Expert care when heart failure progresses
Advanced heart failure is a form of heart failure that has progressed to the most serious stage. Heart failure gets worse over time. Based on a patient’s risks and symptoms, the American College of Cardiology and the American Heart Association classify the progression of this disease as:
- Stage A: High risk of developing heart failure
- Stage B: Left ventricle is not performing well or is structurally abnormal
- Stage C: Current congestive heart failure diagnosis or previous symptoms
- Stage D: Diagnosis of heart failure with reduced ejection fraction and have advanced symptoms do not get better with treatment.
Though this condition is serious, there is hope for patients with this disease if patients receive timely and effective care. There is a “Golden Window of Opportunity” when heart failure patients should be referred for advanced care before it is too late (American Heart Association scientific statement October 2021). The clinical signs and symptoms that indicate when a patient should be referred for advanced heart failure care are:
- Inability to tolerate guideline directed medical therapy
- Frequent hospitalizations
- Recurrent heart rhythm issues or ICD shocks
- Worsening kidney function
Our Advanced Heart Failure Program team provides diagnosis, a comprehensive scope of medical and surgical options treatment options, and ongoing patient support for heart failure patients as described on the above page link. Providing advanced heart failure care to patients in the Washington DC, Baltimore, Maryland, and Virginia areas.
Symptoms of advanced heart failure
- Shortness of breath
- Dry, hacking cough
- Fatigue
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Irregular heartbeat, also known as arrhythmia
- Swelling in the legs, feet, or abdomen
- Weight loss without diet or exercise changes
These symptoms may be worse or better from day to day or even at different times of the day. The main difference from less-advanced heart failure is that these symptoms may appear with ordinary activity or even during rest.
Causes of advanced heart failure
Everyone loses some ability for the heart to pump blood as we age. However, heart failure is a result of medical conditions that either damage the heart outright or make it work harder. Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity contribute to heart failure. Medical conditions that may lead to heart failure are:
- Arrhythmia or irregular heart beat
- Amyloidosis
- Cardiomyopathy or disease of heart muscle
- Coronary artery disease
- High blood pressure or hypertension
- Heart valve disease
- Congenital heart defect
- Diabetes
- Obstructive sleep apnea
- Sarcoidosis
Risk factors of advanced heart disease
Certain medical conditions can increase your risk for health failure, including:
- Coronary artery disease
- High blood pressure or hypertension
- Heart valve disease
- Congenital heart defect
- Diabetes
Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity increase your risk of heart failure.
You can take important steps to prevent heart failure by engaging in regular physical activity, maintaining a healthy body weight, not smoking, eating fruits and vegetables, moderate alcohol intake, and maintaining a healthy weight.
Diagnosis and testing
Diagnosing advanced heart failure is the first step to developing a treatment plan. Our specialists may recommend one or more diagnostic and imaging procedures.
Angiogram (Angiography)
An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.
Cardiac Catheterization
Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.
Chest X-ray
Chest X-rays use a small dose of radiation to create pictures of the structures inside the chest, including the lungs, heart, and chest wall.
Computerized Tomography (CT) Scan
The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.
Echocardiogram
An echocardiogram uses high-frequency sound waves to create images of your heart.
Electrocardiogram (ECG)
An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.
Heart Biopsy
In this biopsy, your doctor will remove small samples of your heart muscle tissue to monitor function or diagnose a problem.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets, and computer technology to create images of your heart and blood vessels.
Stress Tests
Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.
Technetium Pyrophosphate
Uses a radioactive form of PYP that is often used to diagnose cardiac amyloidosis.
Treatments
We offer a wide spectrum of treatments for patients with advanced heart failure. These include CardioMEMS™ remote patient monitoring, Barostim™ heart assist device, inotropic therapy, interventional heart failure treatment, as well as, ventricular assist devices, Extracorporeal Membrane Oxygenation (ECMO) and heart transplants. Along the way, patients have access to palliative care to relieve symptoms and stress.
Facebook Live: Advanced Heart Failure
Our providers
Location: Change location Enter your location
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Nana Afari-Armah, MD
Heart Failure And Transplantation Cardiology
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Keki Balsara, MD
Cardiac Surgery
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Jennifer Rebecca Brown, MD
Heart Failure And Transplantation Cardiology & Cardiology
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Erika D Feller, MD
Heart Failure And Transplantation Cardiology
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Richa Gupta, MD, MPH
Heart Failure And Transplantation Cardiology
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Mark Robert Hofmeyer, MD
Cardiology & Heart Failure And Transplantation Cardiology
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Sandeep M Jani, MD
Heart Failure And Transplantation Cardiology
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Ajay Kadakkal, MD
Heart Failure And Transplantation Cardiology
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Rania Kaoukis, MD
Heart Failure And Transplantation Cardiology
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Ahmed N Khan, MD
Heart Failure And Transplantation Cardiology
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Mrinalini Krishnan, MD
Heart Failure And Transplantation Cardiology
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Phillip Hong Lam, MD
Heart Failure And Transplantation Cardiology
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Miguel A Pinilla Vera, MD
Heart Failure And Transplantation Cardiology
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Maria Esperanza Rodrigo, MBBS
Heart Failure And Transplantation Cardiology
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Farooq H. Sheikh, MD
Heart Failure And Transplantation Cardiology
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Weining David Xu, MD
Heart Failure And Transplantation Cardiology
Our locations
Distance from Change locationEnter your location
MedStar Washington Hospital Center
110 Irving St. NW Washington, DC 20010
MedStar Union Memorial Hospital
201 E. University Pkwy. Baltimore, MD 21218
MedStar Southern Maryland Hospital Center
7503 Surratts Rd. Clinton, MD 20735
MedStar Good Samaritan Hospital
5601 Loch Raven Blvd. Baltimore, MD 21239
MedStar Health: Cardiology at Bel Air
12 MedStar Blvd. Suite 170 Bel Air, MD 21015
MedStar Health: Cardiology Associates at Annapolis
2002 Medical Parkway Suite 500 Annapolis, MD 21401
MedStar Health: Cardiology at Glen Burnie
808 Landmark Drive Suite 120 Glen Burnie, MD 21061
410-766-8677
MedStar Health: Cardiac Electrophysiology at Reston Town Center
1830 Town Center Drive Suite 405 Reston, VA 20190
Ask MedStar Heart & Vascular Institute
Have general questions for our heart and vascular program? Email us at AskMHVI@medstar.net. If you have clinically-specific questions, please contact your physician’s office.