What is congestive heart failure?
CNN Headline News interviewed Samer Najjar, MD, medical director, Heart Failure, Heart Transplantation, and Mechanical Circulatory Support Programs, about the use of ventricular assist devices for patients with congestive heart failure. One of Dr. Najjar's patients was also interviewed. To watch the report, click on the link.
Congestive heart failure (CHF) can often be a confusing and frightening term. In order to understand congestive heart failure, it is important to remember that the heart works as a pump, and propels blood throughout the circulatory system.
The heart squeezes blood through the circulatory system, and also to relaxes and accepts blood as it returns from the body and the lungs. Any disruption in the heart’s ability to either squeeze (systolic dysfunction) or relax (diastolic dysfunction) can lead to “failure” of the heart to adequately perform.
As a result, the heart compensates by working at a higher pressure within its chambers. Higher pressures inside the heart can lead to substantial symptoms.
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|George Ruiz, MD, with his fellows, who are studying more effective ways to treat heart failure.|
What are the symptoms of heart failure?
There may be several reasons why the mechanics of pumping may be altered. Part of the challenge of caring for patients with heart failure is to decipher what might be causing the problem.
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|VIDEO GALLERY: Finding Balance - Our Team Approach to Managing Heart Failure|
Both medication and surgery may play a role in the management of patients with CHF. Given how effective they may be, medications are often considered the first line of therapy for patients with CHF. Medication used to improve the heart’s function and the patient’s ability to function normally includes:
Our inpatient management of cardiac dysfunction also includes the use of intropic medication (medications that increase the squeezing capacity of the heart), as well as ultrafiltration for fluid removal.
As our physicians manage patients through various treatment strategies, we depend heavily on an integrative approach to managing CHF. CHF specialists rely on a diverse team that routinely brings together expertise from various fields. Our team is comprised of:
Surgical options for treatment
If coronary artery disease is contributing to the heart’s dysfunction, the team may consider coronary bypass surgery (CABG). If prior heart attacks have damaged key walls of the heart, surgical reconstruction or new devices may be also be used to improve heart function. If one or several of four heart valves are exacerbating the heart’s dysfunction, surgical or percutaneous valve repair or replacement may be considered.
|A Ventricular Assist Device device is so small, it can fit in the palm of your hand.|
Ventricular Assist Devices
In some cases, despite aggressive therapies, the heart muscle cannot adequately sustain the body’s circulation. In those situations, advanced cardiac support, in the form of ventricular assist devices (VADs) or transplantation, may be considered in appropriate candidates.
VADs can be used as a bridge to support patients awaiting heart transplantation, or as “destination therapy” for some select patients who are not candidates for cardiac transplantation. VADs often allow patients to regain much of the functional capacity that they have lost to heart failure. MedStar Washington Hospital Center’s VAD program offers several advanced-mechanical support options, including:
Our physicians perform research in the areas of investigational drugs for systolic and diastolic heart failure patients, as well as new drugs that may repair the heart muscle. CHF specialists are involved in the development and testing of new devices designed to improve the symptoms and outcomes of patient’s with heart failure.
Our participation in clinical trials means that we offer the newest technologies and approaches to the management of our patients.
Clinical trials we participate in include:
For further information about heart failure clinical trials, please contact:
Ravjyot Chawla, MD or Linda Matuskey, RN