Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: CHF (Cardiomyopathy) -AND- COPD (Emphysema+Asthma)

Forum: The Heart Forum
Topic: Cardiomyopathy


I am a 62 yr old, 6 ft--225# (BMI=31), non-smoking (30+ yrs) AND
non-drinking (20 yrs), DWM. I am a professional with a BSEE, MBA. This
information is my attempt to put a face and an image on the message!

I have:

¨ 1) COPD: Chronic Obstructive Pulmonary Disease
Emphysema: (Diffused-Obstruction of the small airways)
Asthma: (Intrinsic-No allergies)
(Diagnosed: 1977)

¨ 2) CHF: Congestive Heart Failure
Cardiomyopathy: (Idiopathic Dilated)
(Diagnosed: Dec, 1995)

¨ 3) Rectus Diastasis: (with a Significant Stomach distension)
(Diagnosed: Dec, 1995)

___

I have been hospitalized 16 times (for A stay of 10-to-12 days at a
time) with the COPD over the last 20 years (haalf of the stays weere in
the first 4 years), with most of my Admissions being under "Emergency
conditions"!

A Full Pulmonary Function Test showes:
"... Severe obstructive lung defect... decrease in flow rate at
peak flow at 50% & 75% on the flow volume curve. ...increased
lung defect is confirmed by an increased RV. ...Comparison of
FRC, PL & FRC indicates significant non-communicating gas
volume."

In Oct/Nov, 1995. I was hospitalized twice for COPD. During my last
stay, I stopped breathing 3 (three) times. My Pulmonologist ordered an
Echocardiogram. As a result of that test, I was diagnosed with CHF
(with Rectus Diastasis also being noticed). The Echocardiogram showed
an EF of 25% (with a markedly dilated left ventricle), LV diastolic
dimension of 81 mm, Bi-atrial enlargement, & severe mitral valvular
regurgitation).

Concern over the results of this test caused me to go to a Cardiologist
last year. His initial diagnosis, based on the 1st Echocardiogram, was
very pessimistic! Psychologically - This "Hit" me very hard! - The
prognosis gave me, in my estimation, a very short time to live.

As a result, he ordered another Echocardiogram done. Its results confirmed
the EF of 25% & LV diastolic dimension of 82 mm; but showed normal
ventricular valves (although there is regurgitation due to the enlarged
LV).

At a 3rd echocardiogram I had done last December, the readings had
improved over the last two! The heart readings had improved,
with the EF increasing to 32%, and a corresponding decrease in my
diastolic LV Diameter to 76 mm.

I'm taking all the medicines prescribed: Albuterol, Vanceril, Lasix,
Lanoxin, Pravachol, Vasotec, Coudamin, KCl, etc. (as well as Phentermine &
Serzone - to assist in Weight Loss (I can't eat less or exercise more than
I'm doing now!)

I am constantly looking of ways to better the QUALITY OF MY LIFE),
searching for information that covers BOTH of CHF AND COPD, (TOGETHER,
as well as, individually). I try to do whatever I can to meet this goal
(by eating correctly, trying to keep up with my exercising (Using a
Stationary Bike AND walking), relaxation, breathing correctly, etc.

NOTE: * Both the CHF AND COPD cause the two same major problem:
BREATHING and FATIQUE
(Causing the biggest hurdles to exercising more!!)

The heart is a muscle. Therefore reason says that working it (within
reason) can only help? I try, as best as I can with my COPD, to ride my
Lifecycle and walk, to build this "muscle".

There is nothing out on the WEB that I've found that covers BOTH the
CHF and COPD - TOGETHER!!! I'm eating correctly, & trying to exercise
(Stationary Bike AND walking).

** Breathing and Fatigue: Again, Biggest hurdles to exercising more!!

The heart is a muscle, therefore reason says that working it (within
reason) can only help? I try, as best as I can with my COPD, to ride my
Lifecycle and walk, to build this "muscle".

With in the last couple of weeks, BOTH the American Heart Assoc. AND the
National Inst. Of Health have upgraded their warnings on Obesity,
With their warnings of:

Am. Heart Assoc: "...declared obesity a major risk factor, adding
it to a list that includes smoking, high blood pressure, high
cholesterol..." and "...listed obesity as a `contributing
risk` factor for heart attacks."

Natl. Inst. Of Health: "...people...with a BMI=30 or greater
should immediately try to lose 10% of their weight."

My BMI = 31 !

I'd appreciate your thoughts on my reasoning that exercise (aerobic)
will improve the heart: That the EF can be increased (though not to the
50-60%, that's normal)?

I'm trying to find out ANY Information on CHF/COPD! Such as, clinical
trials in my area (Orange County, CA (near LA)), info on exercise with
these condition, others that might have the same problem (that are
trying to work through them), what research is being done in this area,
Support Groups, WEB links, ETC!

Any help that you can provide would be greatly appreciated!!!

Thank you,

PS: I have not found any WEB site that covers both the Cardiomyopathy
& the COPD! ?

____
Dear Roy,
It seems to me that you have a very good handle on each of your conditions and
how they interact, I actually can not add but a few points. Also, a lot of what
is placed or said to the public by the AHA and ACC is geared toward those who have not yet developed
many of the syndromes that you already have, and obviously they are geared toward sedentary people who
never even considered exercising, losing weight, or watching their cholesterol. You on the other hand
are very much aware of all the issues and you should give yourself credit for such thorough care of yourself.
Being near L.A. is to your advantage in that there must be some kind of program for you at the university hospital
that can maybe help and support you in your weight loss goals. The one thing I am still unclear about is was a catheterization
looking for blockages in your coronary arteries ever performed? It is not unusual for people who take such good care of themselves
and who take their heart failure medications regularly to do better but not return to normal as you say. If possible, you should
visit the medical library at the university hospital in L.A. to read a little about COPD and Heart failure. Good Luck.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment can only
be made by your physician(s).

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