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

February 9, 2017

Allison Milionis

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 a 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, he was sweating and he had weight that 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 and 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 beating.

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 severely damaged and worse, it was 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.

The heart can be damaged

There are many ways a heart can be damaged. In some cases, genetics cause abnormal scar tissue in the heart, and 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 been linked to heart disease, as well.

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, but it turns out it’s a real condition.

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

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, shortness of breath, have swelling or unexpected weight gain, make sure you see a provider early,” says Dr. Tam.

She adds that everyone should try to maintain a healthy lifestyle with at least 30 minutes of cardiovascular exercise, five days per week. “Eat a well-balanced diet and especially avoid excessive sodium. It can cause congestive heart failure patients to retain fluid and worsen their symptoms,” she says.