cancer has dropped 10 percent.

Once acutely lethal, heart disease has now become a chronic disorder that one can often manage for years. In fact, because of all the advancements that have already been made, it’s now quite common for doctors to see patients with heart failure who are older and have other diseases.

In medicine, actual cures of disease are relatively rare. There are very few disorders that we can make disappear. More often, success is achieved by transforming an acutely lethal condition (e.g., heart attack, HIV infection) into a chronic condition that can be managed for years (heart failure, HIV/AIDS).

At UT Southwestern, we continue to make groundbreaking advances to improve the management of heart disease, both for today and the future.

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