Heart Failure | Miami Cardiac & Vascular Institute
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Heart Failure
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Miami Cardiac & Vascular Institute provides prevention and treatment services for heart failure. Our physicians work with you to help you manage and treat your condition before it has serious consequences. Our goal is to improve your health and quality of life.

Specific treatment for heart failure will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

The cause of the heart failure will dictate the treatment protocol established. If the heart failure is caused by a valve disorder, then surgery may be performed. If the heart failure is caused by a disease, such as anemia, then the underlying disease will be treated. Although there is no cure for heart failure due to damaged heart muscle, many forms of treatment have been used to treat symptoms very effectively.

The goal of treatment is to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy.

Treatment of heart failure may include:

  • Controlling risk factors:
  • Quitting smoking
  • Losing weight and increasing moderate exercise
  • Restricting salt and fat from the diet
  • Avoiding alcohol
  • Proper rest
  • Controlling blood sugar if diabetic
  • Controlling blood pressure
  • Limiting fluids
  • Medication, such as:
  • Angiotensin converting enzyme (ACE) inhibitors. This medication decreases the pressure inside the blood vessels and reduces the resistance against which the heart pumps.
  • Angiotensin receptor blockers (ARB). This is alternative medication for reducing the workload on the heart if ACE inhibitors are not tolerated.
  • Diuretics. These reduce the amount of fluid in the body.
  • Vasodilators. These dilate the blood vessels and reduce the workload on the heart.
  • Digitalis. This medication helps the heart beat stronger with a more regular rhythm.
  • Antiarrhythmia medications. These help maintain normal heart rhythm and help prevent sudden cardiac death.
  • Beta-blockers. These reduce the heart's tendency to beat faster and reduce the workload by blocking specific receptors on heart cells.
  • Aldosterone blockers. Medication that blocks the effects of the hormone aldosterone, which causes sodium and water retention.
  • Biventricular pacing/cardiac resynchronization therapy. A new type of pacemaker that paces both pumping chambers of the heart simultaneously to coordinate contractions and to improve the heart's function. Some heart failure patients are candidates for this therapy.
  • Implantable cardioverter defibrillator. A device similar to a pacemaker that senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm.
  • Heart transplantation
  • Ventricular assist devices (VADs). These are mechanical devices used to take 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.

LVAD Device

The left ventricular assist device, LVAD or VAD, is a kind of mechanical heart. It's placed inside a person's chest, where it helps the heart pump oxygen-rich blood throughout the body.

Unlike an artificial heart, the LVAD doesn't replace the heart. It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery or is too weak to effectively pump on its own.

Like the heart, the LVAD is a pump. One end hooks up to the left ventricle – that's the chamber of the heart that pumps blood out of the lungs and into the body. The other end hooks up to the aorta, the body's main artery. A tube passes from the device through the skin. The outside of the tube is covered with a special material to aid in healing and allow the skin to regrow.

The pump and its connections are implanted during open-heart surgery. A computer controller, a power pack, and a reserve power pack remain outside the body. Some models let a person wear these external units on a belt or harness outside.

An LVAD restores normal blood flow to a person whose heart has been weakened by heart disease. This relieves symptoms such as being constantly tired or short of breath. And sometimes it lets the heart recover normal function by giving it a chance to rest.


Heart Failure Disease Resource Program

Just because you have a chronic heart condition doesn’t mean you shouldn’t get the most out of life. Miami Cardiac & Vascular Institute recognizes the special challenges that heart patients face. Our Heart Failure Resource Program was created to address their needs and provide treatment for heart failure.

Heart Failure Disease Resource Program Goals
The Heart Failure Resource Program is a comprehensive, multidisciplinary inpatient and outpatient program that helps patients and their cardiologists manage chronic heart conditions. The Heart Failure Resource Program provides high-quality, cost-effective care and the most advanced disease management options available.

A primary feature of the program is a unit designed for heart failure patients. Program staff members, under the direction of the patient's cardiologist, help heart failure patients maintain clinical stability and avoid hospitalization. When hospitalization is necessary, the Heart Failure Resource Program team works to shorten the hospital stay and helps patients return to a normal routine as quickly as possible. Their goals are improving quality of life and long-term treatment outcomes for heart failure patients. They also promote heart failure treatment research and educational outreach to the public and healthcare providers.

Your Heart Health Team
If you or someone you love is struggling with heart failure, our Heart Failure Resource Program is a great source of education and support. Our specially trained team, made up of the patient's cardiologist, a nurse practitioner, a nutritionist and a patient educator, works one-on-one with patients to help them manage their disease. The team develops an individualized lifestyle plan for each patient and shares the latest medical information with them.

Once patients leave the Institute, they receive follow-up phone calls from the Heart Failure Resource Program team. Patients also are invited to the monthly support group meetings facilitated by team members.

Heart Failure Support Group
South Miami Hospital offers a free bimonthly support group, Supporting Hearts, for people living with or at risk for heart failure, as well as their family members and friends. This group meets the first Monday of each month, in English from 2 to 3 p.m. and in Spanish from 3 to 4 p.m., in the Victor E. Clarke Education Center at Miami Cardiac & Vascular Institute at South Miami Hospital, 6250 Sunset Drive, First-floor Conference Room. Experts in heart failure prevention, diagnosis and treatment help educate people about how to change their diet and activity levels to improve their health.

The care team at Miami Cardiac & Vascular Institute encourages all patients and family members to learn more about conditions and diseases that affect the heart and overall cardiovascular system. The links below provide more information about heart conditions and diseases that might be treated within this program.

Heart Failure
Heart failure, also called congestive heart failure, is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the heart's diminished capacity to pump reflects a progressive, underlying condition.

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In addition to a complete medical history and physical examination, diagnostic procedures for heart failure may include any, or a combination of, the following:

  • Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Echocardiogram (also called echo). A noninvasive test that uses sound waves to evaluate the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
  • Electrocardiogram (EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
  • BNP testing. B-type natriuretic peptide (BNP) is a hormone released from the ventricles in response to increased wall tension (stress) that occurs with heart failure. BNP levels rise as wall stress increases. BNP levels are useful in the rapid evaluation of heart failure. In general, the higher the BNP levels, the worse the heart failure.

The Institute’s commitment to providing you with the best possible care means we also conduct research on the latest devices and other advances to treat structural heart disease.

Congestive Heart Failure

ISCHEMIA – Primary objective is to determine whether an invasive (INV) strategy of routine early cardiac catheterization with intent for optimal revascularization in addition to optimal medical therapy in patients with stable ischemic heart disease (SIHD) and at least moderate ischemia on stress imaging reduces the incidence of the composite of cardiovascular death or nonfatal myocardial infarction compared with a conservative (CON) strategy of optimal medical therapy alone with cardiac catheterization and revascularization reserved for patients with refractory angina, acute coronary syndrome, acute ischemic heart failure or resuscitated cardiac arrest.
Principal Investigator: Ramon Quesada, M.D.
Co-investigators: Marcus St. John, M.D., Bernardo Lopez-Sanabria, M.D., Jonathan Roberts, M.D., Alvaro Gomez, M.D., Ramon Lloret, M.D. (Active Enrollment)

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