Top-Rated Care for Heart Failure Patients
About six million people in the United States currently have heart failure, and many millions more are at risk. When you learn you have heart failure, daily life can feel like it is turned upside down. One way to take back control is through knowledge. Being an active partner in the care and management of your heart failure empowers you to improve your symptoms and positively affect your long-term health.
Schedule an AppointmentIf you or someone you love has been diagnosed with heart failure, contact UH Harrington Heart & Vascular Institute. Our heart failure team has the experience and expertise to treat even the most complex heart failure conditions.
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Why Choose UH for Heart Failure Care?
The expertise of our nationally renowned heart failure team enables us to offer help and hope to many individuals, including the critically ill, the frail, the elderly and those who may be classified by other hospitals as “no option” patients.
Our comprehensive program is designed to successfully tailor specialized, advanced medical and surgical therapies to the unique needs of our patients. Based at University Hospitals Cleveland Medical Center, highlights include:
- Recognition in the top 1 percent of nearly 5,000 hospitals nationally as a Best Hospital for Cardiology & Heart Surgery by U.S. News & World Report
- Joint Commission Certification of our ventricular assist device (VAD) program for meeting rigorous standards to support better patient outcomes
- Distinguished site for heart transplantation, with certification by the Centers for Medicare & Medicaid Services (CMS)
- Leading clinical trials available only at select sites nationwide, bringing the latest in medications, devices and stem cell therapies to our patients
Our heart failure team works with each patient to minimize symptoms, slow or stop the progression of underlying disease, reduce the need for hospitalization, and help live a longer, healthier life.
Diagnosing and Treating Heart Failure
The team at UH Harrington Heart & Vascular Institute is experienced at providing expert diagnosis and treatment for patients with heart failure. Our heart specialists utilize state-of-the-art technology to diagnose heart failure and provide personalized patient care and the full spectrum of treatment options, from diet and lifestyle modifications to advanced surgical procedures.
What is Heart Failure?
Heart failure is a chronic (lifelong) condition where the heart is unable to pump enough oxygen-rich blood to meet your body's needs. It is defined by a combination of complaints, such as shortness of breath with exertion, fatigue, and swelling of the ankles and legs.
Heart failure is not a disease per se. It can be caused by many different problems, including heart attack, high blood pressure, viral infections or genetic predisposition, among others. Patients with heart failure can find it difficult to be active and do things like walking, climbing stairs or other daily activities. Less blood to major organs can also cause slower thinking, and impaired kidney and liver functions.
Heart failure requires timely medical attention.
Heart Failure and Ejection Fraction
You may hear the term “ejection fraction” or EF mentioned by your health care team. What is EF and how is it connected with heart failure? Ejection fraction is a measurement obtained when a cardiac ultrasound (or echocardiogram) is performed. It is used to describe the contracting power of your heart and represents the percentage of the amount of blood pushed out of the heart with each contraction. A normal heart, when filled with blood, is able to pump out between 55 and 65 percent of its content at each beat. If a heart is only able to pump out less than 50 percent - say 40 percent - then we say the heart's EF is 45 percent. Low EF and heart failure are not the same. In fact, some people can have heart failure with normal EF, while others have no heart failure despite having low EF.
Heart failure with reduced ejection fraction: Also known as systolic heart failure, this type of heart failure occurs when patients with EF less than 50 percent develop shortness of breath, fatigue and swelling of the legs. This type of heart failure is most commonly caused by coronary disease, but it can also occur from viral illnesses, exposure to toxic chemotherapy, illicit drug use and alcohol, genetic causes or no identifiable reason. In this condition, the heart becomes progressively larger and weaker. However, this process can sometimes be slowed down or even improved with appropriate medical interventions. This type of heart failure has been well studied, and there are many possible treatments for it. These include medications, pacemakers, heart pumps and even heart transplant.
Heart failure with preserved ejection fraction: Also known as diastolic heart failure, this type occurs when patients with EF greater than or equal to 50 percent develop symptoms of shortness of breath, fatigue and swelling of the legs. This type of heart failure is associated with different conditions, including obesity, lung disease, diabetes, obstructive sleep apnea and inactivity. Treatment of this condition is less well established, and often the most important intervention is to address the underlying cause. This can include losing weight, treating lung disease, using a CPAP mask and so on.
Causes of Heart Failure
Over time, all of us lose some blood-pumping ability in our hearts. However, heart failure results from the added stress of health conditions that either damage the heart or make it work too hard. The heart weakens to the point where it is no longer able to fill with or pump blood as well as it should. Certain proteins and hormones might be released into the blood as the heart weakens. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.
Causes of heart failure include:
- Coronary heart disease
This is a condition in which a fatty blockage builds up inside the coronary arteries, narrowing the arteries and reducing blood flow to your heart.
- Diabetes mellitus
In diabetes, over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.
- High blood pressure (hypertension)
Blood pressure is considered high if it stays at or above 140/90 mmHg. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. High blood pressure causes chronic stress on the heart, leading to higher risk of heart attack, stroke and heart failure.
- Other heart conditions or diseases
Heart conditions such as arrhythmias (when a problem occurs with the rate or rhythm of the heartbeat), cardiomyopathies (when the heart muscle becomes enlarged, thick or rigid), congenital heart defects (when there are problems with the heart’s structure that are present at birth) or heart valve disease (when one or more of your heart valves doesn’t work properly, which can be present at birth or caused by infection, other heart conditions, and age).
- Severe lung disease
When the lungs don’t work properly, the heart has to work harder to get available oxygen to the rest of the body. High blood pressure in the lung arteries can cause strain on the right heart, leading to weakening of right-sided chambers.
- Other factors
These can include illegal drugs such as cocaine; alcohol abuse; thyroid disorders (having too much or too little thyroid hormone in the body); low red blood cell count (severe anemia); too much vitamin E; treatments for cancer, such as radiation and chemotherapy; HIV/AIDS; sleep apnea; and being overweight (obesity).
When the cause of heart failure is unknown.
Symptoms of Heart Failure
With heart failure, your body has a hard time getting rid of extra salt and fluid. Most often, the fluid builds up in the legs, belly and lungs. The heart needs to work harder to pump this extra fluid, which causes you to feel tired. These are the most common symptoms of heart failure:
- Feeling short of breath or finding it hard to breathe
- Not being able to lie flat without using extra pillows
- Feeling more weak or tired
- Swelling in feet, ankles, legs, belly or veins in the neck
- Sudden weight gain
- Heart feels like it is racing, pounding or skipping a beat (called palpitations)
At first, you may feel tired and out of breath after routine activities such as climbing stairs. As fluid continues to accumulate, your symptoms get worse and you may begin to feel tired and breathless after simple activities such as getting dressed or walking across the room or while lying flat.
In addition, the fluid that builds up during heart failure can cause weight gain, frequent urination, and a cough that’s worse at night and when you're lying down. This cough may be a sign of acute pulmonary edema, a condition in which too much fluid builds up in your lungs and emergency medical treatment is required.
Who is at Risk for Heart Failure?
Heart failure is more common in people with the following risk factors:
- Over age 65
- Have had a heart attack
- Congenital heart defect as a child
- Diabetes mellitus
- Uncontrolled blood pressure
- Excessive alcohol consumption
- Illicit drug use
Contact your doctor if you have any of the symptoms listed above or if any symptoms you already have get worse. Many times these issues can be treated by making changes in your medicines or diet. The sooner you tell your doctor, the better. Acting quickly may help lower your chances of needing to go to the hospital for treatment.
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Every day our team of heart specialists is helping patients with heart failure live life to the fullest again.
Managing your heart failure can be easier with our helpful patient education resources. Get information on managing your care at home, medication safety, support groups and more.
Get information on referrals, medical education, research and clinical trials.