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    Cognitive impairment and congestive heart failure
    avatar
    An_253854 posted:
    My daughter-in-law, aged 45, has been diagnosed with congestive heart failure. She is enrolled in a heart failure clinic program and is compliant with her treatment. She is awaiting test results that may determine whether or not she needs an implanted defibrillator.

    She is having problems with word retrieval and recently, she has left the water running in the bathroom sink twice. I found an article mentioning cognitive impairment as a possible effect of congestive heart failure. Is that what's going on? Is it likely to be progressive? At what rate might it progress?
    Reply
     
    avatar
    cardiostarusa1 responded:
    Hi:

    "She is awaiting test results that may determine whether or not she needs an implanted defibrillator."

    It is often said that an implantable cardiodefibrillator (ICD) is like having a rescue squad inside your chest. As demonstrated in clinical studies (patients meeting the current criteria), in some cases, those with a low (moderate) or very low (severe) left ventricular ejection fraction (LVEF), an ICD can improve the outcome (especially if the heart's electrical system goes haywire).

    The % factor

    Some individuals who have a low (moderate) or a really low (severe) LVEF feel fine and function well, while others do not. LVEF is the single-most important clinical indicator of heart function, how well the heart is pumping.

    Understanding Your Ejection Fraction

    http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx


    **To get a decent estimate of LVEF, a MUGA scan is reported as being the most accurate of the non-invasive imaging.

    Pertinent excerpt from an About.com article

    When is the MUGA scan more useful than other heart tests?

    The advantages of the MUGA scan over other techniques (such as the echocardiogram) for measuring the LVEF are twofold
    . First, the MUGA ejection fraction is highly accurate, probably more accurate than that obtained by any other technique. Second, The MUGA ejection fraction is highly reproducible. That is, if the LVEF measurement is repeated several times, nearly the same answer is always obtained. (With other tests, variations in the measured LVEF are much greater.)

    .

    As applicable to the patient, in some cases, along with a doctor recommended/authorized exercise regimen (unless contraindicated), LVEF can be increased, sometimes substantially, by customizing/tweaking prescription drug-therapy (e.g., Coreg, which showed, back in its clinical trial days, that it could boost LVEF in some individuals) and supplemental (complimentary or integrative medicine) therapy, as deemed applicable.

    Just one example of complimentary medicine is the use of the supplement Coenzyme Q10 (CoQ10 or ubiquinone, a vitamin-like substance) for heart failure (though currently not scientifically proven, some doctors may advise the patient to give it a try) which may/can (i.e., along with doctor directed prescription drug-therapy, and with the doctor knowing about any supplements being taken) help to improve LVEF in some, with other supplements sometimes added to the mix.

    "I found an article mentioning cognitive impairment as a possible effect of..."

    There are numerous articles regarding this.

    L@@K back in the Media

    Heart Failure Linked To Cognitive Impairment

    Feb. 7, 2009

    http://www.sciencedaily.com/releases/2009/02/090205083524.htm


    "Is that what's going on?"

    "Is it likely to be progressive?"

    "At what rate might it progress?"


    Realistically, there is no way to truly know/determine this via the Internet, especially since everyone is unique with each and every health/medical situation/case being different.

    Best of luck to your daughter-in-law down the road of life.

    Take care,

    CardioStar*

    WebMD member (since 8/99)



    -

    -

    Be well-informed

    WebMD/Cleveland Clinic

    Living with Heart Failure

    http://www.webmd.com/heart-disease/heart-failure/living-with-heart-failure


    Heart Failure Society of America

    Heart Failure Stages

    (Class I-IV)

    http://www.abouthf.org/questions_stages.htm

    Heart Failure Center

    Stages of Heart Failure

    http://www.heartfailurecenter.com/hfcheartfailurestages.shtm

    Classifications of Heart Failure

    http://www.heartfailurecenter.com/hfcheartfailureclassifications.shtm


    LEARN ABOUT the Heart



    WebMD

    The Heart: (Human Anatomy) Pictures, Definition, Location in the Body and Heart Problems

    http://www.webmd.com/heart/picture-of-the-heart



    How the Heart Pumps

    Animated Tutorial

    http://your-doctor.com/healthinfocenter/medical-conditions/cardiovascular/heartpump-tutorial.html

    .

    WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.

    WebMD DOES NOT endorse any specific product, service or treatment.
     
    avatar
    billh99 responded:
    One of the causes memory problem is poor blood flow to the brain. That might be caused by the CHF. Or it might be caused by plaque in the arteries.

    Or it might be a side effect on one or combination of her meds.

    Or it my be something completely different.

    Make sure that she discusses this with here cardiologists and if needed a neurologist.
     
    avatar
    James Beckerman, MD, FACC responded:
    In some cases, it is possible for congestive heart failure to impact cognition. Medications may also have this effect. I would recommend that you bring this up specifically with her physicians to see if some sort of formal evaluation would be appropriate as the next step. I wish her all the best.


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