"The Heart of the Matter"

brought to you by NEMA - The National Emergency Medicine Assoc.


Return to Topic List

Week: 514.3 Guest: Louis Grenzer, M.D. Topic: Heart Failure - Part One Host: Richard Roeder Producer: Ed Graham

NEMA : This is a discussion of heart failure with cardiologist Dr. Louis Grenzer from Baltimore, Maryland.

NEMA : Dr. Grenzer, would you explain the term "heart failure."

GRENZER: There's a lot of definitions of heart failure, none of which is really absolutely acceptable but the one I like, and it's fairly simple, easy for people to understand is that the heart muscle is not able to pump strongly enough to get blood out to meet the demands of your peripheral tissues so it's a weakness of the heart muscle and it's not able to pump forward normally.

NEMA : Heart failure certainly doesn't sound as ominous as "heart attack" but in fact, heart failure causes tens of thousands of deaths in this country every year. Why is heart failure potentially such a mortal disorder?

GRENZER: Well, the reason for that is ordinarily when you develop heart failure, there's a reason for it and heart attack might be one reason for it, i.e., a heart attack can damage part of the heart muscle and therefore it's not as strong as it was before and it's not able to pump the blood out. There's a lot of other reasons people get heart failure. Viruses can cause it. Problems with your heart valve can cause it but any of the causes of heart failure indicate, or any of those things that result in the development of heart failure indicate that there has been damage to the heart muscle and although the heart muscle does pretty well even with a certain amount of damage, if that damage progresses, then you're in real trouble because the heart is not able to get enough blood out to adequately get blood to your kidneys, your brain, and all the other vital organs so when you develop heart failure, it indicates you've already had a good amount of damage to the heart muscle. Basically, the heart's a muscle and its function is to pump the blood and if it's not able to pump the blood forward, then a lot of complications can develop.

NEMA : Why is one of the common symptoms of heart failure a build up of fluid in the legs or hands or other parts of the body?

GRENZER: In defining heart failure, I defined it by saying the heart is not able to pump the blood forward adequately. But when that happens, the pressure builds up and actually the blood then backs up and you get a high pressure of blood in the lungs and then it can back up to the right side of the heart and you get a high pressure in your veins so that fluid leaks out so the heart failure starts as an inability to pump forward but it results in a back up of blood with a high pressure fluid leaking out and that's why the symptoms commonly are shortness of breath because fluid leaks out into your lungs and interferes with the ability of the lungs to expand. Fluid leaks out because of the high pressure in the veins in your legs and you get swelling of the feet. Fluid backs up into the liver and people with heart failure get an enlargement of their liver. The doctor can feel that when he examines your abdomen. The veins in the neck get distended so that's why the doctor might be taking special note of your neck when he's examining such a patient. Because of that back up, the veins get distended and we can actually see the veins are enlarged when we examine your neck.

Send mail to info@nemahealth.org
Copyright © 1996 National Emergency Medicine Associations, Inc.
Last modified: November 01, 2021