Heart failure is a serious condition that affects about 6 million American adults. It can cause fatigue, shortness of breath and other symptoms. The good news is that you can manage these symptoms and stay healthier longer.

The Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program offers comprehensive inpatient and outpatient services for adults with heart failure. Our multidisciplinary team includes specially trained heart failure cardiologists, cardiac surgeons, nurse practitioners, social workers, patient navigators, a dedicated pharmacist and other specialists to provide the highest quality care for all our patients.

What Is Heart Failure?

Normally the heart pumps oxygen-rich blood through the body. If you have heart failure, the heart is not pumping as well as it should. This can be caused by damage to the heart or another condition. If the heart isn’t pumping like it should, the body doesn’t get the oxygen it needs to work properly.

How Does a Healthy Heart Work?

The human heart is about the size of a closed fist. It has four chambers and is made of strong muscles that push blood from chamber to chamber. The top chambers are called atria, and the lower ones are called ventricles. In order to get blood where it needs to go in the body, the heart muscle has to squeeze and release in a certain way.

If you have heart failure, the heart cannot squeeze and release in the correct way. Heart failure can affect the left side of the heart, the right side or both sides.

What Causes Heart Failure?

Typically, heart failure is cause by atherosclerosis — when the arteries become narrower from the buildup of fatty deposits (plaque) along the walls of the artery.

There are also lifestyle factors that increase the risk of heart failure, including smoking, diabetes, obesity and lack of physical activity.

Other risk factors for heart failure include:

• High blood pressure can increase your risk by damaging the heart muscle over time.
• Type 2 diabetes usually causes patients to have a higher level of fats in their bloodstream, as well as high blood pressure. Both of these conditions are linked to heart failure.
• Metabolic syndrome is some combination of these risk factors: large waistline, high fasting triglycerides, low good cholesterol (HDL), high blood pressure and high fasting blood sugar.
• Hyperactive thyroid can cause an increased heart rate, which leads to a thickening of the heart muscle over time.
• Past heart attack can damage the heart so that it no longer pumps efficiently.
• Abnormal heart valves can be caused by infection, disease, injury or a birth defect. When the valves do not open or close properly, the heart has to pump harder to keep the blood moving.
• Congenital heart defects are heart conditions that are present at birth. If the heart chambers don’t form correctly, the rest of the heart has to work harder to make up for it.

How Is Heart Failure Diagnosed?

After a complete physical examination by your health care provider, you might be given some tests to check for heart issues. Those tests might include:

• Bloodwork to look for abnormal levels of some substances like sodium, potassium or certain proteins
• Chest X-rays that show a more detailed look at the heart muscle
• Electrocardiogram (EKG or ECG), which uses electrodes on the chest that record your heart’s rhythm, frequency of beats and how well it conducts electricity
• Echocardiography (or echo), which uses ultrasound to examine the heart
• Exercise stress test, which is done on a treadmill while your breathing, heart rate, blood pressure and how you feel are monitored

How Does Heart Failure Affect Daily Life?

Heart failure affects your entire body. The most common symptoms include:

• Edema: When the heart is not pumping effectively, blood can’t move as it should. The blood can back up in veins or into other tissues, causing excess fluid to build up. Edema is swelling in the feet, ankles, legs, fingers, hands or abdomen, or swelling in tissues and organs. Edema in the lungs is called pulmonary edema.
• Shortness of breath: This is caused by fluid in the lungs or poor heart function. It can happen during rest or activity, and it can come on suddenly.
• Fatigue: When the heart can’t pump as well as it should, your organs, muscles and tissues can’t get enough oxygen. The result is feeling tired or sleepy, even after resting.

There are other symptoms as well. Because the heart can’t get necessary oxygen to the entire body, you may feel confused or disoriented. The heart also may beat faster. You may have nausea, loss of appetite or a feeling of fullness in the abdomen.

How to Live With Heart Failure

There are six lifestyle changes you can make to help manage heart failure and help you feel better.

• Weight loss or maintenance: Weighing yourself every day might sound like a lot, but if you are at risk for developing edema, a sudden weight gain can signal something is wrong. It’s important to shed excess weight if you have it, or maintain a healthy weight.
• Quitting smoking: Smoking is strongly linked to developing heart failure.
• Getting regular physical activity: Regular exercise can benefit almost anyone, but it is important not to overdo it. Talk to your health care provider about what is the best kind of exercise for you and how much of it you should do.
• Getting enough sleep and rest: Since your body is working overtime, it’s very important to get plenty of good sleep.
• Managing stress, anxiety and mental health: These all have a negative effect on your heart, so taking care of your mental health is important.
• Diet: Eating a heart-healthy diet can help you feel better and mange symptoms.

There are also some medications used for heart failure. When your body is under stress, such as it is during heart failure, it releases hormones designed to compensate for the loss of heart function. The drugs to stop those hormones from damaging the heart include:

• ACE (angiotensin-converting enzyme) inhibitors
• ARNIs (angiotensin-receptor neprilysin inhibitors)
• Beta-blockers
• I_f channel blockers
• Vasodilators
• Mineralocorticoid receptor antagonist
• Sodium-glucose cotransporter-2 (SGLT-2) inhibitors

With the proper lifestyle adjustments, and medication or other interventions, you can live a healthy and full life, even with heart failure. The multidisciplinary team at Norton Heart & Vascular Institute works to create a custom plan to take care of all your needs, from diagnosis and medication management to support groups and resources to secure the medications you need.

Heart Failure Care Designed for Heart Recovery

• Same-day appointments are available for new patients at locations in downtown Louisville and on the campuses of Norton Audubon Hospital and Norton Brownsboro Hospital.
• Our compassionate and dedicated team includes specially trained heart failure cardiologists and advanced practice providers, a social worker, nurse navigators and dedicated pharmacist to help create a custom plan for care and make sure you and your family’s questions are answered at every step.
• When diagnosed promptly, more than 50% of patients with heart failure that wasn’t caused by heart attacks or blockages are cured, compared with about 10% nationally.
• Our program has advanced heart failure monitoring technology to detect signs of a weakening heart before you feel symptoms, with a goal of preventing hospital stays.
• We are a DNV-accredited provider of ventricular assist devices and are recognized as High Performing in Heart Failure by U.S. News & World Report.
• Our advanced care for severe heart failure includes ventricular assist device implants, extracorporeal membrane oxygenation (ECMO) support to give your heart a rest and time to heal, and access to heart transplants with ongoing aftercare.
• Medicare, Medicaid and most major commercial insurance plans are accepted.
• Book appointments, get alerts when an earlier appointment becomes available, communicate with your medical provider, refill prescriptions and more through your free Norton MyChart account.