Heart Failure Stages | Norton Healthcare Louisville, Ky.

The Stages of Heart Failure

The four heart failure stages present their own set of treatments. 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 and Recovery Program have the experience and expertise to diagnose the progress of your heart failure and provide treatments including lifestyle guidance, medication, mechanical circulation devices and heart transplants.

The first steps in our specialists’ heart failure treatment plan are lifestyle recommendations and medication. Our goal will be to halt or slow the progression of your heart failure and improve your quality of life by reducing symptoms such as shortness of breath, decreased function and inability to tolerate exertion.

Norton Heart & Vascular Institute has a robust program of clinical research trials that includes innovative treatment for heart failure.

The Four Heart Failure Stages

No Symptoms, No Limitations

At high risk for heart failure, but no structural heart disease or symptoms of heart failure.

A family history of heart failure or conditions such as hypertension (high blood pressure), diabetes, rheumatic fever, alcohol abuse, medications that can damage the heart muscle and other conditions.

Treatment options

  • Lifestyle adjustments including daily exercise
  • Stop smoking
  • Treatment for high blood pressure, high cholesterol
  • ACE inhibitors or angiotensin II receptor blockers (ARBs)
  • Statins

Mild Symptoms and Slight Limitations

Typical symptoms at this stage include mild shortness of breath and/or angina. This usually will be revealed in an echocardiogram that shows a weakened left ventricle that has 40% or less ejection fraction (a measure of the heart’s pumping ability).

Treatment options

  • Lifestyle adjustments: exercise, stop smoking
  • ACE inhibitors or angiotensin II receptor blockers (ARBs)
  • Beta blockers
  • Remote, wireless monitor for subtle changes to internal volume status (CardioMEMS)
  • Implanted cardioverter defibrillator
  • Wearable cardioverter defibrillator (LifeVest)
  • Revascularization or valvular surgery as appropriate

Significant Activity Limitation Due to Symptoms

Systolic heart failure (reduced ejection fraction). The left ventricle has weakened, possibly because it has become enlarged and can’t contract properly. Additional details on systolic heart failure.

Diastolic heart failure (preserved ejection fraction). The left ventricle can’t fill properly with blood, resulting in less blood pumped through the body. Additional details on diastolic heart failure.

Treatment options

  • Pre-heart failure treatments
  • Diuretics to reduce fluid retention
  • ACE inhibitors or angiotensin II receptor blockers (ARBs)
  • Beta blocker
  • Aldosterone antagonist
  • Revascularization or valve surgery
  • Cardiac resynchronization therapy (CRT)
  • Implanted cardioverter defibrillator
  • Wearable cardioverter defibrillator (LifeVest)
  • Remote, wireless monitor for subtle changes to internal volume status (CardioMEMS)

Severe Limitations With Symptoms Even While Resting

These patients are very limited in movement and spend large amounts of time in bed. Patients at this point have undergone recurrent hospitalizations despite guideline-directed medical therapy.

Treatment options

  • Heart transplant
  • Ventricular assist device
  • Constant infusion of inotrope drugs to address the force of the heartbeat
  • Experimental surgery or medication

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

About 250,000 people a year in Louisville and Southern Indiana choose Norton Heart & Vascular Institute to treat their heart and vascular conditions. That’s more than any other provider in the area.

  • All four of Norton Healthcare’s adult acute-care hospitals are accredited by the American College of Cardiology’s Accreditation Services as Chest Pain Centers, with the highest accreditation level possible for facilities able to treat heart attacks.
  • We have more than 50 board-certified cardiovascular physicians and 35 advanced practice providers. Through training and years of experience, they specialize in areas such as cardiologyinterventional cardiologycardiothoracic surgerythoracic surgery, electrophysiologyadvanced heart failureand vascular surgery.
  • We offer same-day appointments for new patients.
  • We have 27 locations in Louisville and Southern Indiana. Telecardiology is offered at more than 30 clinical sites in the region.
  • Norton Healthcare has four adult-service cardiac catheterization labs, with 14 state-of-the-art rooms. Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital have received the highest level of cardiac catheterization accreditation from the American College of Cardiology — offering lifesaving, minimally invasive procedures for diagnosis and treatment.
  • Our cardiothoracic surgeons and electrophysiologists have more experience than any provider in the area performing hybrid ablation for atrial fibrillation (A-fib). This innovative treatment also can help patients who have had persistent A-fib for more than a year that hasn’t responded to other treatments.
  • Norton Healthcare is the only health care system in Kentucky to receive the prestigious Mission: Lifeline Regional Trailblazer Award from the American Heart Association for being an innovator in creating a system of care for ST-elevation myocardial infarction (STEMI) heart attacks — the most severe type of heart attack.
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