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When someone famous succumbs, interest is sparked and people from all over become engaged in conversation. “How did this happen and how long had it been going on?” are common questions raised. Elizabeth Taylor, the glamorous queen of American movies, and equally famous humanitarian, died late March of congestive heart failure. Known for her seemingly countless illnesses and hospitalizations, she always seemed to pull through and survive. The truth of the matter is that she began suffering from heart failure as early as 2004. Suddenly this diagnosis became a buzz world around the western world.

Congestive heart failure isn’t really a complete diagnosis, but actually a condition in which the heart muscle is failing to function or pump normally. Common symptoms include shortness of breath, fatigue, difficulty lying flat, sudden weight gain, and swollen extremities and abdominal bloating from fluid retention. Fluid accumulates in the legs and belly due to weakness in the heart muscle as a result of the diminished contractility or pumping action.

There are multiple causes of congestive heart failure (CHF). The most common cause is poorly controlledClick image for slideshow hypertension (high blood pressure). Other causes include heart failure related to malfunctioning of one or more of the heart valves, a heart muscle weakened by a massive heart attack, or a heart muscle weakened by viral infection. Up to 10 % of cases of CHF are genetic in origin. Then there remain a large number of cases in which we simply don’t really know the cause. We refer to these as idiopathic.

Why is this such a timely topic? The most common cause of hospitalization in those over the age of 70 is CHF. What you might not know is that, as the heart ages, it often becomes stiffer and has difficulty relaxing. Indeed the heart muscle may pump strongly, but if it can’t relax well due to increased stiffness, filling of the heart with blood will be impaired, and fluid will subsequently back up in the lungs, abdomen and lower extremities leading to the same scenario mentioned above, congestive heart failure. This seems to often be the case in older women.

Treatments include diuretics to help rid the body of excessive fluid, ACE inhibitors to help expand blood vessels and unload the failing heart, and beta blockers to decrease the stress on the heart muscle.

In my practice, I use pharmaceuticals which are essential in treating the heart failure state, but as an integrative cardiologist, I go several steps further. First, I usually add nutraceuticals. We can very productively look at the failure of the heart as a failure of bioenergetics. With today’s diets, the failed heart is typically a nutritionally starved heart and will not have the strength to generate energy. Without the ability to generate energy, the heart muscle and eventually the organism will die.

Dr. Stephen Sinatra, an integrative cardiologist and one of my teachers, often refers to his “awesome foursome”: Co-enzyme Q-10, L-carnitine, D-ribose and magnesium. I use a similar approach. These supplements, and also diet and exercise, will be the subject of my next posting.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements.
©Howard Elkin MD FACC, 2011

*Originally posted Monday, May 9, 2011