Dr. Aman Ghotrais is a Heart Failure Specialist at St. Elizabeth. He sees patients at the Advanced Heart Failure Management Center in the Heart & Vascular Institute building located in Edgewood, Ky. This article was provided by St. Elizabeth Healthcare.
Q: What does a heart failure specialist do? When should people seek help from one?
A: An advanced heart failure specialist treats and manages heart failure. Heart failure is a chronic condition where the heart cannot pump enough blood to meet the body’s blood and oxygen needs. It’s a condition that gets worse over time. Patients we treat typically have worsening symptoms and no longer respond to standard medical therapy. As heart failure specialists, our goal is to help patients live longer and enjoy a better quality of life.
We recommend that patients see a heart failure specialist soon after first being diagnosed to learn about the disease, set expectations and develop a long-term management plan. Patients should see a heart failure specialist if they have worsening symptoms. These include shortness of breath with daily activities, swelling in the legs and abdomen and worsening kidney or liver function. They should also reach out to a specialist if they’ve been hospitalized with heart failure and consistently need to adjust their heart failure medications, especially diuretics (also known as water pills).
Q: What’s something surprising about heart failure that people might not know?
A: There are more than 6 million adults with heart failure in the United States. More patients go to the hospital for heart failure each year than all types of cancer combined. As such, it’s one of the leading causes of death.
Q: What is St. Elizabeth doing around heart failure that is innovative, unique, or leading edge?
A: We now have previously unimaginable options available that let us respond to a patient’s changes as quickly as possible. These options allow us to help patients before they get sick enough to require hospitalization.
One such device is called CardioMEMs. It can track heart health from the comfort of the patient’s home. CardioMEMs is a tiny pressure sensor inserted and implanted into the pulmonary artery during a minor outpatient procedure. It records and sends data to the heart failure team for review. Based on the results, the team can adjust medications remotely.
In 2020, St. Elizabeth implanted its first left ventricular assist device (LVAD), a mechanical and battery-operated heart pump surgically implanted in the chest. It assists the native heart and improves symptoms and life expectancy in patients with advanced heart failure.
Q: What is currently on the horizon for heart failure treatment and management? What changes might we expect in the next few years?
A: Advances in technology and medical therapy are changing how heart failure is managed. There are multiple new drugs that have come to market to treat various types of heart failure.
St. Elizabeth is committed to reducing heart disease and deaths related to heart disease. We offer several national and international heart failure clinical trials that can provide the best care for our patients. We are actively enrolling patients in clinical trials to help those who aren’t doing well on currently approved drug therapies.
There is no question that Left Ventricular Assist Devices (LVADs) save lives, but existing models have limitations. Currently approved LVADs are fueled via a power cable that protrudes through the skin and is attached to an external power source, such as a portable battery. Recently developed technology will allow LVADs to be powered wirelessly and, as a result, fully implanted internally.
Q: Does St. Elizabeth offer screenings for early detection of illness related to heart failure?
A: The purpose of screening is early diagnosis and treatment of a disease. There are no current guidelines for routine screenings for heart failure in the absence of symptoms. However, it is important to control risk factors that increase the chances of heart failure, such as high blood pressure, diabetes, high cholesterol, obesity, significant alcohol use, and poor diet.
Patients with a strong family history of heart disease and prior heart attack or who are taking medications that are toxic to the heart, such as chemotherapy, should be seen by a cardiologist. They may recommend you have an echocardiogram (an ultrasound of the heart) if they consider you to be at high risk for developing heart failure.
Q: From your perspective as a heart failure specialist, what should people be aware of to prevent disease or catch it early?
A: Addressing lifestyle changes is the most important way to minimize the risk of heart failure. We recommend staying active and getting at least 2.5 hours a week of moderate-intensity aerobic exercise. Do not use illegal drugs, smoke or drink significant amounts of alcohol. Follow up with your primary care doctor, and if you are diagnosed with conditions that increase the risk of heart failure, make sure you are on a good medication regimen.
Good nutrition is also essential. We recommend limiting unhealthy fats (saturated and trans fats), as well as excess sugar and salt intake. Try to lose weight if your body mass index (BMI) is 25 or over. Aim for a BMI between 18 and 25. Learn to manage stress and get good sleep. Sleep apnea can increase the risk of heart failure, so talk to your doctor if you have been told you snore at night, if your breathing stops while sleeping and if you gasp for air.
Learn more about Heart Failure Care at St. Elizabeth Healthcare.