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Additional info for 100 Questions & Answers About Congestive Heart Failure (100 Questions & Answers about . . .)
It can come on gradually during the day or may come on suddenly and wake you from sleep. Patients with worsening CHF often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. They often complain of waking up tired or feeling anxious and restless. Shortness of breath occurs JBQ019_PartIII 11/18/05 10:19 AM Page 39 1 0 0 ● ● A B O U T CO N G E S T I V E H E A R T FA I LU R E when your blood “backs up” in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can’t keep up with the supply.
Thyroid, pancreas, and pituitary glands) systems. After completing the residency, the physician is invited by the American Board of Internal Medicine to take an examination to demonstrate his or her understanding of internal medicine. This is a grueling 2-day 22 JBQ019_PartI 11/18/05 10:18 AM Page 23 1 0 0 Q & A A B O U T CO N G E S T I V E H E A R T FA I LU R E examination, the successful completion of which entitles the physician to be called board certified or a diplomate of the American Board of Internal Medicine.
The echocardiogram can also measure the pressure change (or pressure gradient) between the left ventricle and the aorta. Doctors commonly use the echocardiogram to assess the pumping function of the heart by measuring the ejection fraction. Normally, the heart ejects approximately 60 percent of the blood in the left ventricle every time the heart beats. Patients with ejection fractions of approximately 30 JBQ019_PartII 11/18/05 10:19 AM Page 31 1 0 0 Q & A A B O U T CO N G E S T I V E H E A R T FA I LU R E Diagnosis 40–45 percent have mildly depressed ejection fractions; patients with ejection fractions of about 30–40 percent have moderately depressed ejection fractions; and patients with ejection fractions in the 10–25 percent range have severely depressed ejection fractions.