Symptoms | Diagnosis | Treatment Options | Heart Failure Management Clinic | For More Information
Heart failure (also known as congestive heart failure) occurs when the heart is unable to effectively pump or fill with blood. Heart failure symptoms run the gamut from mild to critical—from feeling winded to having kidney or liver failure. As the leading cause of hospitalizations nationwide, heart failure can often lead to reduced quality of life and death.
Coronary artery disease and hypertension are key contributors to the development of congestive heart failure. However, heart valve disease, arrhythmias, viruses, lung disease or even medication side effects may also play a role. Since the reasons for heart failure are so varied, patients require precise diagnosis and careful treatment for the best outcomes.
Our NorthShore Cardiovascular Institute offers a highly integrated, multidisciplinary approach to providing continuous care to heart failure patients throughout our hospital system. Our team of specialists includes cardiologists, cardiovascular and vascular surgeons, pulmonologists and imaging experts with extensive experience diagnosing and treating congestive heart failure with state-of-the-art therapies. In addition to an environment of collaborative care, NorthShore’s leading-edge informatics or electronic medical records system ensures that we seamlessly coordinate our heart failure services from facility to facility.
In partnership with our Mark R. Neaman Center for Personalized Medicine, our team can help identify a wide range of genetic biomarkers that may put you at an increased risk of cardiovascular disease. We can also employ pharmacogenomics techniques to best prescribe cholesterol medicines (statins) based on your unique genetic makeup.
Heart Failure Symptoms
Congestive heart failure often doesn’t occur overnight. Symptoms of this progressive disease usually show up gradually and steadily worsen over a period of time. Common heart failure symptoms include:
- Shortness of breath after exertion, sometimes at rest and/or while sleeping
- Swelling of the ankles, feet and abdomen and/or weight gain due to fluid retention
- Irregular or rapid heart rate
- Fatigue and weakness
- Confusion or dizziness
- Loss of appetite, nausea or vomiting
While patients with heart failure may have one or more of these symptoms, some may have none at all.
Heart Failure Diagnosis
NorthShore Cardiovascular Institute’s multidisciplinary specialists fully understand the complexity of heart failure and take an all-encompassing approach to accurately diagnose the disease. If you suspect you have heart failure or have been referred to one of our experts by your primary care physician or via the Institute’s general cardiology group, you will undergo a thorough evaluation.
We will ask you about your medical history and conduct a physical exam. Your NorthShore cardiologist may also recommend several non-invasive diagnostic tests, including chest imaging, EKGs, echocardiograms (ultrasound exams) as well as advanced imaging such as cardiac MRI, CT and PET scans. We often employ exercise stress testing and specific cardiopulmonary stress testing to help understand functional capacity. More extensive testing may include right heart catheterization and coronary angiography, a minimally-invasive exam that evaluates the arteries that supply blood to the heart as well as tests the pressure in the heart chambers and overall pumping function of the heart.
Heart Failure Treatment Options
Strategies to slow the progression of heart failure, improve heart function and decrease symptoms usually begin with medical management. Your NorthShore specialist may recommend a number of medications, including:
- Standard treatments, such as vasodilators (ACE-Inhibitors, ARB’s, hydralazine and nitrates),beta-blockers and newer agents to help improve blood flow
- Diuretics to reduce fluid retention
- Blood thinners, or anticoagulants, to decrease the possibility of blood clots
- Digitalis glycosides (digoxin) to enhance heart contractions and improve circulation
- Other medical therapies to help slow the heart rate down and decrease the overall workload that the heart is experiencing
Enhanced management of high blood pressure (hypertension), diabetes and/or obesity ‒ common risk factors in the development of heart failure ‒ may also be recommended. Your physician may prescribe hypertensive or cholesterol lowering drugs or suggest lifestyle changes such as smoking cessation and diet modification as part of your congestive heart failure treatment plan.
Sleep apnea has been associated with cardiac disease. Our heart failure specialists closely collaborate with the multidisciplinary experts at the NorthShore Sleep Center, which provides a full-range of diagnostic and treatment options for sleep disorders.
Surgical Treatment Options
When optimal medical therapy is unable to reverse the course of severe heart failure, surgical options may offer benefit. This often includes surgery to repair leaking heart valves, bypass blocked coronary arteries to get more blood and oxygen to the weakened heart, and surgically ablate arrhythmias such as atrial fibrillation.
Extracorporeal membrane oxygenation (ECMO) may be advised in emergent or challenging cardiac situations including cardiogenic shock. A short-term treatment option, ECMO is a type of mechanical circulatory support that temporarily allows the heart and lungs to rest and recover during hospitalization.
For patients with severe heart failure, our team may recommend a ventricular assist device (VAD) to help support blood flow, improve quality of life and enhance function. This type of mechanical heart pump can be implanted as either a temporary “bridge” for patients awaiting heart transplantation or a long-term solution to support the heart and relieve symptoms. NorthShore offers advanced left ventricular assist device (LVAD) surgery, using the latest FDA-approved devices including the HeartMate II™ LVAD and the HeartWare® HVAD.
Heart failure related to heart rhythm disorders such as atrial fibrillation carries a significant risk of sudden cardiac death. For mild to moderate cases of potentially life-threatening arrhythmias, our highly skilled electrophysiologists perform a number of advanced procedures to implant innovative cardiac devices to correct irregular heart rhythms. These include implantable cardioverter defibrillators (ICDs) that work either as a pacemaker or defibrillator to prompt your heart into a normal rhythm and ICDs combined with cardiac resynchronization therapy (CRT), also known as biventricular pacing, for an added therapeutic benefit of coordinated ventricular contraction.
If your heart failure is due to valvular or structural heart disease, the NorthShore Cardiovascular Institute offers a comprehensive heart valve program that features state-of-the-art surgical techniques for valve repair/replacement. At the forefront of valve care, NorthShore was the first medical center in the country to pioneer a minimally-invasive technique for mitral valve repair.
Our team also offers an innovative option to monitor fluid build-up from home through means of implantable pressure sensors. These sensors enable your cardiologist to closely watch for significant fluid build-up while you are at home. Should you start to retain extra fluid, our cardiovascular team is alerted and can intervene accordingly before you become symptomatic.
Heart Failure Management Clinic
Patients with a heart failure or congestive heart failure diagnosis are often at the greatest risk for another hospitalization. At NorthShore’s Heart Failure Management Clinic, our team partners with patients to best manage their condition through education and regular follow ups. Our clinic works to keep discharged heart failure patients healthy –whether they are at home or in a skilled nursing facility. Our clinic helps patients and their caregivers:
- Manage new medications
- Understand discharge instructions and their diagnosis
- Offer diet and lifestyle recommendations
- Facilitate communication with the clinical team
Our clinic strives to help patients achieve the fullest possible recovery from heart failure without setbacks or further hospitalization. Our experienced and specially-trained team is committed to providing the highest level of personalization and compassionate care.
For More Information
Please call 847.570.2250 for more information on congestive heart failure and circulatory support or to schedule an appointment with one of our specialists.