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47 year-old heart transplant candidate now off the list after participating in SBUH study

3/22/2007


In 1999, a 40 year-old appliance company deliveryman, "Mr. R" from Suffolk County began experiencing irregular heart rhythms after acquiring a viral infection. When Mr. R coughed up blood in July of that year, he knew something was terribly wrong. Following an electrophysiology (EP) study at Stony Brook University Hospital, his doctors determined he needed a defibrillator. He noted that he got back to "about 95 percent" from where he was. On the brighter side, during his convalescence he met and married his wife. In December 2003, they had a little boy.

Mr. R’s health remained good until September of 2005, when he experienced difficulty lifting a small microwave at work. Another trip to the hospital resulted in a heart failure diagnosis. In February of 2006, he started retaining fluid, especially in his belly, and so began the "in and out of the hospital every two months" to have his stomach drained – eight times in total.

"When they changed medication, the fluid buildup stopped, but my blood pressure would drop," said Mr. R. "We’d change the dosage and my blood pressure would become normal, but the fluid would build up again."

Mr. R’s heart function continued to deteriorate, and in August that year, after having agreed to add his name to the heart transplant list, he was referred to Hal Skopicki, M.D., Ph.D., FACC, director of the Heart Failure and Cardiomyopathy Center at Stony Brook University Hospital.

"Dr. Skopicki was a godsend; he figured it out," said Mr. R. "He got the meds and treatment under control, and since then I haven’t retained water or fluid. I’m gaining ‘good’ weight – muscle. I can pick up my three year-old son now, I can take the garbage out, and I’m able to walk about a mile – I couldn’t even walk 10 feet before without having shortness of breath."

On top of that, he says, he no longer is being considered for a heart transplant because he does not need one.

During our lifetime, each of us have a 20 percent risk of developing heart failure. There are more than 5.5 million people in the United States with heart failure and over half a million new cases are diagnosed each year. These numbers will continue to increase as our population ages and more people survive other ailments.

What is Heart Failure?
The body depends on the heart’s pumping action to deliver oxygen and nutrient-rich blood to the body’s cells. With heart failure, the weakened heart can’t supply cells with enough blood. This results in fatigue. When blood is not effectively "pushed out" of the heart, water from the bloodstream backs up into the lungs. This may cause difficulty breathing with activity and, when severe, even at rest. Fluid also accumulates in the abdomen and legs with loss of appetite, stomach pain and swelling of the belly and legs. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult, if not impossible.

What Causes Heart Failure?
Although heart failure may strike at any age, it is more common in people over the age of 65. The most common risks associated with heart failure are high blood pressure, heart attacks, damage to the heart valves, and a family history of heart disease. Some medical conditions that may lead to heart failure include an infection of the heart, diabetes mellitus, chemotherapy, and thyroid problems.

The Good News – Advancements in Treating Heart Failure
Although advanced heart failure is a life-threatening condition, advances over the past 10 years have shown that, if managed well, people can live both high quality and long lives despite being encumbered by heart failure.

In fact, the American Heart Association and the American College of Cardiology recently updated the guidelines for the management of heart failure patients. The challenge now is to ensure that heart failure patients become aware of and receive the state-of-the art care. Unfortunately, recent studies show that many heart failure patients are not being given all therapy that could potentially reduce their symptoms and prolong their lives.

Heart Failure Patients Get Free Evaluation and Medical Advice
Under the direction of Dr. Skopicki, hundreds of patients have been treated at the Heart Failure and Cardiomyopathy Center at Stony Brook University Hospital, often with dramatic results. Currently, specialists at the Center are helping heart failure patients by offering a free consultation and evaluation through the OPTIMAL study. The study is designed to empower patients with the necessary skills and knowledge to better manage their heart failure and optimize their health care. Patients are given a personalized "report card" of optimal medications and interventions for their heart failure and asked to discuss these findings with their primary care physician.

The OPTIMAL study is open to all heart failure patients in the community. The aim is to determine whether the no-cost consultation between a heart failure patient and a heart failure specialist will result in delivery of state-of-the art care for the patient. Anyone who has been diagnosed with heart failure, are under a physician’s care and would like to participate in the OPTIMAL study can call 631-444-9799 for a no-cost consultation.

"Once hospitalized with heart failure, there is a 30 percent risk that a patient will die within the following year," said Dr. Skopicki. "The good news is that not only can heart failure be managed, but, in most cases, as with Mr. R, both the symptoms and risks of heart failure can be dramatically reduced."

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