can heart function improve ?

[Jackiesmith7777]

After my husbands stroke seven months ago he was diagnosed with stage 2 heart failure . I asked the arrhythmia nurse if there was a chance he could have another eco cardiogram to see if this had improved because how do we know how much exercise is safe etc if we don’t know this ? She just sort of stared at me blankly and didn’t reply . Thank you for any advice

[10gingercats]

I have an echo twice a year.I have it done(nhs) before seeing the cardio.I do not have to ask. It may depend upon the hospital as to how often they allow you to have an echo. I have 'heart failure' so called plus other heart issues.

[Rosie1066]

I recently found out that I have Stage 2 HF. No one has even mentioned it to me and I only picked it up on reading an Echo I had back in June. Luckily my daughter has a Thoracic doctor friend and she had a word him and he said stage 2 was nothing to worry about now, so I don’t. I’ve read that diet and exercise is good for Stage 2. Very often it is age related.

[Jackiesmith7777 in reply to Rosie1066]

Thank you so much . I worry about it a lot x

[Buffafly]

The BHF has numerous exercise videos plus advice regarding suitable exercise. However the rule of thumb is that you should be able to talk while exercising! The most important thing is not to rush into vigorous exercise - your husband should work up. Is there a handy gym he could join?

[Buffafly in reply to Buffafly]

They have an eight week cardiac rehab email program!

[Jackiesmith7777 in reply to Buffafly]

Yes just around the corner . Funny you should mention talking and walking he was talking to his sister on the phone while he was walking this morning as much as he can with aphasia and seemed less breathless than me lol but as he has high rate Af pulse in 90s but ecg on his Apple Watch has gradually come down to about 105 instead of about 130, worried he might push his heart too much if he over does it .

[mav7]

asked the arrhythmia nurse

Your husband's cardiologist or EP would be the one to ask.

We can't post links but let Google be your friend. Lots of info on the stages of heart failure and exercise. Google "exercise with stages of heart failure". And "stages of heart failure". But again, first speak with the doctor who is familiar with your husband's limits.

[Ppiman]

Knowing a few nurses, and having a fine one as a daughter-in-law, they usually seem to want to help us so the blank stare and lack of response might have been unintended. Mind, there working lives are of long and often arduous 12-hour shifts which can make their working day fifteen hours all told, so the blankness may have been from tiredness.

I believe heart cells that die can never be replaced; however, I have read that heart cells are unusually tough and can recover from various changes and return to a better and more normal state given suitable conditions. Perhaps this means that HF can improve, or at least its progress delayed, but it will depend on the initial cause. I gather, too, that the actual cause of HF is often not well understood, or at least why some people get it and others don't.

You likely have already, but if not, maybe ask your husband's GP about it as he or she is likely to have many patients with it and a pool of long experience or training.

Steve

[Jackiesmith7777 in reply to Ppiman]

Thank you for your advice x

[Broseley]

My mum was diagnosed with HF at age 70. She died at age 93. The GP had recently reviewed her meds that she'd been on for 25 years and stopped some of them. I'm convinced the stress on her heart was too much. If you find a drug combination that works for your hubby, I'd say stick to it!

[Jackiesmith7777 in reply to Broseley]

He s on bisoprolol 5mg a day , edoxoban and dixapoflan probably spelt wrong and antorvaststin . Thank you

[Broseley in reply to Jackiesmith7777]

Mum was on pretty much the same, but had been on digoxin for years not bisoprolol, also a statin, both of which they stopped.

[Silvasava]

I have been diagnosed with HF although I've no idea what stage however I've been on what is called the 4 pillars of meds and my heart has improved. I will always have HF but with the right combination of meds it can be managed and a degree of quality of life maintained.

[Jackiesmith7777 in reply to Silvasava]

Thank you

[Buffafly]

To answer your question in the header the NHS website covers it very well.

[Jackiesmith7777 in reply to Buffafly]

Thank you

[JOY2THEWORLD49]

Hi

I had an ECHO at the beginning of seeing at last a Public Heart Specialist.

This was 1 year 5 months after stroke. I was struggling with avge heart rate of 186 on Metoprolol. Lots of symptoms from the Metoprolol and the razpid heart beat.

Before an operation for right shoulder inner cuff repair, late last year I asked for another ECHO. 2 years 9 months after last one.

I used the operation as an excuse.

I would say that an Echo between 2-3 years should be repeated.

My Echo was improved with the heart showing heart structure no longer enlarged. Also that the rapid AF was under control with CCB Diltiazem 120mg AM and BB Bisoprolol reduced 2.5mg PM was the correct meds for me.

Talking to the latest H/Specialist who asked me if I had flutters, pan or palpitations I said no. He said I did not have heart failure.

I never have had fluttersm palpations or pain ever. Except in my late 30s when I was i a state of anxiety.

An ECG and 24-hour Heart Monitor would give you an update on his now medication. I had 3 together after each change of meds in 2021.

cheri Joy 75. (NZ)

[Jackiesmith7777 in reply to JOY2THEWORLD49]

thankyou yes he couldn’t take diltiazam as it gave him really bad diarrhoea . He is on bisoprolol 5mg which seems to have controlled it to 90s 100s . He is wearing a holster again for two days soon to see if he is dipping in and out of sinus rhythm since his cardioversion . A lot of his readings seem to be inconclusive on his Apple Watch with the ecg and the odd sinus rhythm so we ll see .

[JOY2THEWORLD49 in reply to Jackiesmith7777]

Hi

Never have I heard that Diltiazem when it has a side effect of constipation.

Sometimes it is because of something else but a med gets a bad rap because taken at the wrong time, combined with another drug. BB?

Take care.

As I am in persistent AF and on a steady regime of meds I don't worry and only taking BP 4 times each month.

cheri JOY

[waveylines]

Can stage 2 heart failure be reversed? I think the answer is it depends whether the cause is correctable. Certainly appropriate exercise will help to maintain the heart and can improve function. A friend of mine's husband had a heart attack 18yrs ago. It caused damage to his heart. He attended a cardio gym and since then walks miles. Though his heart is much stronger he cant alter the damage that the heart attack caused. The cardiac nurse wont know the answer to your question. I would ask to speak to his heart specialist.....cardiologist.

[Jackiesmith7777 in reply to waveylines]

Thank you , yes apparently he was on leave . She said she had forgotten so is emailing him for more advice .

[Qualipop]

Yes it can sometimes be improved. I would ask your GP to arrange an echo rather than the arrhythmia nurse.

[Jackiesmith7777 in reply to Qualipop]

Thanks Yes I will , although I wonder if there will be a change in just seven months or whether we should leave it a bit longer

[Qualipop in reply to Jackiesmith7777]

Because you will still have to wait for the appointment, I'd do it now.

[Alicant in reply to Qualipop]

My GP didn’t have a clue…

[Qualipop in reply to Alicant]

Then ask them to tell you who DOES "Have a clue"

[barbara2]

I googled it and found this: Can heart failure get better? Heart failure has no cure. But treatment can help you live a longer, more active life with fewer symptoms. Treatment depends on the type of heart failure you have and how serious it is. March 2022

Stage two of congestive heart failure will produce symptoms such as fatigue, shortness of breath, or heart palpitations after you participate in physical activity. As with stage one, lifestyle changes and certain medication can help improve your quality of life. May 2019

Here is a good link: my.clevelandclinic.org/heal...

[Jackiesmith7777 in reply to barbara2]

Thank you

[JOY2THEWORLD49 in reply to barbara2]

Hi

Excellent piece of knowledge.

Not sure what I have as latest Cardiologist replied that I do not have heart failure.

But I have severe dilation of left atrium and RV regurgitation. Soft Systollic Heart Murmur, functioning normal, pressure normal. No palpations, flutters, or pain.

Persistent AF without the rapid now for over 2 years controlled down to 60s Day, 47 Night.

I've been discharged from outpatients - too many on the list to see a Cardiologist.

cheri jOY. 75. (NZ)

[Desertflowerchild]

In June 2022, the Chief of the Section of Heart Failure Treatment and Recovery and an Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine, wrote: "Historically, heart failure (HF) has been considered as a steady track towards mortality, but the evidence from the field clearly demonstrates that HF is not a death sentence, and that recovery and remission are possible. . . . The primary difference between remission and recovery is in the myocardial substrate, with persistent abnormalities in remission but ‘normal’ structure and function in recovery. Essentially, until the myocardium has become completely non-viable (i.e. late gadolinium scar, dead muscle), that myocardium should be a target for therapy and recovery."

[philologus]

I had HF at stage 4 and the Dr in ER said it was because I'd been taking Tramadol and it had caused lots of ectopics that had confused my poor ticker so that it wasn't pumping properly.

I asked if stopping the Tramadol would mean that my heart could repair itself and was told that it could - as long as there were no other factors involved.

That was about seven years ago. I'm now 78.

I stopped the Tramadol and did a few other things that I'm not allowed to say on here and within two years my HF had dropped to stage 2.

My last scan, about six months ago, showed "mild" HF and I was told that I could now stop all my heart related medication. (I'd been gradually reducing them for a while.)

So my answer to your question is that in my experience HF can be "managed" and sensible exercise is very much a part of that.

When I was recovering I went to a physio for a while and she said that the most important thing to remember is that your calves are like a second heart.

[Hidden in reply to philologus]

"When I was recovering I went to a physio for a while and she said that the most important thing to remember is that your calves are like a second heart."

Can you elaborate on that?

[philologus in reply to Hidden]

heartspecialistsgroup.com/t...

[Hidden in reply to philologus]

Interesting, thank you

[Coco51]

I have recently been diagnosed with some stage - not sure what stage - heart failure.

I've found that a good route to getting some action on tests and treatment is to email my consultant's secretary. I just say that I was expecting an echocardiogram but haven't heard anything and wonder if the appointment has gone astray. Quite often they reply and an appointment arrives the following week.

Was told I'd have an echo 3 months after the start of my HF treatment. when I'd heard nothing that's when I wrote. I had the echo last week.

In my case I was diagnosed in September, and told my HF was caused by pacemaker dissynchrony. I've had a new bi-ventricular pacemaker fitted at the end of October, and been told the condition is probably "reversible" but that it may take up to 18 months for the heart to repair. I hope they are right, the whole thing has been very upsetting as it came out of the blue. My previous echo in March was allegedly OK.

So I now have two consultants - the EP who fitted the new pacemaker (my old consultant during 8 years of AF), and a new HF consultant. When things weren't happening on the HF follow-ups I went to see the HF consultant privately. He remembered me and was amazed because he hadn't been informed I'd had the pacemaker fitted. That also triggered some more appointments. Maybe a private appointment with the HF consultant might help things along for you?

For example, the HF consultant then referred me to his NHS nurse led HF clinic. The HF clinic is going to prescribe Entresto which is better for heart function than Lisinopril apparently. That would not have happened so fast if I hadn't seen him privately I think. Has your husband got a HF Nurse as well as the Arrhythmia Nurse?

I do feel less fatigue, but I have had to stop Flecainide tablets and my AF seems to be creeping back. I take Lisinopril, Bisoprolol, Dapaglaflozin, Spironolactone diuretic, Apixaban and Pravastatin.

I know how worrying this must be for you, having been through it myself. But take comfort from the junior doctor who whispered to me at my diagnosis (as he passed me the tissues to dry my tears) "I don't know they they call it heart failure. In other countries it's called heart insufficiency." Doesn't sound quite so bad does it?

[Jackiesmith7777 in reply to Coco51]

Thank you for your advice . I will do that

[Brianboru]

I should try asking again and politely ask if she doesn’t know to tell you who does !

[Jackiesmith7777]

thank you I will