Heart failure

Your heart is a muscle, and, like all muscles, it can get worn out. When this happens, your weakened heart can no longer pump blood properly to the rest of your body. As a result, the body's organs eventually begin to weaken and fail as well.

There are two types of heart failure:

• Systolic heart failure (systolic left ventricular dysfunction) — in which the left ventricle (heart chamber) doesn't contract enough, preventing enough blood from being pumped out to the body
• Diastolic heart failure (heart failure with preserved left ventricular function) — in which the ventricles do not relax after contracting, preventing enough blood from entering the heart

Heart failure is a condition that develops and progressively worsens over time, if left untreated. There is a particular stage of heart failure in which fluid begins to build up around the heart muscle, contributing to the heart's inability to properly pump. This stage is known as "congestive heart failure" because there is "congestion" around the heart.

The symptoms of heart failure may include:

• Confusion or impaired thinking
• Coughing and wheezing
• Fatigue and weakness
• Frequent urination, especially at night time
• Increased heart rate
• Increased thirst
• Lack of appetite
• Nausea
• Shortness of breath, especially when lying down
• Sudden weight gain of two to three pounds in one day, or five pounds in a week
• Swelling in the feet, ankles and legs

You may experience symptoms of heart failure at any time, especially after you have had a cardiac event or ongoing chronic condition, such as diabetes. In these cases, we recommend you see one of our board-certified cardiologists to talk about heart failure.

Our specialists will listen to your concerns and perform a physical. Depending on what they find, they may also perform or request follow-up appointments for you to have:

• Diagnostic laboratory work (such as blood or urine tests)
• Heart imaging scans (such as electrocardiograms or echocardiograms)
• Other testing, such as exercise stress tests, nuclear imaging or cardiac catheterization procedures

Many things can cause heart failure to begin, including:

• Cardiac events, such as heart attacks
• Cardiac conditions, such as heart arrhythmias, or diseases, such as coronary artery disease

You may also be at risk of developing heart failure if you:

• Have had chemotherapy
• Are obese
• Have a heart valve condition

Talk to your doctor about your personal risk factors and what steps you can take now to prevent heart disease.

Our hospitals offer heart failure clinics and prevention and treatment programs. They are designed to help you and your family understand the condition and find the treatment method that is best for you. In addition to developing personalized diet and exercise plans for you, some of the treatments we provide include:

• Heart and vascular surgery, such as inserting ventricular assist devices (mechanical pumps that help the heart function) or pulmonary artery pressure monitors
• Cardiac resynchronization therapy (CRT)
• Diuretic infusions (intravenous medications)
• Home inotropic infusion therapy (intravenous or infusion pump medications)
• Ultrafiltration (salt and water removal)

If your heart failure can be improved with medication, our cardiologists will review your medical history to find medications that are right for you. They will work closely with your other physicians and prescribe only the medications you need.

An LVAD is an incredible mechanical device that helps blood move through the body when the heart can no longer do this job alone. It involves an internal implant as well as a small external piece that can be worn under or over your clothing.

Typically, patients who have advanced heart failure and have not responded to or improved from other treatments may be candidates for an LVAD. Many of our heart specialists offer this treatment and can help you find out if you can benefit from it. You might be able to receive an LVAD if you:

• Are experiencing heart failure that may reverse itself after temporary support, such as heart failure related to viral infections and postpartum heart disease
• Need a heart transplant but do not yet have a viable donor
• Are not a candidate for a heart transplant but need a long-term LVAD to manage extreme heart failure

Once all medications and other treatment options have been tried without success, you may need a heart transplant to treat heart failure. Our heart surgeons and surgical teams are highly trained to perform this operation with precision and accuracy. They will be with you every step of the way if you need a heart transplant, making sure you are as informed and prepared as possible.

Additionally, you will find our heart failure programs offer multidisciplinary teams. These teams include cardiologists, cardiovascular surgeons, nutritionists, cardiovascular physical therapists and others. They all work together to effectively manage and treat your heart failure. This approach ensures you get comprehensive, high-quality and expert care.

The best way to prevent heart failure is to lead a heart-healthy lifestyle, as advised by your doctor. This may include:

• Beginning an exercise program
• Eating a healthy diet
• Limiting alcohol intake
• Losing weight
• Quitting smoking