The staff at the Healing Hearts Advanced Heart Failure Program at Methodist Heart Hospital look forward to assisting you in the management of your heart failure symptoms. Our program offers medical and surgical therapies for heart failure including optimal medication management, infusion therapy, mechanical assist devices and heart transplantation.
Our inter-disciplinary team members are experts in heart failure management and will determine the best therapeutic strategy at every step of your disease process. We offer a comprehensive outpatient education program regarding proper nutrition, medications, exercise and maintenance of your symptoms.
Understanding Congestive Heart Failure
Congestive heart failure occurs when excess fluid starts to leak into the lungs and/or the peripheral parts of the body. Normally the pumping actions of the left and right sides of the heart complement each other, producing a continuous flow of blood. Heart failure may occur with both ventricles failing, although one ventricle may precede the other in dysfunction.
There are numerous causes of congestive heart failure:
- Valvular heart disease: Incompetency (leakage or blockage) of the heart valves leads to an ineffective flow of blood through the heart. Over time, the heart will attempt to compensate for the problem by ‘enlarging,’ eventually leading to congestive heart failure, heart attack, cardiac arrhythmias, or cardiac arrest (heart stops beating). Valve replacements have improved the survival rate in these patients.
- Cardiomyopathy: This medical term describes a weakness in the heart muscle’s ability to contract. This may result from the effects of longstanding hypertension, diabetes, alcohol abuse or multiple heart attacks, all of which can damage the heart muscle to a point that its pumping function has been compromised.
- Viral myocarditis: In addition to irregularities (arrhythmia) of the heartbeat, this viral infection of the heart can result in poor cardiac muscle function. Viral Myocarditis is one of few causes for heart failure seen in young people.
- Severe anemia: This condition can precipitate heart failure in the patient with a very low red blood cell count. The heart will go into congestive failure as it attempts to compensate for the inadequate number of circulating red blood cells. Red blood cells are necessary for adequate oxygenation of the tissues.
- Myocardial infarction: This can cause sudden acute congestive heart failure in cases where a substantial portion of the heart muscle has become severely damaged. The lack of oxygen to the cardiac muscle results in poor contraction.
- Shortness of breath during normal activities
- Persistent coughing or wheezing
- Fatigue and weakness
- Feeling of suffocation while sleeping, or awakening in the middle of the night short of breath
- Sudden weight gain from fluid retention
- Increased heart rate
- Leg swelling and/or abdominal swelling
Evaluation will include a complete medical history and physical examination. Blood tests and a chest X-ray will be performed. Additional specific tests are used to determine the nature and extent of the heart failure. An ECG can reveal evidence of a potential heart attack or suspected heart abnormalities. Catheterization or angiography, which shows the interior of the coronary arteries, is sometimes recommended.
With the information obtained from your tests, your doctor will determine the appropriate treatment plan for you.
There are excellent medications currently being used for outpatient treatment of heart failure. These medications include ACE inhibitors, diuretics, beta-blockers, vasodilators, digitalis and anticoagulants.
In case of advanced heart failure, inpatient treatment includes intravenous medications.
In most cases heart failure is a chronic condition that can be treated but usually not cured. Heart failure can be successfully managed by taking medications and making healthy changes in habits such as diet and exercise.