Heart Failure

Heart failure can leave you tired, out of breath, and unable to enjoy life with friends and family. Virtua’s comprehensive heart failure program will help you manage your condition—from diagnosis and treatment to cardiac rehab and home care.

Signs and Symptoms of Heart Failure

The heart is a muscle that pumps oxygen-rich blood to all parts of the body. Over time, damage from a heart attack, coronary artery disease, poorly controlled high blood pressure, heart rhythm problems, valve disease, and other issues can cause the heart to weaken or stiffen.

As a result, the heart works less efficiently, and it is unable to supply the body with the nutrient-rich blood it needs.

Common signs of heart failure include:

• Shortness of breath while resting, exercising, or lying flat
• Swelling in your legs and feet
• Abdominal pain, bloating, or decreased appetite
• Severe fatigue
• Decreased ability to exercise
• Persistent cough with white- or pink-tinged mucus
• Rapid weight change 

Heart Failure Diagnosis at Virtua

To determine if you have heart failure, your cardiologist will review your medical history and symptoms and perform a physical examination. This will include listening to your heart for signs of fluid buildup and whooshing sounds (murmurs) in your heart.

Your cardiologist also will order tests, including:

• Blood tests. These tests will check for B-type natriuretic peptide (BNP), an indicator of active heart failure, as well as anemia, thyroid problems, and high cholesterol.
• Chest X-ray. The images can see fluid in your lungs and the condition of your heart.
• Electrocardiogram (ECG). This painless test records the electrical activity in your heart and measures heart rate and rhythm.
• Echocardiogram. A type of ultrasound, this test evaluates your heart function to see how well it is pumping. It will record your ejection fraction (EF), a measure of how much blood is pumped out of the heart with each beat.
• Exercise stress test. Performed while walking on a treadmill or riding a stationary bike, this test measures the strength of your heart during activity.

Based on your symptoms and the results of your tests, you will be placed on a scale from the New York Heart Association. Your placement on the scale will help determine your treatment plan.

• Class I: No heart failure symptoms
• Class II: Everyday activities can be performed without difficulty, but exertion causes shortness of breath or fatigue
• Class III: Difficulty with daily activities
• Class IV: Shortness of breath occurs even at rest 

Heart Failure Treatment at Virtua

Our program ensures people with heart failure know how to manage their condition and have an ongoing source of support and care. We know it’s important for people living with heart failure to remain proactive, so we provide the support you need to stay on top of your health.

Inpatient Care

The Virtua Heart Failure program—recognized by the American Heart Association for outstanding care—begins while you're still in the hospital, with comprehensive education for both those who are newly diagnosed and those who are returning, as well as their families. We focus on improving your quality of life and reducing the risk of being readmitted to the hospital with complications.

If you require a procedure to improve the function of your heart, we provide advanced therapies, such as:

• Implantable pacemakers
• Implantable cardioverter defibrillators
• Cardiac surgery

If your heart can’t pump effectively on its own, you may receive a left ventricular assist device (LVAD), a surgically implanted, battery-operated, mechanical pump. An LVAD may be used as a “bridge” until a heart transplant becomes available, or as a longer-term therapy. Through an innovative “shared care” program, LVAD patients attend follow-up appointments and undergo small procedures at Virtua instead of having to travel to their transplant center.

Outpatient Care

For outpatient heart failure services, we have five dedicated centers in Cherry Hill, Moorestown, Sewell, Willingboro, and Woodbury. Your team of advanced practice nurses, physicians, pharmacists, and dietitians will create an individualized, evidence-based treatment program customized for you, which may include:

• Fluid status review and adjustment to be sure you're drinking the right amount of fluids, including intravenous diuretic therapy
• Exercise endurance testing
• Advanced Drug therapies
• Noninvasive thoracic impedance measurements
• CardioMEMS™ HF pulmonary artery pressure monitoring
• LifeVest monitoring
• Shared care of left ventricular assist devices
• Cardiac resynchronization therapy
• Nutritional guidance
• Coordination with home care, physical and occupational therapy, home inotropic and diuretic medicines, and cardiology-specific psychiatric counseling
• Educational and emotional support
• Participation in clinical research trials

We provide a home care program utilizing community-based care managers—registered nurses who make home visits.

Program participants also are encouraged to participate in our cardiac rehab program to further help rebuild your strength, increase mobility, and get you back to the activities you enjoy.

We also offer peer support through WomenHeart, a support group led by female facilitators who are heart disease survivors, and who trained at WomenHeart Science and Leadership Symposium at Mayo Clinic.