20 Things You Didn’t Know About Heart Failure
Debra K. Moser DNSc, RN, FAAN, FAHA
Barbara Riegel DNSc, RN, FAAN, FAHA

$7.95 		Journal of Cardiovascular Nursing
April 2013 
Volume 28  Number 2
Pages 109 - 110
 
  PDF Version Available!

ABSTRACT
1. Patients hate the term heart failure so maybe that's why it's so hard to figure out where the term came from-no one wants to admit to coining the phase. 2. In the early years, heart failure was referred to as "dropsy," which you might think had something to do with balance or sudden death. But actually, the term dropsy evolved from the Middle English term dropesie, which came from the ancient French word hydropsie, which came from the Greek word hydrops, which came from the earlier Greek word for water: hydor. So early on, fluid retention was identified as a key feature. 3. In 1785, William Withering of Birmingham (England, not Alabama) published an account of medicinal digitalis used to treat dropsy. 4. Digitalis is extracted from the lovely flowering biennial digitalis plant, AKA foxglove, which Withering apparently made into a "digitalis soup," although the recipe is no longer available. 5. This is probably good, because foxglove has been used by some with nefarious intentions as a poison. 6. Withering first learned of the cardiac usefulness of digitalis from an old woman who practiced as a folk herbalist in England. Apparently, the herbalist knew of 20 different ingredients to successfully treat dropsy, but we do not know the other 19 herbs. Considering the current prevalence of heart failure worldwide, it would be nice to know what the other 19 were. 7. Digitalis used to be first line therapy for HF, although it was not approved by the US Food and Drug Administration for heart failure until 1998. But, digitalis is no longer first line therapy because there is no survival benefit associated with its use in heart failure and the therapeutic range is very narrow. 8. It's probably a good thing that digitalis has fallen out of favor, as patients often confuse the words digoxin and dioxin and wonder why we are trying to poison them with toxic chemical compounds. 9. Studies of myocardial contractility were important in the evolution of our understanding of heart failure.

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