Congestive heart failure happens when your heart can't pump enough blood to meet your body's needs. The heart is too weak or stiff to pump blood efficiently. It often develops after other conditions, such as coronary artery disease (narrowed heart arteries) or high blood pressure, have damaged or weakened the heart muscle.
At The UVM Medical Center, we treat congestive heart failure by using a team of experts to diagnose your condition and create a treatment plan that is designed specifically for your situation. Our team is nationally recognized and our treatments are backed by advanced research data.
If you are experiencing chest pain, call 9-1-1 immediately as it could be a heart attack.
Congestive Heart Failure Care at UVM Medical Center
The UVM Medical Center is one of nine medical centers selected nationally to participate in the National Institutes of Health Heart Failure Research Network, a clinical research organization that performs studies that allow patients to receive ground-breaking treatments. We offer inpatient consultation services and comprehensive cardiac rehabilitation services and educational classes for patients living with heart failure.
All aspects of cardiac care at The UVM Medical Center are supported by a team of highly trained & skilled nurses and other healthcare practitioners. Our specialized team of heart experts includes:
- General Cardiologists
- Congestive Heart Failure Specialists
- Interventional Cardiologists
- Cardiac Electrophysiologists
- Cardiothoracic Surgeons
Heart Failure Overview & Symptoms
Congestive heart failure cannot be reversed, but it can be prevented and treated. The key to effective prevention is to control the risk factors and conditions that contribute to it, such as:
The symptoms of congestive heart failure vary slightly depending on whether the condition is chronic or acute. Typically acute systems can be more severe and start or get worse suddenly. Chronic symptoms are similar but not as severe. Symptoms include:
- Shortness of breath when you exercise or lie down
- Fatigue or weakness
- Swelling in your abdomen, legs, ankles, and feet
- Fast or irregular heartbeat (palpitations)
- Difficulty doing physical activity
- A frequent cough or wheezing with white or pink foamy mucus
- Sudden fluid buildup
- Lack of appetite and nausea
- Difficulty concentrating or reduced alertness
- Chest pain
Call 9-1-1 immediately if you are experiencing chest pain as it could be a heart attack.
At The UVM Medical Center, cardiologists who specialize in heart failure thoroughly assess your symptoms to make a diagnosis. Patients with congestive heart failure are often first treated by a general cardiologist. After your initial diagnosis, a team of experts will tailor a treatment plan for you.
If you and your cardiologist determine that a more advanced level of care if the best option to address your heart failure, you'll see one of our sub-specialists. Sub-specialists are cardiologists with advanced training and expertise in a particular area of cardiology. The sub-specialists involved in the care of heart failure include:
- Congestive Heart Failure Specialists - Cardiologists with advanced training in heart failure care. These physicians focus primarily on the care of people with congestive heart failure and are familiar with the most advanced therapies and treatments for this disease.
- Interventional Cardiologists - Cardiologists with advanced training in non-surgical procedures for treating cardiovascular diseases, such as angioplasty and stent placement. They use catheters (thin, flexible tubes) which are threaded through a patient's blood vessels to perform diagnostic tests, clear clogged arteries and repair heart structures, often avoiding the need for open surgery.
- Cardiac Electrophysiologists - Cardiologists with advanced training in treating heart rhythm disorders and electrical diseases of the heart. These specialists offer expertise in implanting pacemakers and defibrillators and performing catheter-based procedures to correct heart rhythm problems.
- Cardiothoracic Surgeons - Surgeons with advanced training in operating on the heart and performing open-heart procedures such as coronary artery bypass surgery. They have special expertise in operating on the heart, lungs, esophagus, and major blood vessels of the chest cavity.
In order to effectively diagnose congestive heart failure, cardiac imaging specialists trained in the latest technology use the following techniques:
- Physical examination - Your doctor will take a thorough medical history and physical examination, checking for risk factors such as high blood pressure.
- Blood tests - Blood tests can reveal other diseases that affect the heart. Your doctor may also check for specific chemical markers of congestive heart failure in the blood.
- Chest X-Ray - An x-ray can be useful in showing the condition of your lungs, as well as the size and shape of your heart and major blood vessels. With heart failure, the heart may be enlarged with fluid buildup visible in the lungs.
- Electrocardiogram (ECG or EKG) - This test records the electrical activity of your heart through electrodes attached to your skin. An ECG can help identify damage to your heart that may be a cause of congestive heart failure.
- Echocardiogram - This is an important test for diagnosing heart failure, enabling doctors to distinguish between different types of congestive heart failure. An echocardiogram uses sound waves to create a video image of your heart. It can help determine if an area of your heart isn't pumping as it should.
- Ejection fraction - This is a measurement of how well your heart is pumping, taken during an echocardiogram. It helps to classify your heart failure and guide your congestive heart failure treatment.
- Stress tests - A stress test shows how your heart and blood vessels respond to exertion, either during exercise or in response to medications that stress the heart. This test can help identify blockages in your arteries that may be causing your heart failure.
- Computed Tomography (CT) scan - The UVM Medical Center offers the latest technology in computed tomography. Highly advanced CT scanners provide comprehensive images of organs within seconds with a high degree of accuracy. A cardiac CT scan can help determine the condition of heart arteries and valves and identify potential causes of heart failure.
- Magnetic Resonance Imaging (MRI) scan - An MRI uses magnetic fields and radio waves to produce cross-sectional images of your body. The UVM Medical Center offers the latest technology in Open MRI, offering a comfortable option for patients in an open setting. A cardiac MRI scan can be used to check the heart arteries and valves, determine if you've had a heart attack and check for any other causes of congestive heart failure.
- Coronary catheterization or angiogram - Cardiologists in the UVM Medical Center's Cardiac Catheterization Laboratory inject a dye into the arteries of your heart through a long, thin tube called a catheter. The dye is visible on x-ray and video, helping to identify any blocked or narrowed arteries that may be causing your heart failure.
The type of treatment you receive will depend on the severity of your condition. Both surgical and non-surgical treatments are options. They include:
- Quit Smoking - Smoking damages heart and blood vessels. If you want to quit smoking, your doctor can recommend a program to help you.
- Eating Plan - Eating healthy is an important way to improve your condition. Patients with heart failure should consider limiting fats and cholesterol, along with alcohol and fluids. Eating less salt is also important. A dietician can help develop a nutritious eating plan that is right for you.
- Maintain a Healthy Weight - If you are overweight, losing weight can be an important factor in improving your health. The UVM Medical Center dietitians can design a weight-loss plan that meets your needs.
- Physical Activity -
Moderatephysical activity most days of the week for patients with congestive heart failure can keep the rest of your body healthy and reduce demands on your heart. Talk to your doctor before you start an exercise program.
There are a variety of medications that may be used to treat congestive heart failure. Many are designed to treat specific underlying causes of your condition. We offer a full range of the latest medicines available for patients with heart failure. These medications include:
- Diuretics - Also known as water pills, these drugs help reduce fluid buildup in the body. They can lessen congestion in the lungs and reduce swelling in the abdomen, legs, and feet.
- Angiotensin-converting enzyme (ACE) inhibitors - These medicines reduce the formation of angiotensin, a substance that causes blood vessels to constrict, resulting in increased blood pressure. ACE inhibitors lower blood pressure and reduce strain on the heart.
- Angiotensin receptor blockers (ARBs) - These drugs block the action of angiotensin, preventing and limiting its negative impact on the blood vessels and the heart. They may be an alternative for patients who cannot tolerate ACE inhibitors.
- Digitalis - This drug, also known as Digoxin, increases the force of your heart muscle's contractions, helping it beat more strongly.
- Beta blockers - Beta blockers help decrease the demand on your heart, helping the heart muscle to relax, slowing your heart rate and lowering blood pressure, including:
- Vasodilators - This type of drug helps the blood vessel walls to widen or relax, improving blood flow and reducing strain on the heart.
- Aldosterone antagonists - These medicines help the body get rid of salt and fluid, and lower the actual amount of blood the heart pumps. In addition, they may prevent fibrosis or scarring of the heart in patients with congestive heart failure.
Heart failure patients may benefit from the UVM Medical Center's Cardiac Rehabilitation program.
UVM Medical Center offers the full range of procedures to treat the underlying causes of heart failure. The following list are procedures used to treat congestive heart failure:
- Angioplasty and Stenting - If your congestive heart failure is caused by coronary artery disease and blocked or clogged arteries, angioplasty and stenting procedures may be needed to help restore blood flow.
- Angioplasty - UVM Medical Center cardiologists insert a catheter with a special balloon into a blocked coronary artery. The balloon is inflated to open up the artery and restore blood flow to the heart.
- Stenting - This procedure involves inserting a stent - a tiny wire mesh device - into a blocked artery to keep it open, restoring blood flow to the heart. Stents are inserted using a catheter, after a balloon is used to open the artery.
- Coronary Artery Bypass Surgery - If you have multiple blocked arteries, your doctor may recommend coronary artery bypass surgery. With this more invasive procedure, surgeons open the chest and insert new blood vessels in the heart. These vessels are taken from other parts of the body and connected to the heart. They create a new pathway that bypasses clogged coronary arteries and allows blood to flow normally.
- Heart Rhythm Procedures - If you have an advanced form of heart failure, your doctor may recommend implanting a mechanical device to help keep your heart beating as strongly as possible.
- Implantable cardioverter-defibrillators (ICDs) - An ICD is a device that monitors the heart rhythm and shocks it back to a normal rhythm if it is beating at a dangerous pace. ICDs are implanted under the skin and attached to the heart with small wires.
- Cardiac resynchronization therapy (CRT) or biventricular pacing - When the left and right sides of the heart no longer work together, the heart is less efficient in pumping blood through the body. CRT improves heart function by sending timed electrical impulses to both of the heart's lower chambers, enabling both sides to work in coordination and improve pumping function. The procedure involves implanting a pacemaker-type device with wires connected to specific areas of the heart.
- Heart pumps or Left Ventricular Assist Devices (LVADs) - Used primarily in very ill patients, these devices are external pumps that are attached to a weakened heart to help it function. Usually, LVADs are used to help keep heart transplant patients alive while they wait for a donor heart. In some cases, LVADs may be considered an alternative to transplantation. They can extend and improve the lives of people with end-stage congestive heart failure.
Learn more about the UVM Medical Center's Heart Rhythm Program.
Please note: Some of the doctors and specialists listed below may not treat this specific condition.