Heart failure basically means that the heart isn't working effectively.
The heart is a pump and it pumps blood to the body to try to meet the body's demands.
What happens is with heart failure, which can be a few different types of heart failure,
but with heart failure the heart isn't meeting the body's demands.
It's not keeping up with the blood flow requirement of the body at rest or with exercise.
And what often happens then is fluid builds up or kind of floods the lungs, the body.
You'll see legs swelling, abdominal swelling and and then patients have a lot of heart
failure symptoms.
Heart failure can be weakening of the heart muscle and so that's where the term failure
comes in although the heart's not completely failing it's just weak.
And another type of heart failure is when the heart squeezes well but what we call diastolic
heart failure, the heart becomes kind of stiff or scarred so it loses some of its elasticity
and doesn't fill up well with blood.
There are multiple causes of heart failure.
Most people think of a heart attack when they think of a cause of heart failure which is
a blockage in the artery of the heart and that causes damage to the heart muscle.
Not all heart attacks will cause heart failure but but some do if there's damage to the heart
muscle.
But there there are also genetic components so we are seeing that more and more patients
have what we would call familial cardiomyopathy.
Myopathy meaning the weak heart muscle so there there is a genetic predisposition and
that's where family history is very important.
In those situations patients don't have coronary artery disease or blockage in the arteries
of the heart.
There are many other causes of heart failure – high blood pressure, valve disorders in
the heart, certain drugs can predispose patients to heart failure.
There are certain infections that can lead to heart failure.
So once we diagnose a patient with heart failure that's the next step.
We we look into what the cause is.
The symptoms are are pretty similar regardless of the etiology, along with the treatment.
So symptoms usually involve exercise intolerance; that's that's probably one of the main things
we tell patients to look for.
If they cannot perform the same activities that they've always performed, if they're
more short of breath, have difficulty with their breathing, fatigue and then also when
they have swelling it can be in the mid section or the abdominal area, leg swelling, palpitations
and nausea, loss of appetite, so quite an array of symptoms.
There are multiple medications that we put patients on for heart failure.
They all target different systems in the body to make the heart stronger.
But the medications are first and foremost a medical therapy for heart failure and these
have been shown to help.
It's very important to take the medications daily and to take them in the right doses,
to follow up regularly with physicians because the goal is to increase these medications.
We know some of the benefits are dose dependent.
Also we'll look at the cause of heart failure.
Let's say heart failure is related to a heart attack then performing a heart catheterization,
opening a blocked artery can potentially improve the heart function.
If heart failure's related to high blood pressure then treating high blood pressure can reverse
the heart failure.
If it's related to a rhythm problem, treating the arrhythmia, controlling that fast heart
rate can reverse the heart failure so that that's where the etiology and and looking
into what's going on is very important.
Well we have a dedicated heart hospital and we have multiple specialists and we all we
all work together.
So we have heart failure physicians such as myself who are trained in advanced heart failure
and heart transplant but then we work well with the other heart cardiology specialties
in treating these patients.
So if there's a rhythm problem we'll refer the patient to an electrophysiologist and
work with them to improve the heart function.
If it's a heart attack or coronary disease we'll work with the interventional cardiologists
or possibly cardiac surgeons if somebody needs bypass surgery.
But we can evaluate the patient with all the imaging and procedures that they need in our
facility and manage the patient with what we would call a multidisciplinary program
because of the involvement of all these specialties.
The heart hospital has dedicated floors that specialize in in the care of patients.
We have a heart failure floor where the nurse nursing staff in addition to the physicians
all care for patients with heart failure.