Sophisticated Heart Failure Treatment Close to Home

Heart failure treatments can cure many cases of a weakened heart when diagnosed early. More severe cases can be managed with medication and circulatory support to help minimize symptoms and keep you enjoying life.

Seeing your primary care physician for annual checkups and paying attention to your risk factors — such as high blood pressure, diabetes, obesity and family history — can help spot emerging heart failure before you have symptoms.

Despite its name, heart failure doesn’t mean that your heart has failed or is about to stop working. However, it is failing to pump the appropriate amounts of oxygen-rich blood to the rest of your body.

Heart failure progresses through four stages. The specialists at the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program have the experience and expertise to slow the progress of your disease and often cure heart failure. For most people, heart failure treatment requires a balance of the right medications, a low-sodium diet and fluid restrictions that can help ease symptoms.

The Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program is revolutionizing heart failure treatment for patients in Louisville and surrounding communities in Kentucky and Southern Indiana. The program helps patients recover heart function and resume living their lives. We use leading-edge technology to help recovery, with as few nights in the hospital as possible.

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First-line Treatment for Heart Failure

Your heart failure treatment will continue for the rest of your life — a longer-term prospect than in the past. Medication, close monitoring and a healthy diet and regular exercise routine can manage the disease. The earlier you start treatment, the better your chance of controlling symptoms, preventing further damage to your heart and regaining heart function.

Your treatment starts with a precise diagnosis to determine how well your heart is pumping blood through your body. Blood tests, stress tests, CT scans, MRI scans, electrocardiograms, echocardiograms and a coronary angiogram are some of the tests our specialists will use to determine the severity, cause and effects of your heart failure.

Rebuilding your heart muscle may be an option through the Norton Heart & Vascular Institute Myocardial Recovery Program, using evidence-based medication choices, close remote monitoring and a holistic approach to lifestyle modification to promote the best possible environment for heart recovery.

Severe cases of heart failure may require surgical repair and mechanical circulatory support — a pump that helps your heart move oxygen-rich blood out to your body. A surgically implanted ventricular assist device can provide long-term relief or serve as a short-term solution while you wait for a heart transplant.

Heart Failure Medications

Heart failure can be treated with a combination of medications.

Neurohormonal blockade: This regimen of different medications with frequent dosage changes can reverse and cure heart failure in most patients if started within three months of symptoms.

Angiotensin-converting enzyme (ACE) inhibitors: These widen blood vessels to lower blood pressure, improve blood flow and decrease workload on the heart. Examples are enalapril, lisinopril and captopril.

Angiotensin II receptor blockers (ARBs): These have the same benefits as an ACE inhibitor, and may be an alternative for people who cannot tolerate ACE inhibitors. Examples are losartan and valsartan.

Cardiac glycosides: These increase the strength of heart muscle contractions. They can slow the heartbeat and may reduce heart failure symptoms. An example is digoxin.

Combination neprilysin inhibitor/ARB: This is used with other heart failure therapies, in place of an ACE inhibitor or ARB alone, to reduce strain on the heart, improve blood flow and aid in removal of fluid. An example is sacubitril/valsartan (Entresto).

Beta blockers: These drugs slow the heart rate and reduce blood pressure. They reduce the signs and symptoms of heart failure and improve heart function. Examples are carvedilol and metoprolol.

Diuretics: Sometimes called water pills, these drugs increase urination and help keep fluid from collecting in the body. This also decreases fluid in the lungs, helping make breathing easier. Some diuretics make the body lose potassium, so you may need to take a potassium supplement. Examples are bumetanide (Bumex), furosemide (Lasix) and torsemide.

Aldosterone antagonists: These diuretics do not cause potassium loss and have additional properties that help the heart work better. They may reverse scarring of the heart and help individuals with severe heart disease live longer. Examples are spironolactone and eplerenone.

Inotropes: These intravenous medications work by increasing the heart’s strength and the force of blood pumping through the body. They also widen blood vessels, allowing blood to flow more easily. Examples are milrinone and dobutamine.

Heart Failure Management

Your heart will work to recover. Part of our job is to give your heart room to heal by preventing additional damage. We use a number of remote monitoring technologies to alert your cardiologist of any changes in your heart’s function that can further weaken it.

CardioMEMS HF System: This permanently implanted device transmits data from your heart when you lie on a special pillow a couple times per week. If the readings are outside of set parameters, it alerts the team at the Advanced Heart Failure & Recovery Program.

LifeVest: Patients newly diagnosed with systolic heart failure and at risk of sudden cardiac death may wear this cardioverter defibrillator. Worn directly against the skin, the lightweight LifeVest detects any life-threatening, rapid rhythm, and shocks the heart back into a normal beat.ReDS System: This is a vest you’ll put on at the Advanced Heart Failure & Recovery Program office. The vest painlessly measures lung fluid in as little as 45 seconds. Excess lung fluid can be a sign of decreased heart function.

Heart Failure Care Designed for Heart Recovery

• Same-day appointments are available for new patients at locations in downtown Louisville and on the campuses of Norton Audubon Hospital and Norton Brownsboro Hospital.
• Our compassionate and dedicated team includes specially trained heart failure cardiologists and advanced practice providers, a social worker, nurse navigators and dedicated pharmacist to help create a custom plan for care and make sure you and your family’s questions are answered at every step.
• When diagnosed promptly, more than 50% of patients with heart failure that wasn’t caused by heart attacks or blockages are cured, compared with about 10% nationally.
• Our program has advanced heart failure monitoring technology to detect signs of a weakening heart before you feel symptoms, with a goal of preventing hospital stays.
• We are a DNV-accredited provider of ventricular assist devices and are recognized as High Performing in Heart Failure by U.S. News & World Report.
• Our advanced care for severe heart failure includes ventricular assist device implants, extracorporeal membrane oxygenation (ECMO) support to give your heart a rest and time to heal, and access to heart transplants with ongoing aftercare.
• Medicare, Medicaid and most major commercial insurance plans are accepted.
• Book appointments, get alerts when an earlier appointment becomes available, communicate with your medical provider, refill prescriptions and more through your free Norton MyChart account.