Why This Doctor Believes Heart Failure is Not a Death Sentence


“I couldn’t breathe,” says 60-year-old Mary McConnell.

“I stepped outside to get something from the garage, and I struggled to take a breath. I went right back in, sat down and asked my husband to take me to the hospital.”

Last fall, McConnell’s frightening symptoms brought her to the emergency room, where she was later transported to the Nassif Heart & Vascular Center at UnityPoint Health – Cedar Rapids. Upon her arrival, she was admitted to the intensive care unit.

McConnell’s cardiologist, Arpit Sothwal, MD, says she was “hypoxic (low on oxygen) and in respiratory failure due to what we believed was heart failure.”

He adds, “She had all the classic signs and symptoms of heart failure – difficulty breathing, chest pain, trouble sleeping, fluid around her lungs, weight gain and lower extremity edema (water retention in the legs).”

Due to clinically suspected congestive heart failure, Dr. Sothwal started McConnell on medication to reduce the extra fluid in her body, which eliminated approximately 30 liters (equivalent to nearly 8 gallons) of excess water and stabilized her condition.

During her hospital stay, McConnell had imaging done of her heart, which confirmed Dr. Sothwal’s suspicion.

Her heart was functioning at only 20%. Normal heart pumping function is 55-60%.

Heart Function Restored

“To determine the cause of heart failure, we first rule out a heart blockage,” Dr. Sothwal explains.

“We performed a coronary angiogram (a diagnostic heart procedure used to check blood flow), and she didn’t have any obstruction in her arteries. That meant she didn’t need any stents or open-heart surgery. On the basis of further testing and clinical evaluation, her heart failure was due to uncontrolled hypertension (high blood pressure).”

Left untreated, high blood pressure gradually weakens the heart muscle until it can no longer effectively pump blood throughout the body. That is when a person receives a heart failure diagnosis. Advancements in heart care have allowed people to live with the condition.

“Heart failure is not a death sentence,” Dr. Sothwal says.

“It may require surgery or an implanted device to improve heart pumping function, but Mrs. McConnell was lucky. We were able to treat her heart failure with advanced medical therapy. Until we knew the optimal dosage, we had her wear an external defibrillator, called a LifeVest, to prevent sudden cardiac death. Fortunately, she responded well to the medicine, and her heart function improved to the normal range,” he adds.

Looking back, McConnell says she didn’t attribute trouble breathing to a heart problem.

“I thought it might have been my lungs, or because I had gained weight. I thought I was tired, because I wasn’t sleeping well at night. It was so frustrating. I kept thinking, ‘I used to be able to do a, b and c,’ but I wasn’t even able to accomplish ‘a’ before I got tired,” she says.

Because McConnell sought care right away, and received treatment early, she returned to her normal activities, including gardening, canning and caring for her family of 17 children.

Dr. Sothwal says the key to preventing permanent heart damage is to be aware of risk factors and go to the emergency department immediately if you have symptoms of heart failure. 

Heart Failure Risk Factors Heart Failure Symptoms
Uncontrolled high blood pressure Unexplained shortness of breath with exertion
Diabetes Trouble breathing while laying down
Obesity Unexplained fatigue or weakness
Lack of exercise Swelling in the feet, legs, ankles or stomach
Smoking, vaping and tobacco use  
Excessive alcohol  
Family history of heart failure
Other heart conditions  

Providing Excellence in Heart Failure Treatment

Since being hospitalized, McConnell regularly sees Dr. Sothwal and his team through the Heart Failure Clinic at UnityPoint Health. This special, long-term program closely follows patients diagnosed with heart failure to monitor medications and prevent recurrent heart-failure-related hospitalizations. Heart failure is a top initiative for UnityPoint Health — to educate more people about the condition, treat it earlier and ultimately prolong and improve heart failure patients’ quality of life.

“I feel better than I have in a long time,” McConnell says.

"I’m really happy with the results and the care I received from Dr. Sothwal. He was very attentive and had a plan right away.”

Heart failure is not a death sentence. The key to preventing permanent heart damage is to be aware of risk factors. Go to the emergency department immediately if you have symptoms of heart failure.

Arpit Sothwal, MD
Cardiologist, St. Luke's Heart Care Clinic