Heart failure is a condition in which the heart muscle weakens and cannot pump blood effectively. It results from high blood pressure, heart attack, valve disease, or other health problems.
The Heart Failure Clinic team focuses on diagnosing the condition.
A team of medical experts, including your physician, cardiologist, physician assistants, and registered nurses will partner to help strengthen your heart and improve your tolerance for activity.
Seth Jawetz, MD, is here to talk about The Heart Failure Clinic at Summit Medical Group.
Selected Podcast
The Heart Failure Clinic At Summit Medical Group
Featured Speaker:
Learn more about Seth Jawetz, MD
Seth Jawetz, MD, FACC
Seth Jawetz, MD, FACC, specializes in cardiology and noninvasive cardiovascular imaging. His expertise includes echocardiography, nuclear cardiology, vascular ultrasound, and cardiovascular computed tomography (CT). Dr. Jawetz has practiced with New Jersey Physicians since July 2009. His research interests are primarily devoted to echocardiography and congestive heart failure diagnosis. He is the coauthor of book chapters and articles on arrhythmias that have been presented at international meetings. Dr. Jawetz says, "The effective diagnostic tools and treatments for heart disease as well as my father's medical practice inspired me to become a physician." He adds, " I enjoy empowering my patients with education to help them take control of their health and health care and live healthy, active lives." When he is not working with his patients, Dr. Jawetz enjoys spending time with his family, cooking, and traveling. He is a New York Yankees and New York Giants fan.Learn more about Seth Jawetz, MD
Transcription:
The Heart Failure Clinic At Summit Medical Group
Melanie Cole (Host): Up to 5 million Americans will develop heart failure at some point in their lifetime. My guest today is Dr. Seth Jawetz. He’s a cardiologist in the Heart Failure Clinic at Summit Medical Group. Welcome to the show. doctor. First tell us what is the difference between heart failure and a heart attack because people confuse these two things.
Dr. Seth Jawetz (Guest): First of all, thank you very much for having me. It’s good to be here with you. Heart failure is the inability of the heart to adequately pump enough blood to the body so that the body is unable to meet all of its necessary metabolic demands meaning that you may not be able to get enough oxygen to your organs so that you can’t function at a full capacity. As opposed to a heart attack which is caused by the blockage of an artery in the heart that causes a portion of the heart muscle to die. Heart attack can lead to heart failure but they’re different and separate entities.
Melanie: How would somebody know if they are in congestive heart failure, if their body is starting to have these issues and collect fluid, how would they know?
Dr. Jawetz: The most common symptoms that we see are shortness of breath or a change in exercise tolerance. Patients will often come to me and say, “I used to be able to walk three or four blocks but now I’m really weak and tired after walking a block or half a block.” People often complain of shortness of breath when they’re lying down. They may wake up at night feeling out of breath, feeling like they have to sit up on the side of their bed. People will often have symptoms of swelling in their legs. Their legs will get puffy, their shoes may not fit properly and all part of this as well as you may gain weight. It’s common when you retain water, you can gain 5, 10, 15 pounds of water in a relatively short period of time.
Melanie: Dr. Jawetz, is this something that can become a chronic condition? Can somebody live quite a while with congestive heart failure?
Dr. Jawetz: Absolutely. The medical therapy that’s been developed over the last several decades has really changed the treatment and management of heart failure. There’s a cocktail of medications that we often put people who have heart failure on to prevent their heart function from getting worse and to maintain their functional status. These medications are really extremely effective in keeping people well and out of the hospital and feeling their best.
Melanie: Speak a little bit about those medications and that cocktail you’re discussing because, for people that are trying to adhere to this medication, they sometimes need to understand why they’re taking what they’re taking.
Dr. Jawetz: Absolutely. If you don’t understand why you’re taking what you’re taking the likelihood is that you will probably not take it as prescribed. The two most standard medications that are given to patients with heart failure are one, there’s a class of medications called a “beta-blocker” and the common medications that people may be on are things like Metoprolol or Toprol or Coreg. What these medicines do is they reduce some of the strain on the heart. They slow the heart rate down a little bit which reduces some of the stress that the heart is under and they block some of the hormones like epinephrine that can have bad effects on the heart. That’s one of the major medications. Then, there’s a second class of medicine called an “ace inhibitor” or sometimes patients may be on what’s called “an angiotensin receptor blocker” which is also abbreviated “ARB”. Those hormones number one, lower your blood pressure a little bit but they also block other hormones that can deleteriously effect the heart function. Then, there are several other medicines that people with more advanced heart failure may be on which have been shown in studies to reduce heart failure or exacerbations or keep people out of the hospital as well. The two primary medicines that almost everybody with heart failure will be on are the beta-blocker and the ace inhibitor medications.
Melanie: If someone is suffering from heart failure and their heart is just not pumping, so they collect fluid, what do you tell them about some lifestyle things? Are they not supposed to be drinking water? Are they going to end up on a diuretic? Speak about some of the things that happen and how you deal with the symptom management.
Dr. Jawetz: Every patient is a little bit different. Primarily, the first thing that we advise people to do in terms of their diet is really to be cognizant of the amount of salt intake that you have. What happens when you eat salt is that you start to retain water and people don’t realize how much salt is in almost all of the foods that we eat, particularly pre-packaged foods, canned foods, tv dinners, frozen foods. Those are all things that are very high in salt content. We usually try not to tell people to restrict their water intake. My advice to my patients is usually drink when you’re thirsty. People will have this misconception that they have to drink eight or ten glasses of water in a day in order to maintain their appropriate hydration status. That’s not really true. If you’re thirsty, you should drink. If you’re not thirsty, you don’t have to drink. Those are two of the main lifestyle changes but a lot of people do require a diuretic. The reason for that is just when the heart is weakened, it just can’t fully pump well to get all that fluid out of the system. The diuretics are very helpful and very good in maintaining an appropriate fluid balance.
Melanie: Where does exercise fit into this picture of taking care of heart failure?
Dr. Jawetz: We encourage all of our patients to exercise as long as they feel okay. One of the things that we encourage is people to participate in a cardiac rehab program when they have heart failure. It’s really been shown to help people improve their functional status. The one qualifier I would make is in people who have coronary artery disease where they’re having chest pains or other symptoms that could be consistent with an active or new blockage in their heart, we ask those people to refrain from exercise until we can take care of that problem. A patient who is stable with heart failure without any active coronary disease, we really encourage them to exercise. The more you do, the more you’ll be able to do in the future. We’ve become very deconditioned very quickly. So, when people sit and do nothing for a week it may take them two months to regain the conditioning that they had beforehand.
Melanie: Tell us about the Heart Failure Clinic at Summit Medical Group. Tell us about your team and what you’re doing there for patients.
Dr. Jawetz: Our primary goal is really to improve the quality of care of our heart failure patients, keep people feeling well, and keep them out of the hospital. We’re establishing a team that’s including cardiologist, the internal medicine program, nurse practitioners, registered nurses, dieticians, pharmacists. We’re all working together to number one, bring all of the established best practices that have been determined by the American College of Cardiology and American Heart Association to our patients as well as we’re working on trying to help identify people, at maybe an earlier stage in their disease before they might potentially decompensate, to try to keep people well and out of the hospital.
Melanie: Then, give your best advice in the last few minutes here, Dr. Jawetz, for people that are living with heart failure and what you really want them to know and what you tell patients every single day.
Dr. Jawetz: The most thing that I tell patients is that this is, as you said before, really a chronic disease that can be very well managed with the current medications. People have this fear based on historical data that heart failure is a very dangerous thing. Don’t get me wrong – it certainly is a significant illness we need to manage but with the current medical therapy people can really do very well. They have to make sure that they take their medications, they follow-up with us regularly. I advise all of my patients to try to walk regularly and make sure that they have a scale at home. One of the first things that patients may notice if they weigh themselves every day is, you can get a 2 or 3 or 4 pound weight gain in just a couple of days and that can be from water retention. If you spot that early and speak with your doctor, you can really prevent worsening decompensation. You can prevent yourself from going to the hospital. We can adjust over the phone, even, a lot of times.
Melanie: Thank you so much. What great information and so important for listeners to hear. You’re listening to SMG Radio. For more information on the Live Well Heart Failure Clinic at Summit Medical Group you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
The Heart Failure Clinic At Summit Medical Group
Melanie Cole (Host): Up to 5 million Americans will develop heart failure at some point in their lifetime. My guest today is Dr. Seth Jawetz. He’s a cardiologist in the Heart Failure Clinic at Summit Medical Group. Welcome to the show. doctor. First tell us what is the difference between heart failure and a heart attack because people confuse these two things.
Dr. Seth Jawetz (Guest): First of all, thank you very much for having me. It’s good to be here with you. Heart failure is the inability of the heart to adequately pump enough blood to the body so that the body is unable to meet all of its necessary metabolic demands meaning that you may not be able to get enough oxygen to your organs so that you can’t function at a full capacity. As opposed to a heart attack which is caused by the blockage of an artery in the heart that causes a portion of the heart muscle to die. Heart attack can lead to heart failure but they’re different and separate entities.
Melanie: How would somebody know if they are in congestive heart failure, if their body is starting to have these issues and collect fluid, how would they know?
Dr. Jawetz: The most common symptoms that we see are shortness of breath or a change in exercise tolerance. Patients will often come to me and say, “I used to be able to walk three or four blocks but now I’m really weak and tired after walking a block or half a block.” People often complain of shortness of breath when they’re lying down. They may wake up at night feeling out of breath, feeling like they have to sit up on the side of their bed. People will often have symptoms of swelling in their legs. Their legs will get puffy, their shoes may not fit properly and all part of this as well as you may gain weight. It’s common when you retain water, you can gain 5, 10, 15 pounds of water in a relatively short period of time.
Melanie: Dr. Jawetz, is this something that can become a chronic condition? Can somebody live quite a while with congestive heart failure?
Dr. Jawetz: Absolutely. The medical therapy that’s been developed over the last several decades has really changed the treatment and management of heart failure. There’s a cocktail of medications that we often put people who have heart failure on to prevent their heart function from getting worse and to maintain their functional status. These medications are really extremely effective in keeping people well and out of the hospital and feeling their best.
Melanie: Speak a little bit about those medications and that cocktail you’re discussing because, for people that are trying to adhere to this medication, they sometimes need to understand why they’re taking what they’re taking.
Dr. Jawetz: Absolutely. If you don’t understand why you’re taking what you’re taking the likelihood is that you will probably not take it as prescribed. The two most standard medications that are given to patients with heart failure are one, there’s a class of medications called a “beta-blocker” and the common medications that people may be on are things like Metoprolol or Toprol or Coreg. What these medicines do is they reduce some of the strain on the heart. They slow the heart rate down a little bit which reduces some of the stress that the heart is under and they block some of the hormones like epinephrine that can have bad effects on the heart. That’s one of the major medications. Then, there’s a second class of medicine called an “ace inhibitor” or sometimes patients may be on what’s called “an angiotensin receptor blocker” which is also abbreviated “ARB”. Those hormones number one, lower your blood pressure a little bit but they also block other hormones that can deleteriously effect the heart function. Then, there are several other medicines that people with more advanced heart failure may be on which have been shown in studies to reduce heart failure or exacerbations or keep people out of the hospital as well. The two primary medicines that almost everybody with heart failure will be on are the beta-blocker and the ace inhibitor medications.
Melanie: If someone is suffering from heart failure and their heart is just not pumping, so they collect fluid, what do you tell them about some lifestyle things? Are they not supposed to be drinking water? Are they going to end up on a diuretic? Speak about some of the things that happen and how you deal with the symptom management.
Dr. Jawetz: Every patient is a little bit different. Primarily, the first thing that we advise people to do in terms of their diet is really to be cognizant of the amount of salt intake that you have. What happens when you eat salt is that you start to retain water and people don’t realize how much salt is in almost all of the foods that we eat, particularly pre-packaged foods, canned foods, tv dinners, frozen foods. Those are all things that are very high in salt content. We usually try not to tell people to restrict their water intake. My advice to my patients is usually drink when you’re thirsty. People will have this misconception that they have to drink eight or ten glasses of water in a day in order to maintain their appropriate hydration status. That’s not really true. If you’re thirsty, you should drink. If you’re not thirsty, you don’t have to drink. Those are two of the main lifestyle changes but a lot of people do require a diuretic. The reason for that is just when the heart is weakened, it just can’t fully pump well to get all that fluid out of the system. The diuretics are very helpful and very good in maintaining an appropriate fluid balance.
Melanie: Where does exercise fit into this picture of taking care of heart failure?
Dr. Jawetz: We encourage all of our patients to exercise as long as they feel okay. One of the things that we encourage is people to participate in a cardiac rehab program when they have heart failure. It’s really been shown to help people improve their functional status. The one qualifier I would make is in people who have coronary artery disease where they’re having chest pains or other symptoms that could be consistent with an active or new blockage in their heart, we ask those people to refrain from exercise until we can take care of that problem. A patient who is stable with heart failure without any active coronary disease, we really encourage them to exercise. The more you do, the more you’ll be able to do in the future. We’ve become very deconditioned very quickly. So, when people sit and do nothing for a week it may take them two months to regain the conditioning that they had beforehand.
Melanie: Tell us about the Heart Failure Clinic at Summit Medical Group. Tell us about your team and what you’re doing there for patients.
Dr. Jawetz: Our primary goal is really to improve the quality of care of our heart failure patients, keep people feeling well, and keep them out of the hospital. We’re establishing a team that’s including cardiologist, the internal medicine program, nurse practitioners, registered nurses, dieticians, pharmacists. We’re all working together to number one, bring all of the established best practices that have been determined by the American College of Cardiology and American Heart Association to our patients as well as we’re working on trying to help identify people, at maybe an earlier stage in their disease before they might potentially decompensate, to try to keep people well and out of the hospital.
Melanie: Then, give your best advice in the last few minutes here, Dr. Jawetz, for people that are living with heart failure and what you really want them to know and what you tell patients every single day.
Dr. Jawetz: The most thing that I tell patients is that this is, as you said before, really a chronic disease that can be very well managed with the current medications. People have this fear based on historical data that heart failure is a very dangerous thing. Don’t get me wrong – it certainly is a significant illness we need to manage but with the current medical therapy people can really do very well. They have to make sure that they take their medications, they follow-up with us regularly. I advise all of my patients to try to walk regularly and make sure that they have a scale at home. One of the first things that patients may notice if they weigh themselves every day is, you can get a 2 or 3 or 4 pound weight gain in just a couple of days and that can be from water retention. If you spot that early and speak with your doctor, you can really prevent worsening decompensation. You can prevent yourself from going to the hospital. We can adjust over the phone, even, a lot of times.
Melanie: Thank you so much. What great information and so important for listeners to hear. You’re listening to SMG Radio. For more information on the Live Well Heart Failure Clinic at Summit Medical Group you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.