Heart Failure Clinic
According to the American Heart Association, congestive heart failure affects nearly 4.8 million people nationwide.
Patients with congestive heart failure are admitted to the hospital an average of three times per year. In addition, 50 percent of patients die within five years of the initial diagnosis. At the St. John Heart Institute, we understand the severity of this problem and have a center dedicated to improve the quality of life of congestive heart failure patients.
The vision of the St. John Outpatient Heart failure Clinic is to ensure that each patient receives the optimal standard of care for chronic congestive heart failure, increasing the quality of life and decreasing hospital stays. Heart failure patients receive individualized care in a warm, friendly environment.
St. John focused, team approach includes:
- Clinic follow-ups with telephone monitoring
- Educational programs on nutrition, exercise and medications
- Office-based infusions by trained nurses
- Monitored ACEI and beta blocker initiation
- Access to cardiologists who specialize in heart failure and physicians trained in the latest surgical treatments
To find out more about the St. John Heart Institute heart failure program, call 918-744-2868.
FREQUENTLY ASKED QUESTIONS
You have congestive heart failure when excess fluid starts to leak into the lungs and/or the peripheral parts of the body. Normally the pumping actions of the left and right sides of the heart complement each other, producing a continuous flow of blood. Heart failure may occur with both ventricles failing, although one ventricle may precede the other in dysfunction. The most common form of initial heart failure is left-sided failure which occurs when the left ventricle is not working properly. This causes blood to back up through the left atrium and into the pulmonary veins, resulting in pulmonary congestion and edema because the fluid is backed up into the lungs. The most common causes of left-sided failure are disease of the coronary arteries, hypertension (high blood pressure), cardiomyopathy (enlarged heart), and rheumatic heart disease. Right-sided failure can occur as a result of damage to the right ventricle, such as a heart attack or enlargement of the right ventricle. Right-sided heart failure from a weakened right ventricle causes fluid to back into the body, resulting in swollen ankles and weight gain.
Symptoms of congestive heart failure may include:
- Persistent coughing or wheezing
- Fatigue and weakness
- Feeling of suffocation while sleeping, unless propped up on two or more pillows
- Unusual swelling in the lower legs and ankles
- Sudden weight gain from fluid retention (two or more pounds overnight)
- Shortness of breath during normal activities
- Increased heart rate
- Digestive problems
If you are having the symptoms of CHF, it is important to see your physician. Your doctor will ask about your medical history and your symptoms. After a full physical examination, your doctor will want to assess the condition of your heart and may conduct some of the following tests:
- Chest X-ray to check for heart enlargement
- Electrocardiogram (EKG) to assess the electrical activity of the heart and to diagnose abnormalities, such as a previous heart attack
- Echocardiogram (Echo) to check valve function and heart size by ultrasound
- Nuclear ventriculogram to evaluate the pumping function of the heart
- Cardiac catherization to diagnose coronary artery disease and evaluate previous heart attacks
With the information obtained from your tests, your doctor will be able to determine the best treatment plan for you. Whatever plan you and your doctor choose will be explained to you in full detail. In most cases, heart failure is a chronic condition that will not go away, although it may be successfully managed by taking medications and making healthy changes in habits such as diet and exercise. Remember, successful treatment of heart failure requires teamwork on the part of you, your family and your doctor. The earlier you start treatment for heart failure, the better your chances of maintaining energy, controlling symptoms and preventing further damage to your heart.
There can be some risks involved with certain diagnostic procedures, and in most cases they are relatively minor. Please ask your doctor to discuss the risks and benefits so that you are fully informed about any tests you may have. It is important to be your own best health advocate. A good way to do that is by committing to routine physical exams and diagnostic tests as often as is recommended by your cardiac specialist. Early detection of heart disease is the key to effective treatment.
Congestive Heart Failure (CHF) is caused by other diseases or conditions that damage or overwork the heart muscle; over time, the heart muscle is weakened. The leading causes of congestive heart failure are:
- Coronary artery disease (CAD)
- High blood pressure (hypertension)
Coronary artery disease, including angina (chest pain or discomfort) and heart attack, are the most common underlying cause of congestive heart failure. Most people with heart failure also have high blood pressure, and about one out of every three people with heart failure also has diabetes.
Other conditions and factors that can cause congestive heart failure include:
- Cardiomyopathy (inflammation of the heart muscle)
- Diseases of the heart valves
- Abnormal heartbeats or arrhythmias
- Congenital heart disease (a heart defect or problem you are born with)
- Treatments for cancer, such as radiation and certain chemotherapy drugs
- Thyroid disorders -- having either too much or too little thyroid hormone in the body (hyper/hypo thyroidism)
- Alcohol abuse
- Cocaine and other illegal drug use
Studies are being done on the relationship between sleep apnea and congestive heart failure. Patients with obstructive sleep apnea may suffer damage to the right side of their heart since it has to pump harder in order to support the added effort of their lungs attempting to overcome the airway obstruction. A test was done on forty-two patients with heart conditions. Nearly half of these patients had severe sleep apnea that had not been diagnosed prior to the study. People with sleep apnea and congestive heart failure should consider treating their sleep apnea. This could greatly help their chances of surviving heart disease. Sleep apnea is the second leading cause of daytime fatigue after insomnia. Getting poor sleep is a major health problem that needs to be addressed sooner.
There are a few tests commonly used throughout cardiology practices to assist in evaluating and treating Congestive Heart Failure (CHF).
- Echocardiogram: An echocardiogram or echo uses sound waves (ultrasound) to take moving pictures of your heart. This test is used to assess the pumping function, also known as your ejection fraction (EF). The test is painless and only takes 45 minutes to an hour to perform.
- Right Heart Cath: This is an invasive testing procedure performed in the Cardiac Cath Lab. Special monitoring catheters are placed to determine abnormalities and record blood pressure in the heart chambers.
- Left Heart Cath: This is an invasive testing procedure performed in the Cardiac Cath Lab. Contrast dye is injected into the coronary arteries to look for any possible blockages.
- Sleep Study: A Sleep Study or Polysomnogram (PSG) is a multiple-component test, which electronically transmits and records specific physical activities while you sleep. The recordings become data, which will be "read" or analyzed by a qualified physician to determine whether or not you have a sleep disorder. Multiple surface electrodes (leads) will read different areas of the body. The electrodes will transmit many different pieces of information to a technologist monitoring you as you sleep. This test is used for CHF patients because combining sleep apnea with CHF can greatly increase mortality if the sleep disorder goes untreated.