ANN ARBOR , MI - The diagnosis of congestive heart failure conjures up an image of complete failure of the heart to do its job, causing death. But with advancements in medicine and technology and a patient's willingness to undergo lifestyle changes many with congestive heart failure can live longer, more productive lives.

In the United States , about five million people have congestive heart failure, with about 750,000 new cases being diagnosed each year. People with heart failure either can't pump enough blood through the body to meet their organs' needs, or they can only do so with elevated pressures within the heart. This leads to a build-up of fluids, either in the lungs or in other parts of the body.

"A variety of different diseases lead to heart failure. Some of the more common conditions include atherosclerosis or hardening of the arteries, heart attacks or and high blood pressure, particularly if its not treated over a long period of time," says Keith Aaronson, M.D., associate professor of cardiology, U-M Department of Internal Medicine.

Breathlessness, a result of congestion in the lungs, is a main symptom of left-sided heart failure. Symptoms of right-sided heart failure include fatigue, swelling of the ankles and legs, enlargement of the liver, and indigestion.

Heart failure is a serious condition, but people can have a reasonable quality of life by changing their daily routines and making decisions tailored for the heart. Exercise is especially critical for patients with heart failure, Aaronson says.

When patients with heart failure exercise, even if it is just taking routine walks, their quality of life is much better. Also, eating a balanced, low sodium diet and taking the right medications are tools for success.

"Here at the U-M, we use a multidisciplinary approach. We work closely with our nurses - who are really case managers for these patients - as well as dietitians and exercise physiologists to tailor an individual program," Aaronson says.

Plus, Aaronson says there has been remarkable progress in the medications for heart failure over the past decade and a half.

"We've nearly tripled the survival for patients with heart failure, compared to what it was in the early 1980s, with the medications we have right now. The medications are critically important, but they are not the entire answer. Following the proper diet is essential if you want to do well with heart failure. Eat heart healthy, low fat foods, and keep salt intake to a minimum—no more than 2 grams of sodium daily,” Aaronson says.

Diet, exercise and medications help people with congestive heart failure to live longer, more productive lives, but what about prevention?

Prevention of congestive heart failure

As the old adage says, an ounce of prevention is better than a pound of cure. A healthy, well-balanced diet that includes heart-healthy foods such as oatmeal, whole grains, fruits and vegetables, and routine exercise are the best ways to prevent or delay the medical conditions that result in congestive heart failure. Most heart failure is traceable to high blood pressure, diabetes and heart attacks, which are largely preventable conditions. If you are overweight, try to shed those extra pounds because diabetes and high blood pressure are associated with excess weight. Talk to your physician about ways to control high blood pressure. This can be done by a combination of diet, exercise and, sometimes, medication.

Facts about congestive heart failure

• Roughly five million people are living with congestive heart failure in the United States .
• Each year, 750,000 new cases are diagnosed.
• Hardening of the arteries, heart attacks, high blood pressure and diabetes are the most common diseases leading to congestive heart failure.
• Symptoms can include shortness of breath, fatigue or swelling of the ankles or legs.
• Treatment includes medication, changes in diet and exercise.

For more information, visit the following web sites:

U-M Cardiovascular Center —Congestive Heart Failure Rehabilitation

National Heart, Lung and Blood Institute: Heart Failure