Congestive Heart Failure Program

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Treating a complex condition like congestive heart failure requires education, specialty training, resources, and understanding in creating an individualized care plan tailored to the unique needs of each patient. Bringing together a diverse and wide range of specialty skills, Deborah’s Heart Failure Team offers state-of-the-art care.

Deborah’s nationally-renowned program has also been recognized by the American Heart Association as a Get with the Guidelines Heart Failure, Gold Plus Award, hospital. This distinction indicates that Deborah promotes consistent adherence to the latest scientific treatment guidelines, achieving significant patient outcome improvements and reductions in readmissions.

What is Congestive Heart Failure?

Nearly 6 million Americans live with Congestive heart failure (CHF), which describes the inability of the heart to adequately pump blood to meet the demands of the body. The most common symptom of heart failure is shortness of breath. With mild heart failure, shortness of breath occurs almost exclusively with exertion. As heart failure worsens, the shortness of breath occurs at lower levels of activity or even at rest. In severe cases of CHF, the heart muscle function deteriorates so badly that fluid backs up into the lungs, creating a life-threatening condition called pulmonary edema.

Heart failure can occur on the left side of the heart, the right side of the heart, or both sides of the heart. Congestive heart failure does not usually happen suddenly. It gradually worsens over the years.

Symptoms and Causes of Heart Failure

Some of the symptoms of CHF include:

  • Shortness of breath
  • Weakness
  • Fatigue
  • Swelling in the extremities
  • Coughing and wheezing
  • Difficulty keeping up with your normal routine and lifestyle

The most common causes of heart failure is damage to the heart from a heart attack. Other causes are also common—severe untreated high blood pressure, blocked or leaking heart valves, disease of the heart muscle itself (cardiomyopathy) or damage to the heart from a viral infection (endocarditis/myocarditis).

Diagnosis of Heart Failure

A physician can often tell from a physical exam that a person has CHF based on swelling in the legs and feet, and hearing fluid in the lungs with a stethoscope. Additional testing will confirm a preliminary diagnosis and might include:

  • Blood tests
  • Electrocardiogram (EKG)
  • Echocardiogram
  • Chest x-ray
  • Cardiac catheterization
  • Stress Test
  • CT Scan
  • MRI

These tests will help your physician calculate your ejection fraction, which measures how much blood is pumped out (or ejected) by your ventricles with each heart contraction, as well as classify your heart failure from Stage A-D. Based on a complete picture of your specific condition, a treatment plan can be put into place.

Treatment Options

Excellent medications are available for earlier stages of heart failure. These medications widen blood vessels to help lower blood pressure, increase blood flows, control abnormal heart rhythms, and help draw excess fluid off your body. Sometimes you will need to take several medications to help control your CHF.

If your heart failure is caused by blocked vessels or damaged valves, surgery may be recommended to clear the blockages or repair, or replace, the valve.

Individuals with CHF are also at significant risk for abnormal heart rhythms, some of which can be fatal. More than half the deaths of patients with CHF are sudden—the result of a serious heart rhythm disturbance called ventricular fibrillation. While medication can lower the risk of ventricular fibrillation, the only effective treatment when it occurs is an electrical shock to the heart (defibrillation). An implantable cardioverter defibrillator (ICD), a device similar to a pacemaker, is often recommended for patients with CHF.

A patient whose CHF has progressed to more critical stages may be recommended for a VAD, or Ventricular Assist Device. This surgically implanted mechanical device, which can take over the pumping function of the heart, can be used both to support sick patients until a donor transplant heart becomes available. Increasingly, VADs are now being used for patients who are not eligible for a heart transplant, and become a permanent replacement to help their heart function.

LVAD Certification

Why Deborah Heart and Lung Center?

A significant gap exists in the treatment of patients with heart failure. Appropriate medication is prescribed in less than 75% of patients hospitalized with heart failure at the time of discharge. Even fewer receive the appropriate combination of medications at the doses shown to prevent repeat hospitalization and reduce the risk of death. Fewer patients still receive pacemakers to improve their heart’s pumping capacity or potentially life-saving treatment with a device that can shock the heart out of a life-threatening heart rhythm such as an ICD. Additionally, very few cardiac centers offer patients the option for a VAD implant as a long-term heart failure solution.

Deborah Heart and Lung Center provides comprehensive care to patients with all forms of heart failure. Our comprehensive team approach can treat patients with even the most advanced forms of congestive heart failure. Since so few patients with heart failure can be offered heart transplantation, the specialists at Deborah strive to maximize heart performance and minimize risk, using medications and specialized implanted devices. This is a unique approach to the management of heart failure and is not offered in such a coordinated fashion in most other hospitals and medical centers.

Patients with heart failure should know that with the right medications, their symptoms can improve. Over time, their physical function can significantly increase as well. With the appropriate medications and device therapy, patients can increase their activities of daily living and rest assured that they are protected from serious cardiac arrhythmias.

Deborah Heart and Lung Center also remains an excellent option when seeking a second opinion. The CHF team works closely with community cardiologists and primary care physicians in order to deliver coordinated care. Second opinions are frequently sought to both confirm a current diagnosis and treatment plan, as well as learning about other treatment options.

The Team

Medical Director, Kulpreet Barn, MD

Dr. Barn holds numerous Board Certifications, including one of the very few regional Advanced Heart Failure/Transplant Cardiology certifications, offering expertise in:

  • Advanced Heart Failure
  • Transplant Cardiology
  • General Cardiology
  • Internal Medicine
  • Echocardiography
  • Cardiovascular Computed Tomography (CT)
  • Nuclear Cardiology
  • Registered Physician in Vascular Imaging
Dr. Barn

Advance Practice Nurses

JoAnne Chichetti, DNP, RN, APN-C, CHFN

Abroo N. Muzaffar, MSN, RN, APN-C, CHFN, CCRN-CMC

These highly-trained, expert Advance Practice Nurses bring a wealth of clinical experience in managing heart failure. The integrated team approach ensures that patients receive the very best care by utilizing the latest techniques and technologies, ultimately resulting in a better quality of day-to-day life for patients in heart failure.

Dr. Muzaffar
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