What is Heart Failure?
Heart failure is a condition where the heart muscle can’t pump as well as it should. This can leave you feeling short of breath, fatigued and cause swelling in your legs and ankles. Heart failure can be caused by many conditions, including coronary artery disease, high blood pressure or diabetes.
At Penn, we offer a variety of treatment options to help manage heart failure and help you live life to the fullest. Many of the treatments offered here at not available at other regional hospitals. We are also one of the most active heart failure programs in the United States and are proud to have earned the Get With The Guidelines®— Heart Failure Gold Quality Achievement Award from the American Heart Association.
Types of Heart Failure
Heart failure can be complicated, especially since different types of heart failure can be called different things. There are three main types that you will hear about:
- Left-sided or left ventricular heart failure: When the left side of your heart doesn't pump out all of the blood that it collects, causing fluid to back up into your lungs.
- Right-sided or right ventricular heart failure: When the right side of your heart can't pump properly, causing blood to back up into your veins.
- Congestive heart failure: Not all types of heart failure are congestive, but you will sometimes hear the terms used interchangeably. In congestive heart failure, blood flow slows down and fluid collects in the veins and around the heart, causing excess fluid to build up in the body's tissues.
What are the Different Stages of Heart Failure?
Doctors often describe the severity of heart failure by how much the patient’s physical activity is limited. The American College of Cardiology (ACC) and the American Heart Association (AHA) use the following classifications:
||At high risk for heart failure but without structural heart disease or symptoms of heart failure.
||Structural heart disease but without signs or symptoms of heart failure.
||Structural heart disease with prior or current symptoms of heart failure.
||Refractory heart failure requiring specialized interventions.
Your doctor will use the different stages as a guide to help recommend potential treatment options. The most common treatments for heart failure are:
(At high risk for heart failure)
|- Quit smoking.
- Exercise regularly
- Treat high blood pressure
- Treat lipid disorders
- Discontinue alcohol or illegal drug use
- If you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions, taking medications as prescribed
(Heart disease, without signs of heart failure)
|- All patients should take an ACE inhibitor or ARB
- Beta-blockers should be prescribed for patients after a heart attack
- Surgery options should be discussed for coronary artery or valve disease
(Heart disease, with signs of heart failure)
|- African-American patients may be prescribed a hydralazine/nitrate combination if symptoms persist
- Diuretics (water pills) and digoxin may be prescribed if symptoms persist
- An aldosterone inhibitor may be prescribed when symptoms remain severe with other therapies
- Restrict dietary sodium (salt)
- Monitor weight
- Restrict fluids (as appropriate)
- Pacemaker or ICD may be recommended
(Heart failure not responding to treatments)
- Patient should be evaluated to determine if the following treatments are available options:
- Heart transplant
- Ventricular assist devices
- Surgery options
- Research therapies
- Continuous infusion of intravenous inotropic drugs
- End-of-life (palliative or hospice) care
It’s important to identify heart failure early and to control risk factors, including other medical conditions that may be making your heart work harder. For end-stage heart failure patients, Penn offers new, innovative treatments, such as:
Why Our Program is Different
Our team includes some of the best cardiologists and cardiovascular surgeons in the nation, as well as specialists in cardiac imaging, pulmonary medicine, diabetes and rehabilitation medicine. We follow more than 3,500 heart failure patients and more than 639 heart transplant patients.
Heart failure specialists at Penn among a select group of physicians certified by the American Board of Internal Medicine in the new Advanced Heart Failure and Transplant Cardiology specialty. Only 225 doctors are certified in this specialty worldwide. We are also proud to have a dedicated team of certified heart failure nurses who have specialized knowledge and training in heart failure care. This specialization in care leads to improved quality of life and a better life expectancy for heart failure patients. This team is able to provide continuous care as your condition evolves, and their experience spans the breadth and depth of heart failure care.