Heart Failure Explained: What You Need to Know

Did you know that heart failure affects nearly 6 million Americans and is the leading cause of hospitalization in people older than 65? Heart failure is a significant and life-changing condition. For many, it brings challenges that require an in-depth understanding of the disease and access to expert care. When treatments no longer provide relief, a heart transplant often becomes the lifeline to a healthier future.

What is heart failure?

Heart failure occurs when the heart cannot efficiently pump enough blood to meet the body’s needs. This leads to symptoms such as:

1. Shortness of breath: Often triggered by physical activities or even while resting.
2. Fatigue and weakness: Caused by decreased oxygen delivery to muscles and tissues.
3. Swelling (edema): Typically, in the legs, ankles or feet due to fluid buildup.

What are the causes of heart failure?

Heart failure often results from other underlying conditions that weaken or damage the heart, including:

1. Coronary artery disease: When narrowed arteries reduce blood flow to the heart muscle.
2. High blood pressure (hypertension): Over time, it forces the heart to work harder, causing damage.
3. Cardiogenic shock: A life-threatening effect of worsened heart failure or a severe cardiac event. It occurs when the heart suddenly cannot pump enough blood to meet the body’s needs. Immediate medical attention is critical to prevent organ damage or death.
4. Lifestyle factors, such as smoking, obesity, lack of exercise and poor diet.

How is heart failure diagnosed? 

Effective diagnosis begins with a comprehensive evaluation, including:

1. Medical history: Identifying symptoms and any contributing conditions.
2. Physical examination: Checking for visible signs of fluid retention or abnormal heart rhythms.
3. Tests: Echocardiograms, cardiac stress tests, chest X-rays and blood tests help assess heart function.

Treatment typically starts with medications and lifestyle changes. However, in advanced cases, these solutions may no longer suffice, leading to the consideration of heart transplantation.

What is cardiogenic shock?

Cardiogenic shock is a critical condition where the heart suddenly loses its ability to pump enough blood, often stemming from severe heart failure or a major cardiac event. This results in dangerously low blood pressure, inadequate blood flow and potential organ failure.

How does cardiogenic shock develop?

Patients with heart failure are especially vulnerable during episodes where the heart’s function worsens dramatically. Symptoms to watch for include:

• Severe shortness of breath
• Rapid heart rate
• Confusion or altered mental state due to reduced oxygen to the brain

Recognizing and treating cardiogenic shock quickly can save lives. At Ochsner, we have a shock team protocol that extends throughout the Ochsner system, allowing us to treat patients as early and effectively as possible. Treatments may include medications to stabilize blood pressure, mechanical support devices like ventricular assist devices (VADs) or even heart transplantation for suitable candidates.

When does heart failure require a heart transplant?

A heart transplant becomes essential when heart failure advances to the point where conventional treatments can no longer sustain a patient’s health or quality of life. These cases are termed end-stage heart failure. 

What is an LVAD, and how can it help?

A left ventricular assist device (LVAD) is a mechanical pump that helps the heart circulate blood when it is too weak to do so on its own. LVADs are often used as a bridge to heart transplantation or as a long-term solution for patients who are not transplant candidates.

At Ochsner, our Mechanical Circulatory Support (MCS) Program offers advanced LVAD technology to help patients with severe heart failure regain their quality of life. These devices can:

• Improve blood flow and reduce symptoms like fatigue and shortness of breath
• Allow patients to resume daily activities and enjoy a better quality of life
• Serve as a life-saving option for those awaiting a heart transplant

Our team of experts provides comprehensive care, from device implantation to long-term management, ensuring patients receive the best possible outcomes.

When does heart failure require a heart transplant?

A heart transplant becomes essential when heart failure advances to the point where conventional treatments can no longer sustain a patient’s health or quality of life. These cases are termed end-stage heart failure.

What are the signs you may need a heart transplant?

Patients who are candidates for a heart transplant often exhibit:

• Extreme fatigue that significantly impacts daily activities
• Frequent hospitalizations due to worsening symptoms
• Severe shortness of breath, even at rest
• A declining response to medications or therapies

The team at the John Ochsner Heart & Vascular Institute carefully evaluates each patient’s eligibility for this lifesaving procedure, considering physical health, emotional readiness and overall prognosis.

What is the heart transplant process?

The path to a heart transplant involves intense preparation, surgical precision and ongoing care.

1. Pre-transplant evaluation: Before a transplant, patients undergo rigorous evaluations such as:
   1. Medical tests: Including blood tests, imaging scans and stress testing to gauge overall health
   2. Psychological assessments: Ensuring emotional readiness for the procedure and post-surgical recovery
   3. Consultations: Collaborations with a multidisciplinary team, including cardiologists, surgeons and nutritionists
2. Surgery: The actual transplant surgery involves replacing the failing heart with a healthy donor heart. This complex, hours-long procedure takes place under general anesthesia with a skilled surgical team.
3. Post-surgery recovery: After surgery, patients require:
   1. Close monitoring in the hospital to prevent complications.
   2. A rehabilitation program to regain strength gradually.
   3. Long-term follow-up appointments to ensure the new heart functions optimally.

What are the benefits and risks of heart transplants? 

A successful heart transplant offers patients:

• A renewed chance at life, free from the debilitating symptoms of heart failure
• The ability to resume normal activities like work, exercise and family life
• Improved longevity and quality of life

While heart transplantation is lifesaving, it comes with inherent risks, including:

• Surgical complications, such as infection or bleeding
• The risk of organ rejection, lessened with immunosuppressive medications
• Long-term reliance on medication and the need for regular medical follow-ups

At the John Ochsner Heart & Vascular Institute, we offer comprehensive post-surgery care to help patients minimize these risks and optimize their recovery.

Heart transplants at Ochsner

The John Ochsner Heart & Vascular Institute has been at the forefront of heart transplant care for decades, offering patients world-class expertise and compassionate support. As Louisiana’s only heart transplant center accredited by the United Network for Organ Sharing (UNOS), Ochsner has performed over 1,000 heart transplants, making it one of only 13 healthcare systems in the United States to reach this milestone.

Facing heart failure is a daunting experience, but with advancements in medical science and expert care, a heart transplant can provide a path to renewed health and hope. At the John Ochsner Heart & Vascular Institute, we combine leading expertise with compassionate care to guide patients every step of the way, from diagnosis to rehabilitation.

Take the first step towards a healthy heart and schedule an appoint with a cardiologist today!