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
