Myocardial Recovery Program

From Heart Failure to Recovery: Schedule Online or Call.

Heart failure recovery is possible. At the Norton Heart & Vascular Institute Myocardial Recovery Program, the team of heart failure cardiologists, advanced practice providers and nurse educators are restoring hearts to effective functioning. Fatigue, shortness of breath, swelling and other symptoms no longer slow down recovered heart failure patients.

Enlargement or thickening of the heart muscle — a frequent cause of heart failure — can be reversed by gradually introducing appropriate medication, regular monitoring, cardiac rehabilitation and lifestyle changes.

With months of treatment your heart can return to its normal function — full heart failure recovery, or myocardial recovery.

You may be eligible for the Myocardial Recovery Program if you meet key criteria for heart failure: The left ventricle is pumping only 40% or less of blood from the chamber and you have been taking heart-failure medication for less than three months. Recovery is achieved when your heart can pump 50% or more of the blood from the left ventricle. Normally the heart pumps 55% of blood or more.

Norton Heart & Vascular Institute Myocardial Recovery Program

The myocardium is the heart muscle itself. Like any muscle, it can get larger, stiffen, loosen, weaken and change shape. Unlike any muscle, these changes can affect your overall health.

The heart failure cardiologists at the Myocardial Recovery Program, part of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program, have developed a regimen of medication and close monitoring that allows the heart muscle to return to its normal shape and flexibility.

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More than half our patients whose heart failure wasn’t caused by heart attack or significant blockage of a coronary artery are cured if treatment starts soon enough after symptoms appear. The national average for these cases is 10%

Restoring efficiency to your heart and recovering from heart failure may take several months of medication and close monitoring with remote sensors and office visits. If medication isn’t bringing about recovery and your heart failure progresses, we will talk about advanced heart failure therapies that may provide additional options.

How to Recover From Heart Failure

The first step toward myocardial recovery is cardiac testing. These tests will help your care team understand the condition of your heart muscle so that a customized treatment plan can be created.

Several medications will be used to assist the heart as its function improves. You also will have frequent follow-up appointments during the recovery process. Typically, you will visit weekly for four weeks, then every two weeks for two months, then monthly depending on your progress.

You also may be called by a member of our nursing staff with dosage and medication adjustments.

Our team will work closely with to maximize your results and progress by modifying your treatment plan.

Many of the medications your heart failure cardiologist will prescribe will need to be taken for an extended period of time, with frequent dosage adjustments.

  • Beta blockers are the single most important medication you will take during your recovery. Beta blockers improve your heart’s ability to relax, pump blood and maintain a normal heart rate. Examples of beta blockers are carvedilol (Coreg) and metoprolol succinate (Toprol-XL).
  • Angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors help widen blood vessels to reduce the workload on your heart. They also improve blood flow and lower blood pressure. Examples of ARB and ACE medications are lisinopril (Prinivil), enalapril (Vasotec), losartan (Cozaar) and valsartan (Diovan).
  • Angiotensin receptor-neprilysin inhibitors (ARNIs) help widen blood vessels, improve blood flow, lower blood pressure, remove fluid and regulate hormones that cause you to retain fluid. The main ARNI medication is a combination of sacubitril and valsartan (Entresto).
  • Cardiac glycosides increase the strength of heart muscle contractions. They also can slow the heartbeat. An example of a cardiac glycoside is digoxin (Lanoxin).
  • Diuretics are sometimes called water pills. They increase urination and help keep fluid from collecting in the body. They can make you feel better but do not play a role in myocardial recovery. Examples are furosemide (Lasix) and bumetanide (Bumex).
  • Aldosterone antagonists are diuretics that do not cause potassium loss. They also help the heart work better. They may reverse scarring of the heart and help individuals with severe heart disease live longer. Examples are spironolactone (Aldactone) and eplerenone (Inspra).
  • Inotropes are given intravenously either continually or in intervals. They increase the heart’s strength and force of blood pumping through the body. They also widen blood vessels, which allows blood to flow more easily. Not everyone will need this type of medication. It may be given for a short time until other medications are introduced. Examples include milrinone (Primacor) and dobutamine (Dobutrex).

Our goal is to maximize the medication doses you can tolerate. Higher doses of medications can improve results, so we’ll try to have you on the strongest dose you can tolerate. We’ll increase dosages gradually to avoid dizziness and other side effects of your heart rate or blood pressure dropping too quickly.

How Will I Know When I’ve Recovered From Heart Failure?

An MRI or echocardiogram will be performed at three months after your diagnosis to evaluate your heart function. Testing will continue every three months for one year to monitor your progress.

How Long Does Heart Failure Recovery Take?

Recovery is different for everyone, but generally we see results in as soon as two months and as long as nine months, with the average being three to six months.

Can I Return to Work?

You may be able to return to work, depending on your job. Together with your health care team, we can help you determine when to return to work.

What Happens if My Heart Does Not Recover?

If your heart continues to remain weak after three to six months, we will continue to adjust and increase medications to achieve the greatest benefit for your heart. If you continue to not feel well, we will talk about advanced heart failure therapies that may provide additional options.

How Often Will My Medications Change?

Typically during the recovery process, we will adjust medication doses at every visit. If you are not seen every week, we may call you on the phone to increase your medications if you are feeling well.

If I Am Doing Well, Why Would I Have to Take More Medicine?

Your heart will continue to improve after recovery with continued medication. Regardless of the cause, heart failure is a lifelong condition that is best managed by supportive medical therapy. Evidence shows that when the patient can tolerate a target dose of the right combination of medications, the best possible outcome is achieved. Each of your medications provides a specific type of support for a weakened heart muscle.

If My Heart Recovers, Will I Have to Take Medication Forever?

Studies show that if your heart recovers and you stop taking your medication, your heart may become weaker in as soon as six weeks. Our plan will be to continue the medications as long as your body is responsive and you experience limited side effects.

What If I Can’t Afford All My Medications?

If you cannot afford your medicine, we may be able to assist you. Please notify our social worker if you need assistance.

During and After Recovery, What Activity or Lifestyle Restrictions Will I Have?

During your recovery, your activity will be limited by how you feel. If you take part in certain activities that you have concerns about, please discuss them with your health care team.

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.

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