Re: Ejection Fraction

Posted By CCF CARDIO MD - MTR on March 09, 1998 at 08:31:46:

In Reply to: Ejection Fraction posted by Jamie on March 04, 1998 at 20:45:59:







: What is considered "early detection" with regards to CHF/cardiomyopathy?
Does this generally affect the prognosis, as it might with cancer?



  
Dear Jamie, thank you for your question.  CHF is usually detected once symptoms
begin so therefore early detection (before symptoms develop) infrequently occurs.
When cancer is detected early, a tumor can be surgically removed or chemotherapy
can be initiated which greatly improves prognosis.  CHF is usually caused by
progressive diseases like coronary artery disease or dilated cardiomyopathy that
can't be reversed if detected early. The prognosis in CHF generally worsens with time
as progressive heart failure and heart rhythym disturbances typically are the terminal
events. Coronary artery disease leads to heart attacks
where the heart muscle is damaged and ceases to contract normally.  CHF results when
the heart is unable to contract sufficiently to move fluid out of the lungs.  Dilated
cardiomyopathy occurs when the coronary arteries are normal and the heart muscle dilates.
CHF develops because the dilated heart contracts poorly and also, can't move fluid out
of the lungs.  With coronary artery disease, heart attacks occur well before heart
failure develops so if patients are counseled about diet, smoking, high blood pressure,etc.
at a young age, coronary artery disease may not develop and heart failure may not ensue.
However, at that early stage, there is usually no relation between heart failure and coronary
artery disease.  Dilated cardiomyopathy is caused by many different diseases some of which
are auto-immune where the body attacks its own tissues.  However, a large clinical trial
demonstrated that treating these patients which powerful drugs to reverse this process
had no positive impact.  Therefore, early detection of CHF will not affect prognosis and
will not have any impact on survival.  Patients should be counseled that if symptoms like
shortness of breath, ankle swelling, chest pain, or severe fatigue develop, they should
be seen by their physician and a diagnostic work-up should ensue.  Otherwise, mass
screening for CHF would be impractical and unlikely to improve outcomes.
   I hope you find this information helpful.  There have been many questions in the Heart
Forum recently on CHF so I suggest you take a look at some of these questions for further
information.  Also, the American Heart Association website has helpful information.
Information provided in the Heart Forum is for general purposes only.  Specific diagnoses
and therapies can only be provided by your physician.