Acute decompensated heart failure (ADHF) is a condition that includes new or worsening symptoms of heart failure that often lead to hospitalization or an emergency department visit. On this page, we will use ADHF for all acute heart failure syndromes.

There are different types of heart failure and different stages, which help doctors decide how to treat your ADHF. Precise diagnosis of heart failure and customized treatment for your condition are reasons more patients in Louisville and Southern Indiana entrust Norton Heart & Vascular Institute with their heart failure care than any other provider in the area.

Our team of board-certified and fellowship-trained specialists and advanced practice providers at the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program has the experience and expertise to diagnose the progress of your heart failure and provide treatments including lifestyle guidance, medication, mechanical circulation devices and evaluation for heart transplants. Our program is a member of the UK Gill Heart & Vascular Institute Affiliate Network. That means that when a heart transplant is needed, our providers work closely with UK HealthCare heart transplant providers to walk each patient through evaluation, testing and the organ transplantation process.

Acute Heart Failure Vs. Advanced Heart Failure

“Heart failure” makes it sound like the heart has stopped working completely, but that’s not really what’s happening. Heart failure means your heart beats, but it cannot pump blood as well at it should. This results in fatigue, shortness of breath and other symptoms. Heart failure is a condition with no cure, but it can be managed with drugs and other treatments. Many people are living with heart failure.

Heart failure can get worse over time, especially if it is not treated properly. Advanced heart failure means the most severe version of the condition.

Acute heart failure means symptoms get worse or develop suddenly. Initially, symptoms are severe. Acute heart failure may follow a heart attack if there has been damage to an area of your heart. It also may be caused by the body suddenly being unable to compensate for chronic heart failure. Sometimes, acute heart failure is severe initially but may last a short time; it does, however, require medical intervention.

Stages of Heart Failure

Doctors use classifications of heart failure to understand how to best treat you. These classifications are based on how severe your symptoms are and how much you are limited by them.

1. No limits on physical activity: Everyday activities do not cause excess fatigue, increased heart rate or shortness of breath.
2. Slight limits on physical activity: Physical activity results in fatigue, increased heart rate or shortness of breath. You are comfortable while resting.
3. Definite limits on physical activity: Minor activity causes fatigue, increased heart rate or shortness of breath.
4.  Unable to do any physical activity without discomfort: Heart failure symptoms continue even while resting. Any physical activity causes discomfort to increase.

Decompensated Heart Failure

When something is decompensated in the body, it means there has been a breakdown of a structure (such as an organ or muscle) or system that had been working before. The heart no longer can make up for the failure caused by the breakdown.

If the structure or system is able to continue working, even with the breakdown, it is called compensated heart failure. There are often no symptoms in compensated heart failure.

Treatment for Heart Failure

The Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program helps patients protect and recover heart function using leading-edge technology and medication.

For many people, heart failure treatment requires a balance of the right medications, a low-sodium diet and fluid restrictions that can help ease symptoms. Medication can be protective, which means it may help stop further damage to the heart.

Some heart failure medications may include neurohormonal blockade, or other medicines such as:

• Angiotensin-converting enzyme (ACE) inhibitors. These widen blood vessels to lower blood pressure, improve blood flow and decrease workload on the heart. Examples are enalapril, lisinopril and captopril.
• Angiotensin II receptor blockers (ARBs). These have the same benefits as an ACE inhibitor, and may be an alternative for people who cannot tolerate ACE inhibitors. Examples are losartan and valsartan.
• Cardiac glycosides. These increase the strength of heart muscle contractions. They can slow the heartbeat and may reduce heart failure symptoms. An example is digoxin.

Your doctor also may want to give your body a chance to recover itself and to prevent further damage. The Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program uses active monitoring to see any changes in your heart rate, blood pressure and other symptoms. An example of active monitoring is the CardioMEMS HF System. This permanently implanted device transmits data from your heart when you lie on a special pillow daily. If the readings are outside of set parameters, it alerts the team so they can reach out to make changes as needed before you ever feel symptoms. Everyone’s heart failure looks different — from symptoms and severity to progression and recovery. The team at Norton Heart & Vascular Institute offers high-quality care from board-certified physicians with expertise and training in heart failure recovery.

Heart and Vascular Care for the Whole Person

Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who are seeking to improve cardiovascular health or living with a heart condition.

Cardiac Rehabilitation Program

Our cardiac rehabilitation providers are leaders in developing and applying innovative techniques that can help you recover and resume your life.

Connecting Hearts Support Group

The group provides education and support to individuals who have had a heart attack, are living with a heart condition or are at risk for cardiovascular disease.

Heart Health Screenings

Prevention is the best way to manage heart disease, and screenings are available to detect early signs of cardiac and vascular disease and identify risk factors.

About Norton Heart & Vascular Institute

Every year, more than 137,000 people in Louisville and Southern Indiana choose Norton Heart & Vascular Institute specialists for their heart and vascular care. That’s more than any other health care provider.

• Norton Healthcare’s adult-service hospitals in Louisville all have received Chest Pain Center accreditation from the American College of Cardiology (ACC). This is the seventh consecutive accreditation for all four hospitals, which ensures quality for the treatment of heart attack.
• Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
• Norton Healthcare has the most facilities across the city of Louisville with the ability treat a life-threatening heart attack.

• You have access to more than 100 physicians and advanced practice providers with specialized training and experience in a comprehensive range of conditions and treatments.
• Patients can make appointments at 28 locations in Louisville and Southern Indiana. Telecardiology is offered at more than 30 sites in the region.
• Norton Audubon Hospital, a key location for Norton Heart & Vascular Institute services, has been recognized with a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
• U.S. News & World Report 2023-24 Best Hospitals ranked Norton Healthcare’s adult-service hospitals in Louisville as high performing in heart attack, heart failure, aortic valve surgery and heart bypass surgery.
• Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV – Healthcare and the Centers for Medicare & Medicaid Services.
• Communicate with your health care provider, renew prescriptions, get lab results and more through your free Norton MyChart account.