What is Heart Failure?

Heart failure (HF) occurs when, for any number of reasons, the heart is unable to pump enough blood to meet the body’s demands. When this occurs, blood pressure within the heart and lung blood vessels increase eventually leading to congestive symptoms and commonly to shortness of breath.

Approximately 90 percent of patients admitted to a hospital for HF have pulmonary congestion (excess fluid). Episodes of pulmonary congestion can lead to a downward spiral of progressive cardiac deterioration.

What happens when you have heart failure?

Heart failure occurs when the heart is not pumping as well as it should be and therefore the weakened heart cannot supply cells with enough blood. This results in:

  • shortness of breath
  • trouble breathing
  • fatigue
  • swelling

Patients with HF are frequently hospitalized, have a reduced quality of life and face a higher risk of death.

What causes heart failure?

There are many underlying causes of HF. In the U.S., about 50 percent of HF is caused by coronary artery disease. Other causes include high blood pressure, persistent cardiac arrhythmias (such as atrial fibrillation), heart valve disease, congenital heart disease, diabetes, and infections and diseases of the heart muscle itself.

How is heart failure treated?

Heart failure typically is treated first with changes in lifestyle and a combination of drugs, which tend to be more effective when the disease is in its earlier stages. When these treatments are no longer able to effectively manage HF, other procedures are required. These procedures range from minimally invasive procedures to highly invasive surgery.

  • Pharmacology — Medications that are proven to reduce mortality in HF patients include angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta-blockers.
  • Stenting, balloon angioplasty and bypass surgery — When coronary artery disease is the cause of the heart failure, balloon angioplasty, stenting and bypass surgery can treat the underlying problem and sometimes relieve HF symptoms.
  • Device therapy — Some patients can be treated using cardiac resynchronization therapy (CRT). CRT involves pacing in three chambers of the heart (rather than one or two chambers). A CRT device paces the right atrium (RA) and right ventricle (RV),plus the left ventricle (LV). The goal of CRT is to synchronize the two ventricles (RV and LV) for optimal contraction. CRT can be provided through either a pacemaker or an implantable cardioverter defibrillator (ICD) — which offers an additional measure of safety to the patient should he or she be at risk for sudden cardiac arrest.
  • Heart transplant – Heart transplants can cure HF, but are only performed in about 1 percent of patients with advanced HF, due to the scarcity of donor organs, invasiveness of the procedure, and the high cost of the procedure. As a result, while waiting for a transplant, some patients receive a left ventricular assist device (LVAD), which is a mechanical pump that assists the heart.

How has heart failure typically been monitored?

There are several ways to monitor HF in patients, including:

  • Directly measuring pulmonary artery (PA) pressure via a right-heart catheterization procedure, which is the standard of care for managing worsening HF in hospitalized patients.
  • Patient self-monitoring with equipment such as blood pressure cuffs and electronic scales.
  • In-clinic devices used by health care providers during frequent office visits.
  • Implantable devices that alert patients when they detect impedance changes across the thoracic cavity that may be indicative of fluid accumulation in the chest.

What is CardioMEMS and how will it help me manage my heart failure?

Clinicians can directly measure pulmonary artery (PA) pressure from inside the body with the CardioMEMS HF System. At home, HF patients use a portable electronic unit and a special pillow containing an antenna to take daily sensor readings. This is a simple process that takes only a few minutes and the pressure readings are then wirelessly transmitted to a secure website. Clinicians use that data to stabilize PA pressures by proactively managing medications and other treatment options while also providing an early indication of worsening HF.

Courtesy of St. Jude Medical Inc.