Advanced Heart Failure Symptoms & Treatment

A team of MedStar Health advanced heart failure specialists stand together for a group photo.

Expert care when heart failure progresses

Advanced heart failure is a form of heart failure that has progressed to the most serious stage. Heart failure gets worse over time. Based on a patient’s risks and symptoms, the American College of Cardiology and the American Heart Association classify the progression of this disease as:

Stage A: High risk of developing heart failure
Stage B: Left ventricle is not performing well or is structurally abnormal
Stage C: Current congestive heart failure diagnosis or previous symptoms
Stage D: Diagnosis of heart failure with reduced ejection fraction and have advanced symptoms do not get better with treatment.

Though this condition is serious, there is hope for patients with this disease if patients receive timely and effective care. There is a “Golden Window of Opportunity” when heart failure patients should be referred for advanced care before it is too late (American Heart Association scientific statement October 2021). The clinical signs and symptoms that indicate when a patient should be referred for advanced heart failure care are:

Inability to tolerate guideline directed medical therapy
Frequent hospitalizations
Recurrent heart rhythm issues or ICD shocks
Worsening kidney function

Our Advanced Heart Failure Program team provides diagnosis, a comprehensive scope of medical and surgical options treatment options, and ongoing patient support for heart failure patients as described on the above page link.

Symptoms of advanced heart failure

The symptoms of advanced heart failure are similar to those of heart failure in an earlier stage. These include:

Shortness of breath
Dry, hacking cough
Chest pain
Fatigue
Irregular heartbeat, also known as arrhythmia
Swelling in the legs, feet, or abdomen
Weight loss without diet or exercise changes

These symptoms may be worse or better from day to day or even at different times of the day. The main difference from less-advanced heart failure is that these symptoms may appear with ordinary activity or even during rest.

Causes of advanced heart failure

Everyone loses some ability for the heart to pump blood as we age. However, heart failure is a result of medical conditions that either damage the heart outright or make it work harder. Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity contribute to heart failure. Medical conditions that may lead to heart failure are:

Arrhythmia or irregular heart beat
Amyloidosis
Cardiomyopathy or disease of heart muscle
Coronary artery disease
High blood pressure or hypertension
Heart valve disease
Congenital heart defect
Diabetes
Obstructive sleep apnea
Sarcoidosis

Risk factors of advanced heart disease

Certain medical conditions can increase your risk for health failure, including:

Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity increase your risk of heart failure.

You can take important steps to prevent heart failure by engaging in regular physical activity, maintaining a healthy body weight, not smoking, eating fruits and vegetables, moderate alcohol intake, and maintaining a healthy weight.

Diagnosis and testing

Diagnosing advanced heart failure is the first step to developing a treatment plan. Our specialists may recommend one or more diagnostic and imaging procedures.

Technetium Pyrophosphate

Uses a radioactive form of PYP that is often used to diagnose cardiac amyloidosis.

Treatments

We offer a wide spectrum of treatments for patients with advanced heart failure. These include CardioMEMS™ remote patient monitoring, Barostim™ heart assist device, inotropic therapy, interventional heart failure treatment, as well as, ventricular assist devices, Extracorporeal Membrane Oxygenation (ECMO) and heart transplants. Along the way, patients have access to palliative care to relieve symptoms and stress.

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