“Wake Me Up Before You Go-Go”
Recognize these? No? Maybe too young or too old, or don’t listen to the radio very much. These are all songs by George Michael.
What about these people?
-- Elizabeth Taylor
-- Ginger Rogers
-- Danny Thomas
-- Donald O’Connor
Recognize them? At least a couple, right? Well, along with George Michael, they all have something in common — each of these people from congestive heart failure, or CHF.
That’s the same as a heart attack, right?
Wrong, but we’ll talk about that in a minute. First let’s consider how common and how important this condition is. In addition to being pretty important to the people already listed, it’s very important to the millions of us who have been given the diagnosis of CHF. In fact, it was only a few years ago that such a diagnosis meant that you had a 50 percent chance of dying from it within 5 years. Thankfully, its diagnosis and treatment are continuing to improve and this is no longer an automatic death sentence. Yet, CHF has moved up the list of most-common-causes-of-death in America and now sits at No. 3, behind only heart attacks and cancer. So this is something real and something really serious.
But where did this come from? How did it get to be the third leading cause of death in this country? A lot of us might not have even heard of it, and if we have, we don’t know much about it. Turns out this condition has been recognized for centuries. In fact, in the Gospel of Luke, Chapter 14 Verse 2 tells us that “There in front of him (Jesus) was a man suffering with dropsy”. (NIV)
Wait a minute. I thought we were talking about CHF. What is this “dropsy” business?
Like a lot of older medical terms that have fallen into disuse (the Ague – malaria, falling sickness – epilepsy, and the French Pox – syphilis), the term “dropsy” was a descriptive term used to indicate the disease process associated with accumulation of water in the lungs as well as in the lower legs. It derives from the Greek word hydrops, which refers to “water”, and turns out to not only be descriptive but accurate. Dropsy, or CHF, is caused by a weakening of the heart muscle itself — an inability to efficiently pump the blood that is being returned to it — resulting in the “leaking” of fluid into various parts of the body. This can happen almost anywhere, but we are most familiar with the fluid accumulation that occurs in the lungs, legs and feet.
The symptoms are what we might expect: swelling in our feet and legs, especially during the day, and shortness of breath. This “shortness” can be a little tricky, since it usually begins with subtle changes. We might first notice increasing difficulty going up stairs, or having to stop at the mailbox and rest before heading back to the house. This inevitably progresses until the slightest exertion causes problems. Something else to keep in mind is that CHF can manifest itself by a persistent cough — nothing bad a first, and frequently misdiagnosed as bronchitis
So what causes this and who’s at risk?
There are several causes of CHF, including a heart attack, medications, congenital problems, various vascular diseases, high blood pressure and viral infections. The end result is the same: a weakened and inefficient heart. A lot of us are at risk, especially those with undiagnosed or untreated hypertension. That’s why it’s important to “know your numbers” and to manage your blood pressure and any other medical problems you may have. While we have an increasing number of treatments for this disease, it’s a tough one, and in this instance, an ounce of prevention might be worth a ton of cure.
Dr. Robert Lesslie is a graduate of Dixie High School and Erskine College. He is current an emergency room doctor in Rock Hill. Lesslie can be contacted at firstname.lastname@example.org