Dear Dr. Garner,

I was sad to see Mayor Koch pass. I read with great interest about his medical condition.
I have been having similar symptoms. My ankles are always swollen, worse at the end of the day.
I am short of breath and have to prop myself up at night to sleep. I am 78 and have been pretty healthy except for some high blood pressure. Do you think it sounds like I have heart failure?
Thank you for the column. I hope the show comes back soon.

Heart Failure Concerns in Flushing

 

Dear Heart Failure Concerns,
I would first like to acknowledge a very special person. His fund of knowledge is amazing. I am proud he considers me a friend. He has been a loyal supporter of our “Ask the Doctor” TV show from the very beginning, 18 seasons ago. Happy Birthday Msgr. Austin P. Bennett! May you have many happy years ahead.
Before I address your question, I want to stress how important it is to see your doctor. The symptoms you describe can be very serious and represent heart failure or other serious conditions. Your doctor can evaluate your problem best after talking with you, getting a good history and examining you to see where the problem arises.
Heart failure can be deadly. We saw Mayor Koch have problems that advanced very quickly. In heart failure, the heart is not pumping effectively, and the body does not get the oxygen it needs. Fluid begins to back up into the lungs and legs, for example.
This condition usually develops over many years with conditions such as high blood pressure gradually weakening the heart muscles.

Some symptoms are:
– Shortness of breath either when you lie down or exert yourself
– Feeling tired/weak all the time
– Swelling of your legs or feet
– Constant coughing or wheezing
– Decreased appetite
– Difficulty concentrating
– A racing heart or an irregular rhythm

This condition cannot be reversed, but through medication and other treatment, there can definitely be improvement.
Heart failure can be treated in different ways depending upon the cause. For example, surgery of the heart valves may be helpful for malfunctioning valves. Medications are usually started before invasive treatment (surgery) is attempted.
Almost six million people in our country have heart failure.

Unfortunately, about half the people who have heart failure will die within five years. This is why it is important to get treatment early so that you will be among the survivors.
The bottom line is that the earlier the treatment begins, the better will be your quality of life and chances for a long life.
There is a scale put out by the New York Heart Association that some of you might find useful in grading the severity of heart failure:
Class 1 – You have no symptoms.
Class 2 – You become fatigued or short of breath only when you exert yourself with no limitation of normal activity.
Class 3 – Limitation of normal activities with shortness of breath developing after moderate activity.
Class 4 – You are short of breath even when you are at rest.
The scale helps determine your treatment.

Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.