We believe that patients are most successful in managing their disease when they become active partners in their care plans, and we encourage each patient to work closely with their physician, nurse practitioner and other team members.
For more information about our Heart Failure Program, or to schedule an appointment, please call (609) 632-0150.
Heart Failure Program
Patients diagnosed with heart failure often struggle with repeated hospitalizations and lifestyle limitations. Many patients, however, can take control of their condition and improve the quality of their lives. Our team of dedicated heart failure specialists, located close to home, design a personalized and comprehensive care plan for each patient aimed at keeping them well.
Meet our Team
Kulpreet Barn, MD, FACC; Abroo Muzaffar, NP; and Stacey Hamaoui, RN
Heart Failure Definition
Heart failure is a condition in which the heart cannot pump enough blood to the rest of the body. Heart failure is often a long-term (chronic) condition, but it can sometimes develop suddenly. It can be caused by many different heart problems. The condition may affect only the right side or only the left side of the heart. These are called right-sided heart failure or left-sided heart failure. More often, both sides of the heart are involved. Systolic heart failure is present when your heart muscle cannot pump (eject) the blood out of the heart very well. Diastolic heart failure occurs when the heart muscles are stiff and do not fill up with blood easily. These problems mean the heart is no longer able to pump enough oxygen-rich blood out to the rest of your body. As the heart's pumping becomes less effective, blood may back up in other areas of the body. Fluid may build up in the lungs, liver, gastrointestinal tract, and the arms and legs. This is called congestive heart failure.
Heart Failure Symptoms
Heart failure symptoms:
Types of Heart Failure
Left-sided heart failure
Blood tests. Your doctor may take a sample of your blood to look for indicators of other diseases that affect the heart.
Chest X-ray. X-ray images help your doctor see the condition of your lungs and heart.
Electrocardiogram (ECG). This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack that may be underlying heart failure.
Echocardiogram. An echocardiogram uses sound waves to produce a video image of your heart. This image can help doctors determine how well your heart is pumping by measuring the percentage of blood pumped out of your heart's main pumping chamber (the left ventricle) with each heartbeat. This measurement is called the ejection fraction. The echocardiogram can also look for valve problems or evidence of previous heart attacks, as well as some unusual causes of heart failure.
Stress test. Stress tests measure how your heart and blood vessels respond to exertion. You may receive a drug intravenously that stimulates your heart similar to exercise. Stress tests help doctors see if you have coronary artery disease.
Cardiac catheterization (angiogram). In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at your groin or in your arm and guided through the aorta into your coronary arteries. A dye injected through the catheter makes the arteries supplying your heart visible on an X-ray. This test helps doctors identify narrowed arteries to your heart (coronary artery disease) that can be a cause of heart failure.
6MWT. The six-minute walk test (6MWT) measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six minutes. The individual is allowed to self-pace and rest as needed as they traverse back and forth along a marked walkway.
Cardiopulmonary stress test. The Cardiopulmonary Exercise Test is a highly sensitive, non-invasive stress test. It is considered a stress test because the exercise stresses your body’s systems by making them work faster and harder. A disease or condition that affects the heart, lungs or muscles will limit how much faster and harder these systems can work. A CPET assesses how well the heart, lungs, and muscles are working individually, and how these systems are working in unison. Your heart and lungs work together to deliver oxygen to your muscles, where it is used to make energy, and to remove carbon dioxide from your body.
Treatment and Drugs
Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are a type of vasodilator, a drug that widens blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart.
Angiotensin II receptor blockers. These drugs have many of the same benefits as ACE inhibitors. They may be an alternative for people who can't tolerate ACE inhibitors.
Digoxin (Lanoxin). This drug increases the strength of your heart muscle contractions. It also tends to slow the heartbeat and reduces heart failure symptoms.
Beta blockers. This class of drugs not only slows your heart rate and reduces blood pressure but also limits or reverses some of the damage to your heart. These medicines reduce the risk of some abnormal heart rhythms and lessen your chance of dying unexpectedly. Beta blockers may reduce signs and symptoms of heart failure, improve heart function, and help you live longer.
Diuretics. Often called water pills, diuretics make you urinate more frequently and keep fluid from collecting in your body. Because diuretics make your body lose potassium and magnesium, your doctor may also prescribe supplements of these minerals. If you're taking a diuretic, your doctor will likely monitor levels of potassium and magnesium in your blood through regular blood tests.
Aldosterone antagonists. These drugs include spironolactone (Aldactone) and eplerenone (Inspra). They are potassium-sparing diuretics but also have additional properties that may reverse scarring of the heart and help people with severe heart failure live longer.
Advanced Diagnostic and Treatment Options
LVAD and transplantation
An LVAD, or Left Ventricular Assist Device, (also called a VAD, ventricular assist device, or MCS device, mechanical circulatory support device) is a mechanical pump that can dramatically improve quality of life for people with advanced heart failure. It is an implantable mechanical pump that helps pump blood from the lower chambers of your heart (the ventricles) to the rest of your body. VADs are used in people who have weakened hearts or heart failure. Sometimes LVADs are used as a “bridge” while patients wait for a transplant. For other patients, an LVAD is a permanent therapy.
Transplantation: heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't improved sufficiently.
Cardiac Connections is a program we offer to our patients with end-stage heart failure that are not candidates for advanced heart failure therapies. It allows patients to continue receiving treatment for heart failure without having repeated admissions to the hospital for heart failure hospitalizations. Patients are seen by a nurse practioner within 72 hours of admissions and are seen by a nurse 1-2x weekly or more often if symptomatic. Patients receive daily phone calls to evaluate their status and if there are any significant changes, a nurse is sent immediately to evaluate. Patient can still continue to see their cardiologist, neurologist, nephrologist or any specialist they wish.
ROADMAP is a post-market study of the HeartMate II Left Ventricular Assist System as a Destination Therapy device. The study will involve ambulatory advanced heart failure patients who are not yet dependent on intravenous inotropic support and are typically categorized as INTERMACS profiles 4-6, within the existing FDA-approved indication for Destination Therapy. The primary objective of the prospective, multi-center, non-randomized, controlled, observational study is to evaluate and compare the effectiveness of HeartMate II support versus Optimal Medical Management (OMM).
What is Heart Failure?
What is heart failure?