Heart Failure Program

Heart failure afflicts 5.7 million people in the United States. It is one of the most common causes of hospitalization among those aged 65 and older. Also called congestive heart failure (CHF), the condition results when fluid builds up in the body. The heart cannot pump blood as efficiently as it should. The heart is still working, but cannot meet the body’s need for blood and oxygen.

Heart failure symptoms usually develop over time. The heart becomes weaker and less able to ensure the flow of blood that the body needs. CHF will get worse if left untreated. Heart failure usually results in an enlarged heart. The good news is: Making lifestyle changes now can help prevent your developing CHF. Following your cardiologist's advice is important. Healthy changes will help you feel better and potentially avoid developing CHF.

Heart failure is a progressive condition that has four stages: A, B, C and D. They range from “high risk of developing heart failure” to “advanced heart failure.”

Stage A – Considered to be pre-heart failure, Stage A means you may be at risk if you have one or more contributing medical conditions such as:

• High blood pressure
• Diabetes
• Cardiovascular disease
• Metabolic syndrome
• Family history of cardiomyopathy

Treatment includes modifying lifestyle to manage risk factors, as well as medication to control the predisposing medical conditions.

Stage B – Also considered pre-heart failure, people at Stage B have been diagnosed with dysfunction or structural changes in the left ventricular of the heart, but have never had symptoms of heart failure. Treatment includes the interventions in Stage A as well as medications and possibly surgery if there is a risk of coronary artery blockage, a heart attack, valve disease.

Stage C - At Stage C, patients have been diagnosed with heart failure and may be having:

• Shortness of breath
• Fatigue
• Weakness in the legs and a reduced ability to exercise
• Swollen feet, ankles, lower legs and abdomen (edema)

These symptoms may improve or worsen from day to day. Treatment may include medications such as beta-blockers, ACE inhibitors, vasodilators and diuretics. Additional monitoring of weight, sodium intake and fluid will also be necessary. Implantable devices such as a pacemaker and cardiac defibrillator may also help manage symptoms.

Stage D – Stage D patients have advanced symptoms and are in the final stage of heart failure. In addition to treatments from Stages A, B and C, patients may need more advanced options such as:

• Heart surgery
• Continuous infusion of intravenous inotropic drugs
• Ventricular assist devices
• Heart transplant
• Palliative or hospice care

People with heart failure may experience the following:

• Swelling in feet, ankles and legs
• Shortness of breath, especially when lying down
• Tired, run-down feeling
• Coughing or wheezing, especially when you exercise or lie down
• Weight gain from fluid buildup
• Confusion or can’t think clearly

If you experience any of these symptoms, contact your cardiologist for an appointment.

• Medications - Your cardiology provider may give you medications to strengthen your heart and water pills to help your body get rid of excess fluids
• Diet - You may be advised to follow a low-sodium (salt) diet (2000 mg per day)
• Oxygen support - You may be provided oxygen for use at home
• Intervention - Surgery or cardiac devices may be needed, in some cases

Be sure to follow the medical advice given to you by your cardiologist. Some additional steps you can take to help manage your heart failure include:

• If you smoke, quit
• Be sure to take your medications exactly as prescribed
• Take your blood pressure daily and record the results
• Lose or maintain your weight based on your cardiologist's recommendations; then weigh daily to check for weight gain caused by increased fluid
• Track your daily fluid intake; avoid or limit alcohol and caffeine
• Eat a heart-healthy diet that’s low in sodium, saturated fats and trans fat
• Be physically active
• Get adequate rest