Heart Failure

Heart Failure Diagnosis and Treatment

Our heart team will need your medical history and family history, as well as physical exam and test results, to diagnose heart failure. Because the signs and symptoms of heart failure are also common in other conditions, we will need to find out whether you have a disease or condition that can cause heart failure, such as coronary artery disease, high blood pressure or diabetes.

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For an appointment with one of our heart failure specialists, call 216-844-3800.

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Diagnosing Heart Failure

Medical and Family Histories

Tell your doctor if you or others in your family have or had a disease or condition that can cause heart failure.

Physical Exam

Your doctor will conduct a physical exam to listen to your heart for sounds that aren't normal He or she will also listen for extra fluid in your lungs and look for swelling in your ankles, feet, legs, abdomen, and the veins in your neck.

Diagnostic Tests

Because no single test can diagnose heart failure, if you have signs and symptoms of heart failure, your doctor may recommend one or more of the following tests:

Electrocardiogram (EKG). An EKG, which provides a picture of the electrical activity that causes your heart to beat, may detect conditions such as an abnormal heart rhythm or a previous heart attack.
Blood tests. Your doctor may ask for a blood test to check your brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) levels, which may be elevated with heart failure.
Chest X-ray. A chest X-ray shows the size and shape of the heart and the large blood vessels in the chest. It also can show if there is fluid in the lungs.
Echocardiogram. An echocardiogram uses ultrasound (high-frequency sound waves) to assess the size and function of the heart's chambers and the structure and function of the heart valves.
Holter monitor. A Holter monitor records your heart's electrical activity for a full 24- or 48-hour period while you go about your normal daily routine.
Exercise testing. An exercise or stress test determines how well your heart performs during exercise and can signal a shortage of blood supply to your heart caused by blockages in the coronary arteries.
Heart (cardiac) catheterization. Cardiac catheterization helps to measure how well your heart is functioning and provides pictures of your coronary arteries so your doctor can look for blockages.
Thyroid function tests. Thyroid function tests show how well your thyroid gland is working and include blood tests, imaging tests and tests to stimulate the thyroid.
Other tests. Computed tomography (CT), magnetic resonance imaging (MRI) and nuclear scanning are sometimes used to look at the heart muscle and coronary arteries.

Full Scope of Heart Failure Treatment Options

Heart failure treatment depends on the cause. Once we determine the cause of your heart failure, our multidisciplinary team, which consists of cardiologists and surgeons who specialize in heart failure, will design a treatment plan that is ideal for your age, overall health, medical history, disease progression and preferences.

The goal of treatment for heart failure is to reduce symptoms, reduce the chance of developing complications, and slow or stop the progression of the underlying process. We are pleased to offer the entire spectrum of heart failure treatment options including:

Diet and Lifestyle

What you eat and how much fluid you drink can make your heart failure symptoms better or worse. Your care team will discuss ways to support a healthy lifestyle, which may include:

Decreasing salt and water
Limiting the amount of fluids you drink
Weighing yourself every day
Controlling your weight
Stopping tobacco use
Limiting alcohol
Enrolling in cardiac rehab

Medications

Many medicines are used to treat heart failure. Some help lessen your symptoms; others can help slow the progression of heart failure. Our dedicated team is specially trained in prescribing the most effective medications for optimal results in each patient.

Medical Procedures and Surgery

For heart failure patients needing more advanced care, our team is highly skilled in the latest techniques and procedures, with excellent outcomes. If appropriate, your care team may recommend:

Cardiac resynchronization therapy: Some people with heart failure develop abnormal electrical conduction in the heart. A special type of pacemaker, called cardiac resynchronization therapy (CRT) or biventricular pacing, can treat this. It helps both the right and left heart chambers to beat together in synchrony.
Implantable cardioverter-defibrillator: While some abnormal heart rhythms are treated with medications, your doctor might recommend an implantable cardioverter-defibrillator (ICD). This is a device that shocks the heart and brings it back to a normal rhythm. An ICD is implanted under the skin in your upper chest when your pumping function gets weaker and prevents it from dying due to abnormal heart rhythm.
CardioMEMS: For patients diagnosed with heart failure, even the slightest changes in pressure in their pulmonary arteries can detect serious issues. Until recently, patients may have required a visit to a physician’s office or possibly even hospitalization to address those issues. Enter the CardioMEMS HF System – a therapy management and monitoring tool for heart failure patients that reduces the need for hospital readmissions.
Bypass surgery or stenting: Coronary artery bypass surgery is sometimes recommended for people with heart failure who also have blockage in the heart arteries or severe disease of the heart valves.
Ventricular assist device (VAD): Our highly skilled team leads in the development and surgical implantation of mechanical circulatory and ventricular assist devices (VADs). A VAD is an artificial heart pump that is implanted in the chest of patients with very severe heart failure. The device takes over the pumping function for one or both of the heart’s ventricles or pumping chambers. A VAD may be necessary when heart failure progresses to the point that medications and other treatments are no longer effective. These tools may be considered a long-term therapy, or a bridge until a transplant or other treatment is available. Following implantation, many of our patients with VADs can return home and live normal, active lives.
Heart transplantation: Heart transplantation can be helpful for some people with severe heart failure who have not responded to other treatments. A careful screening process is required for transplantation.

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