Advanced Heart Failure Care (2024)

  • Augusta Our Approach
  • Augusta About Heart Failure
  • Augusta Symptoms
  • Augusta Diagnosis
  • Augusta Management

Our Approach

The Advanced Heart Failure Program is part of Heart and Vascular Care at AU Health. Our knowledgeable multidisciplinary teams see patients in all stages of heart failure (HF) at our many locations throughout Augusta, Georgia, and the surrounding area.

We understand how serious advanced HF is and that patients want every opportunity to live longer, more fulfilling lives. Our board-certified advanced heart failure cardiologists and cardiothoracic surgeons aim to give every patients a chance to do just that. We offer:

  • Goal directed medical management: Choosing the right combination of medications can be tricky. Our advanced HF providers have the expertise to order the right combination of medicines to reduce symptoms, prevent hospital admissions, and increase quality of life. You will be seen regularly at the Heart Failure Clinic to manage your symptoms.
  • Access to the HF multidisciplinary team: Includes highly-trained cardiologists, nurse practitioners, cardiothoracic surgeons, HF coordinator, pharmacists, dietitians, nurses, social workers, and palliative care providers.
  • CardioMEMS HF System: A device that allows us to remotely identify the fluid load on your heart prior to you ever experiencing symptoms of shortness of breath and swelling. This means we can treat you faster.
  • Ventricular Assist Device (VAD): A device that helps the ventricles of the heart pump blood to the rest of the body. The VAD can be surgically implanted in patients who have severe heart failure with limited options.

Advanced Heart Failure Care (1)

QUALITY ACHIEVEMENT AWARD

2023 Get With The Guidelines® Heart Failure: Gold PlusThis inpatient quality program strives to improve outcomes for heart failure patients including reduced readmissions; and increased healthy days at home.

Hospitals receiving Get With The Guidelines® Gold Plus Achievement Award have reached an aggressive goal of treating patients with 85 percent or higher compliance to core standard levels of care as outlined by the American Heart Association/American Stroke Association® for 2 consecutive calendar years. In addition, those hospitals have demonstrated 75 percent compliance to (four out of ten heart failure quality measures or four out of seven stroke quality measures) during the 12-month period.

About Heart Failure

The termheart failure means that the heart is struggling to keep up with its workload. Your body depends on the heart’s pumping action to deliver oxygen and nutrient-rich blood to your cells. With heart failure, the heart muscle is unable to pump enough blood to meet your body’s needs.

Causes of heart failure

Most people who develop heart failure have (or have had) another heart condition. The most common conditions that can lead to heart failure are:

  • Coronary artery disease
  • High blood pressure
  • Previous heart attack

What are the risk factors that can lead to heart failure?

Some risk factors are irreversible and cannot be changed, the more risk factors you have, the greater your chance of developing heart failure, these include:

  • Family history (genetics)
  • History of heart attacks

Other factors can be modified, treated, or controlled through medication or lifestyle changes, such as:

  • Diabetes
  • Excessive consumption of alcohol over the years
  • Obesity or having a body mass index “BMI” of 30 or greater
  • Smoking and/or drug use

Additional conditions that contribute to the development of heart failure:

  • Cardiomyopathy
  • Congenital heart disease
  • Heart valve disease
  • Heart arrhythmias (irregular beats)
  • Low red blood cell count
  • Myocarditis
  • Severe lung disease
  • Thyroid disease

What is ejection fraction?

An important term to understand is ejection fraction (EF). Your EF reflects how well your left ventricle (or right ventricle) is pumping blood with each heartbeat. Your EF can go up and down based on your heart condition and how well your treatment is working.

  • Ejection fraction (55-70%): Heart’s pumping ability is normal. However, even though heart function is normal you may have heart failure with preserved EF (HFpEF).
  • Ejection fraction (40-54%): Heart’s pumping ability is slightly below normal.
  • Ejection fraction (35-39%): Heart’s pumping ability is moderately below normal. This could mean that you have heart failure with reduced EF (HFrEF).
  • Ejection fraction (less than 35%): Heart’s pumping ability is severely below normal. Severe heart failure with a low EF increases the risk of life-threatening conditions.

Symptoms

Symptoms of heart failure can range from mild to severe and can come and go. There may be times when you have no symptoms at all, but be aware, this doesn't mean your heart failure is gone. Unfortunately, it will continue to get worse over time. You may experience more (or different) signs and symptoms. If this happens, it is essential to let your doctor know! Symptoms can include, but are not limited to:

  • Confusion or impaired thinking.
  • Decreased appetite.
  • Persistent cough or wheezing with white or pink blood-tinged phlegm.
  • Rapid weight gain from fluid.
  • Rapid heart rate (tachycardia) of more than 100 beats per minute.
  • Shortness of breath.
  • Swelling of the legs, ankles, feet and abdomen.

Diagnosis

To diagnose heart failure, your doctor will carefully review your medical history, symptoms and perform a physical examination. Using a stethoscope, your doctor can also listen to your lungs for signs of congestion and for any abnormal heart sounds. They may examine the veins in your neck and check for fluid buildup in your abdomen and legs as well. After that you may have:

  • Blood tests
  • X-rays
  • Echocardiogram (ECHO)
  • Electrocardiogram (EKG/ECG)
  • Stress test
  • Cardiac catheterization
  • Magnetic resonance imaging (MRI)

Management

Heart failure is a chronic disease that will need lifelong management. With treatment, signs and symptoms of HF can improve and your heart may even become stronger. Here's what you can do:

  • Track your daily fluid intake.
  • Participate in our cardiac rehabilitation program
  • Get no more than 7-8 hours of sleep per night
  • Avoid or limit caffeine consumption
  • Keep track of your symptoms
  • Manage your stress
  • Make and keep appointments to see your doctor.
  • Avoid alcohol and smoking
  • Eat a heart-healthy diet
  • If you are overweight, talk to your doctor about weight loss options.
Advanced Heart Failure Care (2024)

FAQs

What is the life expectancy of someone with advanced heart failure? ›

End stage heart failure is the final and most severe stage of heart failure, during which time a person experiences symptoms, even while at rest. Symptoms may include shortness of breath, fatigue, and heart arrhythmias. The life expectancy for individuals with end stage heart failure is around 6–12 months.

What is the treatment for advanced heart failure? ›

Depending upon the stage and symptoms of your heart failure, your doctor may prescribe medications to help with the following: Reduce strain on heart and relax vessels (e.g., ACE inhibitors or ARBs) Reduce fluids and salt (e.g., diuretics) Boost heart strength and maintain heart rhythm (e.g., digitalis, ACE inhibitors)

What is considered an advanced stage of heart failure? ›

Someone with advanced heart failure feels shortness of breath and other symptoms even at rest. In the American Heart Association and American College of Cardiology's A-to-D staging system, advanced heart failure is stage D.

What is the difference between heart failure and advanced heart failure? ›

Advanced heart failure means the condition has progressed to where traditional therapies and symptom management are no longer working. Of the more than 6 million American adults living with heart failure, about 10% have advanced heart failure. Their treatment decisions can become more complex.

What is the life expectancy of someone with worsening heart failure? ›

2. About half of people who develop heart failure die within 5 years of diagnosis. 3. Most people with end-stage heart failure have a life expectancy of less than 1 year.

What is the timeline for advanced heart failure? ›

The life expectancy for a person with end stage heart failure will depend on the severity of the condition and how they have responded to treatment. Once heart failure progresses to stage D, people experience poor quality of life and high symptom burden and face a median life expectancy of only 6–12 months.

What do the final days of congestive heart failure look like? ›

Increased fatigue

Poor heart function and difficulty sleeping due to discomfort and shortness of breath can lead to extreme exhaustion for end-stage heart failure patients.

Can you reverse advanced heart failure? ›

Even for the 1 in 10 patients coping with extreme heart failure, the condition can still be reversed for some, Dr. Berkowitz says. That may require: Implantable heart pump.

What are three things that can worsen heart failure and why? ›

Several factors can make heart failure symptoms worse, including:
  • anaemia (a condition where the blood doesn't have enough healthy red blood cells)
  • too much salt, fluid, or alcohol in your diet.
  • pregnancy.
  • some viral and bacterial infections.
  • kidney diseases.
  • lung diseases.
  • not taking prescribed heart failure medicines.

At what stage of heart failure do you need oxygen? ›

When Would I Need It? Your doctor will usually suggest oxygen therapy when heart failure causes very low levels of oxygen. But if your levels are closer to normal, it's more of a gray area. In this case, recent studies seem to show that oxygen therapy may be harmful because you get too much oxygen.

How to tell if heart failure is getting worse? ›

Warning signs of worsening heart failure
  • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week)
  • Extra swelling in the feet or ankles.
  • Swelling or pain in the abdomen.
  • Shortness of breath not related to exercise.
  • Discomfort or trouble breathing when lying flat.
  • Waking up short of breath.
Aug 14, 2021

At what stage of heart failure do you need a defibrillator? ›

So don't be alarmed if you look at your Epic report or your medical chart, and you see that ejection fraction is 50%. So 50% or higher is normal. And we start really worrying about sudden cardiac death, is when the ejection fraction is 35% or less. And then we should start considering a defibrillator.

How to treat advanced heart failure? ›

Surgery or other procedures
  1. Coronary bypass surgery. You may need this surgery if severely blocked arteries are causing your heart failure. ...
  2. Heart valve repair or replacement. ...
  3. Implantable cardioverter-defibrillator (ICD). ...
  4. Cardiac resynchronization therapy (CRT). ...
  5. Ventricular assist device (VAD). ...
  6. Heart transplant.
Apr 20, 2023

What is the survival rate for advanced heart failure? ›

Prognosis by Stage
Five-Year Survival Rates
Stage A97%
Stage B95.7%
Stage C74.6%
Stage D20%
1 more row
Jan 30, 2024

What does an advanced heart failure cardiologist do? ›

This includes treatment of patients with difficult to control heart failure, the ability to implement a wide array of electrophysiologic and hemodynamic support devices and complex percutaneous and surgical procedures in patients who may benefit from them, and evaluation of prospective patients for heart ...

What is the most common cause of death in heart failure patients? ›

Approximately 90% of heart failure patients die from cardiovascular causes. Fifty per cent die from progressive heart failure, and the remainder die suddenly from arrhythmias and ischaemic events.

How long does the final stage of heart failure last? ›

If a patient has end-stage heart failure it means they are at high risk of dying in the next 6 to 12 months. These are the common symptoms of end-stage heart failure: pain. breathlessness on minimal exertion or at rest.

How quickly does heart failure progress? ›

Outlook for heart failure

It can severely limit the activities you're able to do and is often eventually fatal. But it's very difficult to tell how the condition will progress on an individual basis. It's very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.

What are the four stages of congestive heart failure? ›

Heart failure can progress, so researchers have identified four stages of the disease — A, B, C and D. Health care professionals also classify heart failure when it has progressed to stages C and D. This classification measures a patient's overall heart function and severity of symptoms.

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