If you or someone you love suffers from heart failure, receiving proper
care and treatment is essential. Torrance Memorial's
Lundquist Lurie Cardiovascular Institute is one of the leading centers for treatment of heart failure in the greater
Los Angeles area. Torrance Memorial offers a comprehensive in-patient
and out-patient program to improve quality of life and manage every aspect
of heart failure.
A Team Approach
At Torrance Memorial, we offer a comprehensive team approach. You and your
family will join a team of skilled and dedicated staff including cardiologists,
nurses, dieticians, pharmacists, and case managers that will help you
every step of the way.
- We offer the most technologically advanced therapies
- We provide in-depth patient and family education including nutritional
and fitness counseling
- Support groups are available to help patients and families deal with the
emotional aspects of living with a chronic condition
- Advanced telephone monitoring allows assistance with home management
- A dedicated practitioner is available to provide assistance to you 24/7
What is Heart Failure?
Heart failure is condition that occurs when the heart has lost its ability
to pump enough oxygen rich blood to the body's tissues. It is also
known as congestive heart failure or CHF. There are many causes of heart
failure including
Symptoms
If the heart can't pump effectively, the fluid can build up in your
body resulting in a variety of symptoms including:
- Shortness of breath during activity or rest
- Swelling of legs, ankles and feet
- Feeling tired and weak
- Lack of appetite or nausea
- Persistent coughing or wheezing, most often when laying down
- Confusion or feelings of disorientation
- Chest pain or palpitations
Diagnosis
After a careful medical history has been taken and a physical examination
has been completed, there may be several tests your provider may order
to help determine if you have heart failure. These tests include:
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Blood tests: A blood test to check for a chemical called brain natriuretic peptide
(BNP) can be helpful in diagnosing heart failure. Other blood tests can
be done to check for possible causes of heart failure or to check for
problems made worse by heart failure.
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Chest x-ray: An x-ray is done to look for fluid around your heart and lungs. This x-ray
can also show the size of your heart which may be enlarged in heart failure.
-
Electrocardiogram (EKG or ECG): This is a non-invasive test that records the electrical activity of the
heart. This test is helpful in looking for heart rhythm problems that
may be causing heart failure. It can also be done to determine if the
heart muscle is damaged and acutely not getting enough oxygen, both leading
to symptoms of heart failure.
-
Echocardiogram (ECHO): This test is useful for both diagnosing heart failure and monitoring heart
failure. It is a non-invasive procedure that uses sound waves (ultrasound)
to evaluate how well the heart is working. It can identify if there are
problems with the heart muscle or problems with the heart valves.
-
Cardiac catheterization or coronary angiogram: This test is done if your physician suspects blockages in the arteries
that supply the heart muscle. Narrowing of the arteries caused by blockages
can cause heart failure.
-
Exercise Stress Test: This test is done to provide information about the heart when it is stressed.
It can be used to help determine if there is adequate blood flow during
increased levels of activity.
Treatment
Although heart failure is most often a chronic condition requiring lifelong
management, in some cases it can be controlled by treating the underlying
cause. The aim of treatment is to control symptoms, delay the progression
of the disease, and help patients live a longer and happier life despite
their condition. The most common treatment options include lifestyle changes
and medications.
Lifestyle Changes
- Don't smoke and avoid second hand smoke
- Dietary changes that include maintaining a low salt, low fat diet
- Reduce stress
- Monitor your weight daily to watch for fluid build up
- Maintain a healthy weight
- Limit alcohol and fluids
- Remain active
Medication
Heart failure patients often need multiple medications to manage their
condition and control their symptoms. They each work a little differently
to make it easier for your heart to work. It is important that you understand
what medications you are taking and why you are taking them.
Types of Medications
-
Angiotensin converting enzyme (ACE) inhibitors: These drugs widen blood vessels to lower blood pressure and decrease the
workload on the heart
-
Angiotensin II Receptor Blockers (ARBs): These drugs widen blood vessels to lower blood pressure and decrease workload
on the heart. They can be used as an alternative when an ACE is not tolerated.
-
Aldosterone antagonist: A diuretic that preserves potassium and has been shown to reduce hospitalization
and prolong life when used to treat advanced heart failure
-
Anticoagulants: These drugs are also commonly known as "blood thinners". Some
patients with heart failure have an irregular heart rhythm called atrial
fibrillation. This irregular rhythm can lead to the formation of clots.
These drugs prevent clots from forming and are given to prevent strokes.
-
Beta blockers: These drugs lower your heart rate and lower your blood pressure to reduce
the workload of the heart. They have been shown to reduce signs and symptoms
of heart failure and improve heart function.
-
Diuretics: These drugs are also known as "water pills". They result in
more frequent urination by removing excess fluid from the blood stream
and body tissues. Patients taking diuretics may also lose potassium and
may need to have a potassium supplement.
-
Nitrates: These drugs help improve blood flow to your heart by widening or dilating
the arteries that supply the heart muscle.
-
Vasodilators: Vasodilators may be used to improve blood flow by making the blood vessels
in your heart and lungs wider.
Surgical Options
Depending upon the cause and type of heart failure, there may be some surgical
options available as treatment for heart failure.
-
Coronary Artery Bypass Graft (CABG) Surgery: This surgery is also known as "open-heart surgery" or heart-bypass
surgery. It is done to increase blood flow to the heart when there are
blockages in the arteries that supply the heart muscle itself. This surgery
can lower the risk of having a heart attack in the future.
-
Heart Valve Surgery: Heart failure can be a result of a valve in the heart that is not functioning
properly. Some patients may benefit from repairing or replacing the valve.
-
Implantable Cardioverter-Defibrillators (ICDs): This is a small implantable device that monitors your heart rate and rhythm.
It can function similar to a pacemaker and help speed the heart rate if
it is too slow. If the device senses a dangerous rhythm or senses that
the heart has stopped, it can provide a small electrical shock to help
the heart start beating normally again.
-
Cardiac Resynchronization Therapy (CRT): This is also called a biventricular pacemaker. Electrical impulses coordinate
the lower chambers of the heart (right and left ventricles) to pump more
efficiently. This device is usually combined with an ICD to function as
one device.
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