The Importance of Speaking Up: One Woman’s Journey to Chronic Heart Failure Diagnosis

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(BPT) - Despite having asthma, Nichole Steward (pictured, right) considered herself a typical 39-­year-­old living an active life, frequently visiting the beach and participating in roller derby. Though she was surprised when she began experiencing heart palpitations, shortness of breath, and fatigue, Nichole figured that it was nothing serious and might resolve on its own.

As many women do, Nichole tried to explain away her symptoms. The heart palpitations could be due to stress and caffeine, and her constant exhaustion was likely related to her asthma. But when her symptoms persisted, Nichole decided to visit her primary care provider.

Her doctor initially concluded that the symptoms were likely associated with stress and anxiety. However, Nichole, remaining mindful of her family’s history of heart disease, was not ready to accept that answer, and requested additional testing and a referral to a cardiologist.

Prioritizing herself

In June 2018, after the testing she advocated for, Nichole was diagnosed with chronic heart failure, a long-­lasting condition that worsens over time. Heart failure affects six million Americans, and its prevalence is on the rise as the population ages.

Chronic heart failure can change the structure and/or function of the heart and places patients at risk for hospitalization. News of her diagnosis sparked fear and shock for Nichole. “I was worried I had received a death sentence,” she says.

Once diagnosed, Nichole received support from her family and health care team, including a new cardiologist who empowered her to proactively manage her condition. Together, they developed a treatment plan that was right for her, including eating a low-salt diet, maintaining regular physical activity, managing her stress, and taking medicines. As part of her treatment regimen, Nichole takes a medicine specifically made for heart failure called ENTRESTO® (sacubitril/valsartan), which helps reduce the risk of death and hospitalization in adults with chronic, heart failure, and works better when the heart cannot pump a normal amount of blood to the body. ENTRESTO is the number one heart failure brand prescribed by cardiologists. Like all medicines, ENTRESTO is not for everyone, including those who are or plan to become pregnant. See below for Important Safety Information.

By advocating for herself, working with her cardiologist, and surrounding herself with a strong support system, Nichole has come to terms with her diagnosis.

An all­-too-­common story

Unfortunately, Nichole’s story is not unique; women with heart failure can face challenges such as delayed diagnosis and treatment. Nichole encourages women to prioritize their health and stand up for themselves if they don’t feel heard. “It is so important for people — all people, but especially women — to pay attention to their body and any symptoms they may be experiencing,” she says. “As women, we often tend to just suck it up and deal with it.”

Women living with heart failure often report a poorer quality of life than men. It is important for women to prioritize their health and well-being, despite the many other competing priorities in their day-to-day lives.

Today, Nichole continues to live a happy life that she is proud of, and enjoys spending time with loved ones and working at her own small business — a spiritual and metaphysical boutique — and her full­-time job. Hospitalizations are common for people with heart failure, so she keeps her treatment plan top of mind. While everyone's experience is different, since starting ENTRESTO, Nichole has continued to stay out of the hospital for heart failure.

Nichole encourages those currently living with heart failure to work with their health care provider to determine a treatment plan that is right for them.

To learn more about heart failure and ENTRESTO, visit ENTRESTO.com.

What is ENTRESTO?

ENTRESTO is a prescription medicine used to treat adults with long-­lasting (chronic) heart failure to help reduce the risk of death and hospitalization. ENTRESTO works better when the heart cannot pump a normal amount of blood to the body.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about ENTRESTO?

ENTRESTO can harm or cause death to your unborn baby. Talk to your doctor about other ways to treat heart failure if you plan to become pregnant. If you get pregnant during treatment with ENTRESTO, tell your doctor right away.

Do not take ENTRESTO if you:

  • are allergic to any of the ingredients in ENTRESTO
  • have had an allergic reaction including swelling of your face, lips, tongue, throat (angioedema) or trouble breathing while taking a type of medicine called an angiotensin-­converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB)
  • take an ACE inhibitor medicine. Do not take ENTRESTO for at least 36 hours before or after you take an ACE inhibitor medicine. Talk with your doctor or pharmacist before taking ENTRESTO if you are not sure if you take an ACE inhibitor medicine
  • have diabetes and take a medicine that contains aliskiren

Before taking ENTRESTO tell your doctor about all of your medical conditions, including if you:

  • have a history of hereditary angioedema
  • have kidney or liver problems
  • are pregnant or plan to become pregnant; are breastfeeding or plan to breastfeed. You should either take ENTRESTO or breastfeed. You should not do both

Tell your doctor about all the medicines you take, including prescription and over­-the-­counter medicines, vitamins, and herbal supplements. Especially tell your doctor if you take potassium supplements or a salt substitute; nonsteroidal anti-­inflammatory drugs (NSAIDs); lithium; or other medicines for high blood pressure or heart problems such as an ACE inhibitor, ARB, or aliskiren.

What are the possible side effects of ENTRESTO? ENTRESTO may cause serious side effects including:

  • Swelling of your face, lips, tongue and throat (angioedema) that may cause trouble breathing and death. Get emergency medical help right away if you have symptoms of angioedema or trouble breathing. Do not take ENTRESTO again if you have had angioedema while taking ENTRESTO
  • People who are Black or who have had angioedema and take ENTRESTO may have a higher risk of having angioedema
  • low blood pressure (hypotension), which may become more common if you take water pills. Call your doctor if you become dizzy or lightheaded, or if you develop extreme fatigue
  • kidney problems
  • increased amount of potassium in your blood (hyperkalemia)

The most common side effects were low blood pressure, high potassium, cough, dizziness, and kidney problems.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1­-800-­FDA-­1088.

This information is not comprehensive. Please see full Prescribing Information, including Boxed WARNING, and Patient Prescribing Information.

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