Each day, the heart pumps almost 2,000 gallons of oxygen rich blood to every living cell in the body. In order to supply the tissues with this critical nourishment the average heart needs to beat almost 100,000 beats every 24 hours…delivering in total almost 65 million gallons of blood in one’s lifetime. When the heart fails to pump blood at a rate sufficient enough to meet the many requirements of the body, the result is heart failure.
Before the 1900s, very few people suffered from and even fewer died from heart failure. Since then, however, heart disease has become the number one killer in the United States. Congestive Heart Failure (CHF) has been identified as the most frequent cause of hospitalizations in patients over the age of 65 years and results in a 25% hospital readmission rate within 30 days of hospital discharge. With 670,000 new cases identified each year, CHF has become the fastest growing and clinically most relevant cardiac disease in the United States.
For indeed, while the age of technology has made life easier for millions of us, it has also made us more prone to heart disease. Before the Industrial Revolution, most people made their living through some sort of manual labor. Walking was the major means of transportation. Most daily tasks were done by hand. Stairs were climbed, carpets were beat, laundry was scrubbed, and butter was churned. With the arrival of automation, life became less strenuous.
Most manual labor was either replaced or assisted by machinery. Automobiles, washing machines, elevators, and vacuum cleaners became commonplace. Modern conveniences made physical activity unnecessary. Along with the change in lifestyle came a change in diet. Machines were built to homogenize milk, process cheese, churn butter, and make ice cream. Previously, such high-fat treats had to be made by hand. Fried foods, like potato chips, hamburgers, and French fries, became staples in many diets. The combination of a sedentary lifestyle and a rich diet led to an increase in clogged blood vessels, heart attacks, and strokes. Heart disease became commonplace. In fact, the rate of heart disease increased so sharply between 1940 and 1967 that the World Health Organization called it the world’s most serious epidemic.
Today, the causes of heart disease are known and to a certain extent, so are the treatments. The field of cardiology has grown tremendously to meet the demands of the disease. Through the years, tools and techniques for treating heart disease have also evolved to meet the increased need. While many causes of heart disease are not always reversible, the signs and symptoms frequently can be treated with well-established pharmacologic, dietary, and therapeutic modalities.
The use of medication regimens has been consistently shown in well-designed research protocols to not only improve the symptoms of CHF, but also to reduce hospitalization disease, and death. In addition, life and health modifications such as the monitoring of daily weight, reducing salt intake, increasing functional activity, muscle strengthening, and regular physician follow-ups have also proven effective in decreasing symptoms of and in reducing hospitalizations from decompensated CHF. These strategies which have been implemented in most primary and acute care settings nationwide have been expanded into the post hospital environment allowing for a successful transition from hospital to post hospital rehabilitation to home. HCR ManorCare’s team of physicians, consulting cardiologists, center-based nurse practitioners , nurses, therapists and dietitians strive to ensure proper compliance with established medical regimens, specific evidenced-base care pathways, therapeutic interventions and patient education in an effort to improve the quality of lives of our patients while reducing unnecessary and preventable hospital readmissions, morbidity and mortality.
Despite all of the best efforts of their treating physicians and the patients themselves, many patients will remain refractory to interventions and will require more advanced therapy including surgical correction of significant coronary artery disease, repair of valvular lesions, placement of implantable defibrillators and hospital admissions for IV medications. For truly end-stage CHF, consideration for implantation of ventricular assist devices (VAD’s) as either a bridge to transplantation or destination therapy may be considered for appropriate patients. For these patients a strong post-hospital rehabilitation plan like the ones offered at HCR ManorCare will be a critical step in improving their outcomes.