heart care


OGDEN -- McKay-Dee Hospital has the third lowest readmission rate in the country when it comes to heart failure.

Becker's Hospital Review published a list last week in its Infection Control & Clinical Quality E-Weekly of the “47 Hospitals With the Lowest 30-Day Heart Failure Readmission Rates.” It shows McKay-Dee Hospital has the third lowest readmission rate (17.3 percent) in the country. Intermountain Medical Center in Salt Lake City is tied for 11th lowest (18.1 percent), and Dixie Regional is tied for 17th lowest (18.3 percent). Lancaster General Hospital in Pennsylvania got the number spot with 17.1 percent. The national average 30-day heart failure readmission rate is 23 percent.

Dr. Jerry M. John, director of heart failure care at McKay-Dee, said the accolade is an honor and readmission rates continue to be low because of team effort.

"We’ve developed a unique process of care that has provided consistent results based on principles of personalization, redundancy, ownership, continuity, access, self-care, and trial and error," John said.

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body's needs for blood and oxygen. Basically, the heart can't keep up with its workload, John said. At first the heart tries to make up for this by enlarging. When the heart chamber enlarges, it stretches more and can contract more strongly, so it pumps more blood. In addition, the heart develops more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially. The heart also pumps faster to help increase the heart's output.

The body also tries to compensate in other ways. For example, John said, the blood vessels narrow to keep blood pressure up, trying to make up for the heart's loss of power and the body diverts blood away from less important tissues and organs to maintain flow to the most vital organs, the heart and brain.

These temporary measures mask the problem of heart failure, but they don't solve it. Heart failure continues and worsens until these substitute processes no longer work.

"Eventually the heart and body just can't keep up, and the person experiences the fatigue, breathing problems or other symptoms that usually prompt a trip to the doctor," John said. "Heart failure can involve the heart's left side, right side or both sides. However, it usually affects the left side first."

Heart failure is a serious condition, and usually there's no cure. But many people with heart failure lead a full, enjoyable life when the condition is managed with heart failure medications and healthy lifestyle changes, John said. It's important and helpful to have the support of family and friends who understand the condition.

"All of us lose some blood-pumping ability in our hearts as we age, but heart failure results from the added stress of health conditions that either damage the heart or make it work too hard," John said. "All of the lifestyle factors that increase your risk of heart attack and stroke – smoking, being overweight, eating foods high in fat and cholesterol and physical inactivity – can also contribute to heart failure."

Conditions that may lead to heart failure include coronary artery disease, abnormal heart valves, past heart attack, high blood pressure, heart defects at birth, cardiomyopathy, severe lung disease, diabetes and sleep apnea.

Potential signs of heart failure include shortness of breath, persistent coughing or wheezing, buildup of excess fluid in body tissues (edema), fatigue, lack of appetite or nausea, impaired thinking, or an increased heart rate.

"The body's compensation mechanisms help explain why some people may not become aware of their condition until years after their heart begins its decline," John said. "It's also a good reason to have a regular checkup with your doctor."

Successful treatment depends on your willingness to get involved in managing this condition, whether you're the patient or a caregiver. You and your loved ones are an active part of the healthcare team, John said.

In its early stages, heart failure can often be managed with medication and a healthy lifestyle. As the disease progresses and the heart becomes weaker, treatment gets more complex, John said. This is the time to have difficult, yet important, conversations with your family and doctor about the care you want to receive.

Of the 5.7 million Americans living with heart failure, about 10 percent have advanced heart failure. The condition is considered advanced when conventional heart therapies and symptom management strategies no longer work. You feel shortness of breath and other symptoms even at rest.

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