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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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Heart Failure |
High Blood Pressure/Congestive Heart Failure01/07/2009 |
I`m a 40 year-old woman who was recently diagnosed with high blood pressure. I have a history of PCOS. My blood pressure was running 160/105 or much higher daily, and I`d have a "beating in the head" feeling and fatigue. I was put on Diovan HCT, which, so far, is keeping it at a normal range. However, I`m very concerned, because the doctor said that I have congestive heart failure. This diagnosis was based on high blood pressure, swelling/water retention in the ankles, a rapid pulse, and a family history on my father`s side of congestive heart failure. Shouldn`t other tests have been ordered before such a serious diagnosis was made? If so, what tests? I came home quite upset, thinking that I`m going to die soon. I researched congestive heart failure online and learned that 50% of people with congestive heart failure die within 5 years. My husband, who`s an R.N. ( he works in dialysis) is really playing this down, claiming that I`m exaggerating the seriousness of the diagnosis. He said that my legs would look like tree trunks if my heart was that bad. I`m confused. I don`t know if he`s correct or just in denial. I don`t know what kinds of tests that I should request and could use some suggestions. Thanks!
Congestive heart failure is a clinical diagnosis, which means that it is based on patient's symptoms rather than on tests. The main symptoms are fatigue, decreased exercise tolerance, shortness of breath on effort and sometimes shortness of breath when lying down. Swelling of the ankles can also be a sign of congestive heart failure. However, there are varying degrees of heart failure, from very mild to severe and life threatening.
In your case, it would seem appropriate to do and electrocardiogram (ECG) and an echocardiogram. Depending on the results of these tests, you may need an exercise stress test and possible further testing. A primary care physician can order ECG and echocardiogram, but you may then need a referral to a cardiologist.
Not everyone with ankle swelling has heart failure, and it is not clear whether you have heart disease at this point, but you do need a diagnostic workup. In any case, Diovan HCT is a good medication for you, because it treats high blood pressure as well as possible heart failure.
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Max C Reif, MD Professor of Medicine Director of Hypertension Section Division of Nephrology & Hypertension Department of Internal Medicine College of Medicine University of Cincinnati |
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