Heart failure

A heart failure diagnosis begins with a visit to one of our board-certified cardiologists who will perform a physical exam, which includes:

• Listening to your heart and lungs with a stethoscope
• Feeling the abdomen for tenderness and swelling of the liver
• Checking your feet, ankles and legs for swelling

Following your physical exam, we may use additional laboratory tests or heart imaging and screening exams to confirm your diagnosis and determine the extent of your condition. These tests may include:

• Cardiac catheterization procedures, such as coronary angiography
• Echocardiogram
• Electrocardiogram (ECG or EKG)
• Exercise stress test
• Nuclear imaging

We offer complete heart care services and treatments to ensure you can get strong and stay heart-healthy. We will work with you to personalize any lifestyle changes or medications for heart failure.

Our range of other treatment options for heart failure include:

• Cardiac resynchronization therapy (CRT): therapy to restore an incorrect heart rhythm
• Diuretic infusions, including home inotropic infusion therapy: medication given intravenously to reduce liquid in the body
• Heart and vascular surgery: procedures involving the insertion of a ventricular assist device (a mechanical pump to help the heart function)
• Pulmonary artery pressure monitoring: a sensor to measure pressure and heart rate that is implanted in the pulmonary artery
• Ultrafiltration: method of salt and water removal

Lifestyle changes

The following lifestyle changes can help treat the symptoms of heart failure and slow down its progression:

• Avoiding alcohol
• Beginning an exercise program with guidance from your doctor
• Eating a healthy diet that is low in fat and salt and high in fiber
• Losing weight if you are overweight
• Quitting smoking
• Weighing yourself every morning to detect if you are retaining fluid

Medication management

If you and your doctor decide medications are a good option for you, they will most likely prescribe a combination of:

• Angiotensin-converting enzyme (ACE) inhibitors to widen blood vessels
• Digoxin to help your heart pump
• Beta blockers to slow your heart rate and lower blood pressure
• Diuretics to remove excess fluid in your body

You may also be given medications to thin the blood or manage angina (chest pain), cholesterol and high blood pressure.

An LVAD is a mechanical device that circulates blood through the body when the heart is too weak to pump blood adequately on its own. It is designed to supplement the pumping function of the heart. It is surgically attached to the left ventricle and to the aorta, the main artery that carries oxygenated blood from the left ventricle to the entire body. We have Joint Commission Certification for Advanced Ventricular Assist Device (LVAD) treatment.

An external, wearable system that includes a small controller and two batteries is attached by an external driveline. The wearable system is either worn under or on top of clothing. This therapy is recommended by the American Association of Cardiology and the American Heart Association as a treatment option for advanced heart failure.

The type of LVAD we use is a continuous flow, implantable pump.

Candidates for LVAD

If you have advanced heart failure and have exhausted medical therapies, you may be a candidate to receive an LVAD. Studies have shown that patients treated with an LVAD can live longer and enjoy an improved quality of life compared to medication management alone.

There are three main reasons an LVAD may be used, including:

• As a bridge to recovery: An LVAD can be used to support a patient who is experiencing heart failure that may reverse itself after temporary support, such as viral infections and postpartum heart disease.
• As a bridge to transplant: An LVAD can be used to support a patient until a donor heart becomes available.
• As destination therapy: An LVAD can be implanted permanently for long-term therapy in patients with severe heart failure who are not candidates for heart transplantation.

After LVAD implantation

The LVAD is designed to restore blood flow throughout the body, enabling you to breathe more easily and have more energy. An LVAD can significantly reduce heart failure symptoms. You should be able to resume normal activities that you were unable to do prior to receiving the device.

Extracorporeal membrane oxygenation (ECMO) is the process of removing and oxygenating the patient’s blood and returning the blood to the patient’s body. It is advanced life support available to patients experiencing acute failure of the cardio-respiratory system.

EMCO aims to increase oxygen delivery to the body and remove carbon dioxide while the heart and/or lungs recover. 

Our ECMO program has earned the Silver ELSO Award from the Extracorporeal Life Support Organization (ELSO). Achieving the Silver Level Award means that our program has been recognized as on the Path to Excellence in extracorporeal life support.

Heart failure worsens over time and is typically caused by persistent high blood pressure, a heart attack, heart and vascular diseases or congenital abnormalities. Left untreated, the lack of adequate blood flow causes the organs to progressively fail, resulting in numerous medical complications that have a negative effect on a person's quality of life.

Often, you will hear the terms "heart failure" and "congestive heart failure" (CHF) used interchangeably, which is not entirely accurate. CHF actually refers to a point during the course of heart failure in which fluid buildup around the heart muscle causes an inefficiency in pumping.

More than six million Americans are living with heart failure, and it's a frequent cause for hospitalizations. This makes it important to know the symptoms of heart failure, which may include:

• Abdominal pain
• Coughing and wheezing
• Fatigue and weakness
• Frequent urination, especially at nighttime
• Need to sleep upright
• Shortness of breath, especially when lying down or that worsens over time
• Swelling in the feet, ankles and legs
• Weight gain from fluid buildup

There are a number of controllable and uncontrollable factors that can contribute to a heart failure diagnosis, including:

• Amyloidosis (buildup of proteins, called amyloid, in the heart)
• Cardiomyopathy (condition that makes it hard for the heart to pump blood effectively throughout the body)
• Certain medications
• Coronary artery disease
• Diabetes
• Heart arrhythmia (an irregular heartbeat)
• Heart attack
• Heart valve problems, such as:
  • Bacterial endocarditis (infection of the inner lining of the heart)
  • Congenital abnormalities and/or calcium deposits from atherosclerosis (build up in the arteries that restricts blood flow)
  • Rheumatic heart disease (damage to the heart valves resulting from rheumatic fever)
• High blood pressure
• Hyperthyroidism (an overactive thyroid gland)
• Kidney or liver failure
• Thiamine (vitamin B1) deficiency

Your risk of developing heart failure increases as you age, but other common factors that increase your risk include:

• Being a current smoker
• Being overweight
• Being pregnant
• Consuming excess alcohol
• Consuming excess salt or fatty foods
• Having a chronic lung disease, such as emphysema
• Having a prolonged high fever or infection
• Undergoing chemotherapy treatment

The best way to prevent heart failure is to reduce your personal risk of coronary artery disease, high blood pressure and/or diabetes. You can take steps to reduce your risk by:

• Beginning a safe exercise program (as advised by your doctor)
• Eating a healthy diet
• Limiting your alcohol intake
• Losing weight, if needed
• Quitting smoking