Atrium Health Navicent Heart & Vascular Care
Heart Failure Services and Treatment
Heart Failure Services
More than 5 million people are living with heart failure; you don't have to be one of them. The specialists at Atrium Health Navicent use advanced therapies, and a team of cardiologists, cardiac surgeons, nurse practitioners and nurses work with you to develop the best treatment plan. Our goal is to help people with heart failure live full and active lives.
What is Heart Failure?
Heart failure occurs when the heart has a hard time pumping enough blood and oxygen to meet the body's needs. There is no cure for heart failure, and over time, heart failure worsens and symptoms occur more often. The key to managing heart failure is to take an active role in your health and make healthy lifestyle choices.
Common signs and symptoms of heart failure include:
- Shortness of breath-You may have difficulty breathing when you are active, resting or when lying in bed. This happens when fluid backs up in the lungs or when your body isn't getting enough oxygen. Many times, people with heart failure require 2 or 3 pillows to raise their head so they are more comfortable when sleeping or even prefer to sleep in a recliner so they can breathe easier.
- Tiredness-It is common to feel extreme tiredness when active because the heart doesn't pump enough oxygen-rich blood to the muscles.
- Swelling in legs, stomach, overall weight gain-When your kidneys don't work as effective as they should, the body holds onto extra fluid, which causes swelling/edema and weight gain.
- Dizziness-This happens when the heart is not pumping enough oxygen-rich blood to the brain.
- Fast or irregular heartbeat-When the heart muscle doesn't pump hard enough, your heart may beat faster to get the oxygen-rich blood to muscles. You also can have an irregular heartbeat when the heart is enlarged.
- Dry cough-When you have extra fluid in the lungs and particularly when you lie flat, you may develop a dry cough.
- Frequent trips to the bathroom at night-Extra oxygen-rich blood moves to the kidneys when you are lying down at night, leading to more frequent urination.
Types of Heart Failure
The left ventricle of the heart pumps oxygen-rich blood to the body. This ventricle is larger than the other chambers in the heart and supplies most of the heart's pumping power. In left-sided heart failure, the left side of the heart must work harder to pump the same amount of blood to the body. There are 2 types of left-sided heart failure:
- Systolic-The left ventricle loses its ability to pump normally. It can't pump with enough force to push blood into circulation.
- Diastolic-The left ventricle doesn't relax normally because the muscle is stiff. The heart doesn't fill with blood during the resting period between each beat.
The right ventricle pumps blood to the lungs to be re-oxygenated. Right-sided heart failure happens because of left-sided failure. When the left ventricle weakens, fluid builds up in the lungs and causes damage to the right side of the heart. When the right side loses its pumping ability, blood backs up in the veins and causes swelling and congestion, resulting in congestive heart failure.
When blood flowing out of the heart slows down, blood returning to the heart backs up, causing congestion throughout the body. This is most often seen as swelling in the legs and ankles. If fluid collects in the lungs, it causes shortness of breath, especially when a person is lying down. Heart failure also affects the kidneys' ability to dispose of sodium and water; retained fluid continues to collect in the body and can create a medical emergency.
Managing Heart Failure
Heart failure cannot be cured, but it can be managed with lifestyle changes and medication. Successful treatment depends on you. It is important that you take control of your health and involve caregivers and loved ones to successfully manage heart failure.
The following lifestyle changes can help improve heart failure symptoms, slow disease progression and improve your overall health.
- Quit smoking.
- Weigh yourself daily (same time of day, wearing similar clothing). Notify your doctor if you gain 2 or more pounds in a day or 5 pounds in a week.
- Limit fluid intake. Talk to your doctor about the amount of fluid you should drink daily.
- Avoid alcohol.
- Limit sodium in your diet. The American Heart Association recommends 1,500 mg (approximately ½ teaspoon) per day.
- Eat a healthy diet low in fat and cholesterol.
- Stay active. Talk to your doctor about the amount and type of exercise recommended.
- Take your medications as prescribed by your doctor.
- See your doctor for follow-up visits.
- Be aware of your symptoms.
Treatment
Treatment options available at Atrium Health Navicent for managing heart failure and contributing factors include:
- Control of atrial fibrillation and other arrhythmias
- Implantable cardioverter defibrillator TAVR (transcutaneous aortic valve replacement)
- Cardiac resynchronization therapy
- LVAD (left ventricular assist device)
- Cardiopulmonary rehabilitation
- Complex coronary interventions and surgical revascularization (if heart failure is caused by a heart defect or blocked artery)
- Pacemaker implantation
Contact
For more information, please call:
Heart Failure Services & Treatment - 478-633-7022
AFib - 478-633-9007
AngioScreen ®
You could be at risk for stroke or heart attack and not realize it.
- Every 30 seconds in America, someone has a heart attack.
- Every 40 seconds in America, someone has a stroke.
- Every hour, there are 100 deaths from vascular disease.
Vascular disease is the leading cause of death worldwide and is the leading cause of stroke and heart attack. Our integrated vascular screening can identify risk factors and help you lower your risk of heart attack or stroke. AngioScreen® provides information about your heart rhythm, neck and leg arteries and fitness. This data can inform you of any areas of concern and encourage changes to improve your vascular health.
An AngioScreen uses noninvasive ultrasound technology to scan the arteries in your neck to give you a clear picture of your vascular health. In approximately 6 minutes, the scan will be complete, giving you actual pictures of your arteries that you can share with your physician.
Your AngioScreen also includes ankle brachial index (ABI), a screening test for blockages in the arteries that go to the legs. Such blockage is called peripheral artery disease, or PAD. Up to 10 million people have PAD, and 90% do not know they have it. PAD carries a risk of a heart attack equal to a patient who has had a heart attack - even if a PAD patient has never had a cardiac symptom.
The AngioScreen measurements provide an assessment of risk that you can discuss with your physician. Remember that all screening measures have a range of validity, and none are completely predictive. However, the data and images of your arteries will provide important information regarding your risk assessment. Carefully consider this information in consultation with your physician - this can make a difference in your life.
You also will receive a file containing your AngioScreen results. Even if you lose the paper version of your AngioScreen, you can print another copy. You can read more about AngioScreen in our comprehensive brochure.
Ventricular Assist Device Program
Atrium Health Navicent has had a ventricular assist device (VAD) program since 2012, and is 1 of only 2 located south of Atlanta that is certified to provide ventricular assist device as destination therapy. It includes a multidisciplinary team consisting of surgeons, psychiatrists, counselors, nurses, nurse practitioners, dietitians, physical therapists, occupational therapists, financial counselors, a VAD coordinator and many other dedicated staff. The team is joined by specialists at our cardiopulmonary rehabilitation program and heart failure program to provide a full continuum of care.
A ventricular assist device (VAD) is a mechanical pump that supports heart function and blood flow in people who have weakened hearts. The device takes blood from a lower chamber of the heart and helps pump it to the body and vital organs, just like a healthy heart would. Some VADs are intended for short-term use (such as patients recovering from heart attacks or heart surgery) and others are intended for long-term use (such as patients suffering from congestive heart failure).
Some VADs are intended for short-term use (such as patients recovering from heart attacks or heart surgery) and others are intended for long-term use (such as patients suffering from congestive heart failure).
Patient and Caregiver Education
Remember that no chest compressions or MRIs can be done on patients with a VAD. However, airway management and advanced cardiac life support still apply.
Resources for VAD patients and their caregivers:
What to Expect
A VAD has 3 parts:
- A pump-It weighs 1 to 2 pounds and is placed inside or outside of your belly.
- An electronic controller-It controls how the pump works.
- Batteries-They are carried outside your body and connected to the pump with a cable that goes into your belly.
It requires surgery to put a VAD into your body. You will receive general anesthesia to make you unconscious and unable to feel pain during the procedure.
During surgery to implant the pump, the heart surgeon opens the middle of your chest with a surgical cut and then separates your breastbone. This allows the surgeon to reach your heart. Next, the surgeon will make space for the pump under your skin and tissue in the upper part of your belly wall, and then place the pump in this space.
A tube will connect the pump to your heart. A second tube will connect the pump to your aorta or other major artery. Another tube will pass through your skin to connect the pump to the controller and batteries.
The VAD will take blood from your left ventricle through the tube that leads to the pump. Then the device will pump the blood back out to one of your arteries and through your body. Surgery usually lasts 4 to 6 hours. Risks for this surgery include:
- Blood clots in the legs that may travel to the lungs
- Blood clots that form in the device
- Breathing problems
- Heart attack or stroke
- Allergic reactions to the anesthesia medicines used during surgery
- Infections
Frequently Asked Questions
The following questions are frequently asked by VAD patients. Answering questions in advance can help alleviate many concerns and fears. If you need clarification on any of the information shared, be sure to ask questions at your next appointment.
The VAD can be used as long as your heart needs it. If your heart needs support for an extended period, your pump will need to be replaced someday. Patients have been supported for more than 2 years on a VAD.
Taking a bath or swimming is NOT allowed since you might get water inside the VAD. However, you can take showers once your doctor says it is OK and after the nurses have trained you on how to protect your external VAD equipment.
Yes. Once your doctor has approved for you to exercise and you are clear about the exercises you need, you may go ahead with your routine. VAD patients have participated in many different activities, including biking, ballroom dancing, fishing and golfing. However, you should avoid exercising in very hot, humid conditions or very cold temperatures. Walking is an excellent exercise for VAD patients. Consider going to the local mall for a safer, more comfortable walking environment. Contact sports, excessive jumping and swimming are NOT allowed.
All patients have different medication needs after device implantation. Patients often require fewer medications after getting the device because of improved circulation. Your doctor will determine which medications you will need.
Healthy eating is a good idea for everyone, but it is especially important for people living with a heart pump. Because of the pump's location inside the body, some patients may lose their appetite after implant surgery, but this usually goes away over time. You may find it easier to eat several smaller meals throughout the day instead of a few larger meals. Until your appetite comes back, your diet might be supplemented with high-calorie or high-protein liquid beverages. Your doctor will inform you of any special diet plans.
Once you have recovered from your pump implant operation, usually 6 to 8 weeks, or when your doctor says it's OK, you can engage in sexual activities. Avoid positions that will interfere with the exit site or cause tension or pulling on the tube that goes into the skin. The VAD rate may speed up or slow down during sex. Don't be alarmed; this is normal.
Note: Discuss with your doctor before taking any medications (prescribed or over the counter) to improve sexual performance. They may be harmful in your current condition.
Your doctor will let you know when you can take trips away from home and what forms of transportation are safe and acceptable. Once your doctor approves you for travel, your health care team will work with you to make sure that you are prepared to do this safely.
The possibility of returning to work depends on your health and the type of work you do. Talk with your doctor.
Contact the VAD coordinator at 478-365-0721, 24/7 access.
Atrial Fibrillation
Atrial fibrillation (AFib) affects more than 2.7 million Americans and can lead to other medical complications, including heart failure and stroke. It is the most common type of heart arrhythmia (when the heart beats too slowly, too fast or in an irregular way). When a person has AFib, the normal beating in the upper chambers of the heart (the atria) is irregular, and blood does not flow as well as it should from to the lower chambers of the heart (the ventricles). AFib may occur in brief episodes, or it may be a permanent condition.
In Atrium Health Navicent's atrial fibrillation program, our physician champion and AFib program manager work with our team to ensure that our hospital consistently provides the latest evidence-based treatments and patient care to our atrial fibrillation patients. Our dedicated unit features physicians and nurses who are trained to use protocols and best-care practices according to the American College of Cardiology/American Heart Association Clinical Performance and Quality Measures for Adults with Atrial Fibrillation or Atrial Flutter guidelines.
AFib treatment may include:
- Medications to control the heart's rhythm
- Medications to control the heart's rate
- Blood-thinning medication to prevent blood clots from forming and reduce stroke risk
- Radiofrequency ablation for AFib
- Surgery
- Medication and healthy lifestyle changes to manage AFib risk factors
The goals of treatment include reducing the risk of stroke and improving quality of life.
If you would like more information about AFib, call 844-633-7738.