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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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Takotsubo Cardiomyopathy: “Broken Heart Syndrome”

Before I leave the topic of our previous three blogs, I wanted to discuss a relatively new form of cardiomyopathy. Described first in Japan in 1991, Takotsubo cardiomyopathy or Takotsubo syndrome (hereafter abbreviated TTS) has been increasingly recognized as a fairly frequent type of cardiac dysfunction. Also called “broken heart syndrome” and “transient apical ballooning syndrome,” the name derives from the…

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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 category of restrictive. While dilated and hypertrophic cardiomyopathies are defined by anatomic features (an enlarged heart chamber in the first and thickened ventricular walls in the second),…

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

Last week 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 the…

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Cardiomyopathy: When the Heart Muscle is Sick

Over the last several weeks, we have been discussing the subject of CHF (congestive heart failure). I discussed the differences between heart failure from systolic dysfunction (problems with the heart contracting/pumping) and problems 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 conditions, some of which…

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Cardiac Contractility Modulation : The Latest in Device Technology

We have discussed heart failure and its various treatments over the last few blogs. Last week I delved into a particular class of medications, the so-called SGLT2 inhibitors, which are the newest “kid on the block” in our pharmacologic armamentarium to help patients with CHF. Even more recently, I became aware of a new technology called “cardiac contractility modulation” or CCM.…

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

We have 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 over 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”…

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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—many are good at…

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Heart Failure: Is It as Dire as It Sounds?!

In last week’s blog, I talked about sudden death, a quite terrifying term—and it does refer to a scary and sometimes 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, it is…

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