Once again I am trying my best to highlight pertinent points in a simplified manner so it’s easier for the general public to understand.
This chapter is of paramount importance for people dealing with / for whom Heart Failure – Congestive Heart Failure is suspected.
CHF is commonly & fairly associated with old age. My grandmomma dealt with it during the last few years of her life. It was a slow deterioration.
However, speaking on another spectrum – in terms of Dysautonomia, rapid CHF is not a common comorbid finding.
Due to many misconceptions & lack of awareness by cardiologists themselves who cannot dissect the entire background & history of CHF when it originates from Dysautonomia,
It is necessary for me to delve into a little extra technicalities so patients can be cleared of confusion & advocate for themselves correctly.
If readers recall, I mentioned many times;
< THE HEART COMPRISES OF 4 CHAMBERS >
Two upper chambers known as atrium
Two lower chambers known as ventricles.
Chambers are a formation of walls that may be:
1) A normal size
2) Too thick (stiff)
3) Too thin (stretched).
Chapter 40 explained
& chapter 101 recapped:
The left ventricle is the chamber that pumps out oxygenated blood to the remainder of the body.
When this ventricle squeezes – pumps blood out, the squeeze is denoted as
[ EJECTION FRACTION ]
Meaning: An estimated amount of how much blood the ventricle contains, compared to the volume it is capable of ejecting – pumping out.
Ejection fraction abbreviated as (EF) is a diagnostic criteria & tracker for heart failure.
Normal percentage function is 55-70%
Low percentage function is 40, 55% – below – an indication towards possible heart failure
High percentage function is 70% – above : indication towards another abnormality.
Be careful of allowing any “specialist” dupe you into thinking, any amount from 55% upwards is normal.
I was made aware & realised this delusive notion now!!!
Two cardios previously stated;
“You have all & more classical symptoms of left sided heart failure, however the EF does not show anything abnormal”
It was an unfair brush-off & blatant disregard of many warning signs that manifested 18 months ago….!!!
– The reasons behind chapter 100.
After being in the dark regarding the latest researched facts, I read chats, participated in conversations with members on a CHF support group & obtained valuable information based on collective experiences.
Back then, my EF was 78% which is considered high above the normal function & based on my history – a major indicator towards determining another related issue.
A high EF can also indicate towards enlargement of the heart muscle that I already have
Or it could indicate towards an entity, not yet investigated.
These EF’s were dismissed on 3 occasions.
Due to an extreme lack of awareness, gender & age biased inconclusive decusions.
“Because I’m too young to have that”
Many professionals or common people are angered / might not like these points.
I watched a lady who shared her story of a rarely researched & least funded chronic illness on stage infront of a huge audience.
While most applauded her courage, unfortunately quite a few criticized her for uttering – only the truth –
I don’t care who ridicules the blog, critics are meant to be, but I will always remain true by being frank.
The truth has to hurt.
And we are being hurt in the process of diagnostic delays.
Sheer blessings from above & gratitude that I am able to transform pain into gain.
Anyways, I cannot recall what were the percentages that followed thereafter.
However now, I do know that with prayer, my will of not sitting back, searching for answers as much as I possibly can, along with the bit of help from others, I managed to retrieve a big piece from the puzzle, previously discarded!!!
Also important to know:
Not everything can be seen, measured or detected on an echogardiogram!
Here are a few issues that cannot be measured:
❌ It is hard to accurately measure the way the left ventricle relaxes.
Even when measured correctly, the echo may miss major problems with the way the ventricle relaxes.
Unfortunately many reports omit this section ⚠️
❌ The blood flow cannot be measured accurately
❌ The pulmonary flow cannot be measured.
These require further invasive tests!
It takes time to read & comprehend, but I really appreciate all your patience.
Maybe imagine compared to the amount of time required to absorb these facts.. What does it involve living, learning & researching all the time…
Lol. No sympathy comments!
Here is the second part of equal importance:
DID YOU KNOW?
It is possible to have heart failure with a seemingly normal EF.
Nearly half of all patients with heart failure have a normal EF.
For instance, shortness of breath (SOB), dizziness, fainting, etc…
Are common with Dysautonomia.
But, if you have some of the most clear cut distinguishing signs from other mimicked conditions
Such as: extra lung sounds, unable to breathe when laying down flat, pink tinged sputum, a cough with blood, a pallor that changes blue accompanied by an almost syncope / more…
And a cardiologist brushes aside your concern, don’t stop pushing & seeking answers. Where possible.
Demand further clarity & investigation. You are entitled to it.
This syndrome of heart failure showing a normal EF is quite prevalent & termed as either of 2 categories:
1) < Heart failure with preserved ejection fraction (HFpEF) >
If the muscle in the left ventricle becomes so thick & stiff that is is unable to fill in & hold the usual volume of blood, it might still seem to pump out a normal percentage that enters.
Though, in reality, the amount being ejected is not sufficient to meet your bodys requirements.
Pulmonary Hypertension is common in patients with HFpEF.
Increased left atrium (upper chamber) pressure adds to the process & then leads to RV dysfunction
– Right Ventricular Strain.
“Standard tests such as an x-ray & ECG can appear normal for both HFPEF & some noncardiac conditions”.
“You really need an echocardiogram to look for enlargement in the left atrium and a B-type natriuretic peptide blood test to check for hormonal markers of stress and strain on the heart to get an accurate heart failure diagnosis,”
Says Dr. Mandeep R. Mehra,
Executive director of the Center for Advanced Heart Disease and medical director of the Heart and Vascular Center at Harvard-affiliated Brigham and Women’s Hospital.
While cardiologists are familiar with these two different types of heart failure, many other doctors are not!
The diagnosis of HFpEF is relatively new.
2) < Heart failure reduced ejection fraction (HFREF) >
Heart failure with reduced ejection fraction occurs when the left ventricle becomes too thin, weak & stretched out, which then prevents it from pumping sufficient output to the body.
The weakness disables it from squeezing / contracting forcefully enough.
Then obviously the body receives less oxygen rich blood.
Although Dr’s generally look first for water retention in the lower extremities – leg, ankle, swelling etc..
Remember: Not always, but quite often, the above mentioned symptoms are preceeded by fluid build up in the lungs.
Swelling in every case is not due to heart or lung interlinked conditions, other times it is caused by a liver or kidney disease etc.
Want me to elaborate on statistics about inequity & prejudice conclusions…?
I think an insight will be good!