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Right Ventricular Problems: The Overlooked Pump

We have spent a lot of time in the last several blogs on heart failure. Virtually all of these discussions have focused on left ventricular heart failure. What about right ventricular heart failure? Yes, the right ventricle (RV) can fail, too. But many of the most common cardiovascular problems—coronary heart disease, hypertension, valvular heart disease, atrial fibrillation—create dysfunction either exclusively or predominantly for the…

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High-Output Heart Failure: When High Isn’t Good Enough

We have touched on multiple aspects of CHF in several blogs this year, including discussions of how it occurs—whether in the setting of systolic dysfunction or diastolic dysfunction—what its manifestations are, how it is treated, and most recently a look at cardiomyopathies and how they cause CHF. All of these aspects of CHF have one thing in common—the heart isn’t doing…

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Cardiomyopathy (Part III): When the Heart Muscle is Sick

In the last two blogs, we discussed what a cardiomyopathy is, paying particular attention to the categories of dilated and hypertrophic. This week we’ll complete our review of cardiomyopathies with a look at the restrictive category. While dilated and hypertrophic cardiomyopathies are defined by anatomic features (an enlarged heart chamber in the first and thickened ventricular walls in the second), restrictive…

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Cardiomyopathy (Part II): When the Heart Muscle is Sick

Last time we discussed what a cardiomyopathy is, including the three categories of dilated, hypertrophic and restrictive. We then focused on types of dilated cardiomyopathies, along with some discussion about their treatment.  Today I’ll continue our review of cardiomyopathies by focusing on hypertrophic. Whereas a dilated cardiomyopathy is defined by the heart chamber being enlarged, a hypertrophic cardiomyopathy is defined by…

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Cardiomyopathy: When the Heart Muscle is Sick

A few weeks ago, I devoted a couple blogs to the subject of CHF (congestive heart failure). At the time, I discussed the differences between heart failure from systolic dysfunction (problems with the heart contracting/pumping) and that caused by diastolic dysfunction (problems during the relaxation phase of the cardiac cycle). These are clinical syndromes and are brought on by a variety of…

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Why Are My Ankles Swollen?

Hardly a day goes by that I am not asked that question by a patient. The causes are numerous, but most people’s biggest fear is that they have CHF (congestive heart failure). Indeed, peripheral edema (edema fluid causing swelling of the extremities, usually the legs) is often seen with CHF, and probably is its most visible manifestation. In that situation, it is caused…

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SGLT-2 Inhibitors: The New Kid on the CHF Block

We spent a couple blogs discussing heart failure (CHF)—what it is and how we treat it. As time goes on, our armamentarium has expanded.  When I started practicing cardiology 25 years ago, ACE (angiotensin converting enzyme) inhibitors had recently been found to save lives and prevent progression of CHF in patients with systolic heart failure. They became the first “must use” medication…

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Succeeding with Heart Failure

Last week we discussed what it means to have heart failure and how it affects the way we feel. This week we’ll discuss how we treat this condition.  Treatment has two main goals: to help people feel better and to help them live longer. Some of the treatments we use are for one purpose and some for the other—most are good at…

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Heart Failure: What Does That Mean?!

In last week’s blog, I talked about sudden death, a quite terrifying term—and it does refer to a scary and often life-ending event. Another cardiac problem that sounds almost as terrifying is heart failure. Does that mean that the heart has stopped working? Or is it about to stop?  What else could that mean? While heart failure is not a benign diagnosis,…

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