Treating Heart Failure
Heart failure is a condition in which the heart is unable to pump enough blood to the body’s other organs. As the blood flowing out of the heart slows down, blood returning through the veins backs up, causing congestion in the tissues. Often edema, or swelling, results, usually in the legs and ankles, but in other parts of the body as well. Fluid can collect in the lungs, which interferes with a person’s breathing and causes shortness of breath, especially when a person is lying down. Heart failure can also impair kidney function, leading to the body retaining water, and increased edema.
“Heart failure isn’t a single disease, but a constellation of symptoms,” says Leon Feldman, MD, Board Certified Cardiologist/Electrophysiologist and Section Chief of Cardiology at Eisenhower Medical Center. “Patients can suffer weight gain, fluid retention, breathlessness, fatigue, and malaise. Fundamentally, the heart is not working efficiently and the body can’t handle fluids normally.”
Heart failure can result from a number of different causes, including coronary artery disease, a heart attack, high blood pressure, diseases of the heart itself, or congenital heart defects. If a patient suffers from heart failure, the heart keeps working, but not as efficiently as it should. According to the National Institutes of Health, more than five million people in the United States suffer from heart failure. In fact, statistics show that while fewer people are dying from heart attacks than ever before, more people are suffering from heart failure. “Overall, we’re treating heart disease more effectively and there are fewer deaths from heart attacks,” explains Dr. Feldman. “But the fact that our patients live longer gives them time to develop more complications.”
While heart failure is a serious and long-term clinical disorder, better patient education and significant advances in medications and device therapies have significantly improved the prognosis and quality of life for patients suffering from heart failure. The Glickman Heart Failure Clinic, located in the Eisenhower Renker Wellness Center, is the only clinic in the desert that focuses on treating heart failure. The Clinic staff helps patients and their families address the condition so that patients can continue to live comfortable and productive lives.
At Glickman Heart Failure Clinic, the focus is on individualized care and counseling. Registered Nurses who are certified to care for patients with heart failure work closely with each patient in conjunction with the physician to design a treatment plan that includes medication, diet, exercise and lifestyle modifications. According to Mary Jo Killen, RN, BSN, patients at the Clinic are active participants in their own health care. “We educate them about diet, about the need for them to lower their sodium, about which foods they should eat and which they should avoid,” Killen says. “We teach them to read labels and find healthier alternatives.”
Lifestyle changes are complemented with drug therapies, usually beta-blockers, which block adrenaline that might stimulate the heart. The Clinic’s staff helps patients adapt to their new medication regimen, and monitors them closely in case adjustments need to be made. They also work with patients and their physicians to develop a safe and simple exercise program, which can actually help strengthen the heart.
Intensive patient and family education is at the core of the program, so patients and those closest to them will fully understand the condition and be able to recognize any signs or symptoms that might indicate worsening heart failure. The treatment and monitoring usually means a patient can avoid frequent hospital stays, and better enjoy their time with friends and family.
In addition to its focus on patients, Eisenhower’s Glickman Heart Failure Clinic makes it a priority to work with their families. It sponsors the Coachella Valley’s only Heart Failure Treatment Support Group. Open to patients who are being treated at the Clinic and their family members, this free support group features guest speakers who discuss a variety of topics related to heart failure, including treatment options, dietary guidelines, exercise recommendations and tips to successfully cope with and manage heart failure. Feedback from the support group helps guide the program at Eisenhower, ensuring that a comprehensive understanding of patient needs will continue to drive the Clinic’s unique approach to patient care.
Each year, HealthGrades issues detailed reports on nearly 5,000 hospitals in the nation, focusing on several key specialties, including cardiac care. Heart failure is one of six different program areas within the cardiac care specialty evaluated by HealthGrades.
Eisenhower Medical Center received HealthGrades’ highest five star rating for the treatment of heart failure in 2007 and 2008. According to data provided by hospitals to the federal government and analyzed by HealthGrades, Eisenhower treated nearly three times the number of Medicare heart failure patients than the national average. Heart failure patients at Eisenhower fared far better six months after treatment than the national average, with survival rates four and one half percent better than the national average and even one percent better than other hospitals that received a five star rating for treatment of heart failure.
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In the Tenth Annual Hospital Quality and Clinical Excellence Study, the best outcomes are given a five star rating, while average or as expected outcomes receive three stars and poor outcomes receive one star. Only 10 to 15 percent of the hospitals rated by HealthGrades received five star ratings.