From the heart: A friend's journey from heart failure to recovery

By Providence Health Team

The call came in early October. My friend had been admitted to a hospital in Nashville for congestive heart failure. He’d turned 40 only months before – it didn’t seem possible.

By all accounts, Dave Tough was in good health. He ran and worked out at the gym on a regular basis, didn’t smoke, and drank alcohol in moderation. But I’d known him to be a “workaholic.” As an associate professor of audio engineering at Belmont University, composer, and a working musician, Dave rarely let himself rest. Plus, his wife had filed for divorce just months before. Was it possible that stress caused his heart to fail?

When Dave checked into the emergency room, his heart was beating wildly. It wasn’t unusual for him to have a fast heartbeat – he’d been feeling anxious for months. But for the two weeks prior to going to the ER, he’d also had shortness of breath, was sweating more, and had gained weight he couldn’t seem to shed.

The signs were there

Dave was experiencing the classic symptoms of heart failure, but he didn’t believe it. He’d survived non-Hodgkin lymphoma nine years earlier. After chemotherapy, he’d worn a heart monitor for a week. The results showed his heart was healthy.

Providence cardiologist Lori Tam, M.D., says symptoms of heart failure, like the ones Dave experienced, can sneak up. Maybe a 30-minute run on the treadmill starts to feels like a marathon, or lying down to sleep becomes difficult because of shortness of breath.

It’s easy to ignore symptoms that cause gradual changes in the body, but Dr. Tam says that’s a mistake. “It’s important to be aware.”

What is heart failure, exactly?

When Dave told me he had heart failure, I assumed that his heart had actually stopped beating. But that wasn’t correct. Congestive heart failure is not cardiac arrest, which is when the heart malfunctions and stops.

Dave’s heart was beating quickly, but it wasn’t pumping well enough to keep up with his body's demand for oxygen-rich blood. A normal heart pumps 50- to 70-percent of the total amount of blood in the left ventricle with each heartbeat.

Dave’s heart was only pumping between 10- and 15-percent. His heart was both severely damaged and irreparable. He needed a left ventricular assist device, or LVAD, to help keep his heart pumping, but that would be a temporary fix. For the long-term, Dave needed a new heart.

There are many ways a heart can be damaged

In some cases, genetics cause abnormal scar tissue in the heart, while some viruses can have a similar affect. Hypothyroidism can cause slow heart rate, a rise in cholesterol, and an increase in fluid around the heart.

Unhealthy lifestyle choices also wreak havoc. Too much alcohol, smoking, and illicit drug use can cause damage to the heart and arteries. Lack of exercise, obesity, and an unhealthy diet – one high in saturated fats, trans fat and cholesterol – have all been linked to heart disease.

It’s not clear what caused Dave’s heart failure. He wonders if his busy lifestyle contributed. Or maybe he had broken heart syndrome.

I thought that was an expression reserved for romance novels

Turns out, broken heart syndrome is a real condition.

“Broken heart syndrome is also known as takotsubo cardiomyopathy, or stress cardiomyopathy,” Dr. Tam explains. “It’s usually a passing form of congestive heart failure. It’s often triggered by severe emotional distress that temporarily stuns the heart, and causes decreased heart pumping function and congestive heart failure.” As Dr. Tam explains, it tends to have a good prognosis for complete recovery. “Especially if treated with appropriate medications,” she adds.

Whatever the cause, Dave believes he brushed aside the signs for too long.

A happy heart

To say Dave is lucky is an understatement. Within a month of being admitted to the hospital, he received a heart transplant. Two weeks later, he was taking walks around his neighborhood.

He tells me he feels like a new man. He can breathe deep and walk up the stairs in his house without stopping. And his heartbeat is returning to a regular pace. He says he’s calmer – more “Zen-like.” Perhaps it’s his new life perspective, or maybe it’s because his heart isn’t racing anymore. He still has a long way to go in his recovery, but his outlook is overwhelmingly positive.

Don’t ignore the signs

“If you notice a difference in how much you can do, have shortness of breath or swelling, or experience unexpected weight gain, make sure you see a provider early,” says Dr. Tam.

She adds that everyone should try to maintain a healthy lifestyle, including at least 30 minutes of cardiovascular exercise, 5 days per week.

“Also, eat a well-balanced diet,” she adds, “and especially avoid excessive sodium. It can cause congestive heart failure patients to retain fluid, and will worsen their symptoms.”

The most common signs of heart failure include:

  • Extreme fatigue
  • Decreased tolerance for exercise
  • Shortness of breath, especially while lying down
  • Congestion
  • Swelling in legs and/or torso
  • Unexpected weight gain

If you’ve noticed these signs, or are worried about your heart, talk to a health care provider right away. It’s never too early.