Cardiac Clinic Turns Heart Failure into Heart SuccessLast updated: Apr 11, 2016
Like the 5.1 million Americans who will develop heart failure in their lifetime, Edward MacDonald simply wants to feel stronger. His initial symptoms—shortness of breath, heart palpitations, and swollen legs—left him fatigued and unable to complete everyday tasks. The condition had caused his heart muscles to become weak and stop pumping blood to the rest of his body as well as it should.
“I started experiencing blackouts and it was difficult to walk up the stairs or clean the house,” Mr. MacDonald recalls. “I did not want to believe that I had heart trouble, but eventually I had to wise up. I wanted to enjoy life.”
That is why Mr. MacDonald came to the Live Well Heart Failure Clinic at the Summit Medical Group. Together, a team of medical experts including cardiologists, physician assistants, and nurse case managers partner with patients to strengthen the heart muscles and improve tolerance for activity. Throughout a series of five sessions, physicians assess and diagnose the condition, develop an individualized treatment plan, manage medications, and educate patients about how to protect the heart from damage. To enroll, the clinic requires a referral from a primary care physician.
“Heart disease is the number one killer of both men and women,” says Seth Jawetz, MD, a cardiologist in the Heart Failure Clinic at Summit Medical Group. “More than half of these deaths can be prevented with proper precautions, lifestyle changes, and treatments. Our goal at the clinic is to help patients feel stronger so they can lead more normal lives.”
Diagnosing Heart Failure
The key to detecting heart failure, Dr. Jawetz says, is to recognize the potential signs of the condition. “The most common symptom of heart failure is shortness of breath,” he says. “If you used to be able to walk twenty minutes on the treadmill and now you become easily fatigued and out of breath during exercise, that is concerning.” Other symptoms include: chronic cough, swollen legs and feet (caused by a build-up of fluid), fatigue, lightheadedness, chest pains, and palpitations. Patients who experience these symptoms should report them to their primary care physician immediately.
During the initial visit, the Heart Failure Clinic team focuses on diagnosing the condition. Patients receive a comprehensive medical history, physical exam, and undergo a brief test known as an electrocardiogram (EKG), which places sensors called electrodes on the chest to monitor the electrical activity of the heart. In follow-up visits, an echocardiogram, or echo—an ultrasound that takes pictures of the heart chambers, structures, and valves—is often scheduled. Specialized imaging scans, such as cardiac CT and MRI, are used if a more detailed image is needed.
Another important diagnostic tool is an exercise stress test. During the evaluation, patients are hooked up to a heart monitor and asked to walk on a treadmill at different speeds. “When your body exercises, it has to pump more blood. Exercise stress tests tell us how the heart is handling its workload,” explains Dr. Jawetz. “The results give us an idea of how much physical activity we can recommend for patients.”
Mr. MacDonald says coordinating these tests at the Live Well Heart Failure Clinic was extremely convenient. “I know people who have to travel to different places for their appointment, blood work, and scans. Summit Medical Group makes the experience as easy as possible. Everything is located in one place,” says the 61-year-old who first came to the clinic four years ago.
Developing a Cardiac Treatment Plan
Once the condition is diagnosed, physicians work together to treat the problem. For example, heart failure can occur on the left or right side of the heart. The condition can also be caused by a blockage that develops in the artery walls—the tubes that carry blood away from the heart—known as coronary heart disease, which Mr. MacDonald suffers from.
Surgical interventions are often needed to fix structural problems or open up a clogged artery. Most patients require a combination of medicines such as: beta blockers, which slow down the heart rate, ACE inhibitors, which lower the blood pressure, diuretics (water pills), which get rid of excess fluid, and cholesterol-lowering medications, which help prevent blockages.
“The care at the Heart Failure Clinic has been truly wonderful. If I call them, they get back to me right away. They are extremely thorough— filling me in on my test results immediately and constantly making sure my medication is adjusted properly,” says Mr. MacDonald.
Promoting Heart Health
Like many patients who come to the clinic, Mr. MacDonald has other health conditions in addition to heart failure, and needs nine different medications to manage these issues. As a result, Dr. Jawetz says it is beneficial for him to be part of an integrated care facility. At Summit Medical Group, physicians from more than 80 medical specialties and services communicate with each other through an integrated electronic medical record.
“Having the ability to see what another physician is thinking through the electronic records, access diagnostic reports, and view imaging scans, allows us to provide more comprehensive and specialized care,” says Dr. Jawetz. “The right hand always knows what the left hand is doing.”
Another important part of the Heart Failure Clinic is educating patients about lifestyle changes that will keep their heart healthy. When patients are cleared for physical activity, Dr. Jawetz recommends walking for 30 minutes a day at any speed at least five days a week. He also advises patients to maintain a healthy weight, eat nutritious foods, and cut back on substances that can affect heart function such as salt, cholesterol, and alcohol. Nutritionists work with the clinic and are available to help create individual diet plans when needed.] Nurses also educate patients about stress reduction techniques.
“Heart issues have a lot of ups and downs. It is a bit of a dance at times, but the physicians and nurses are always on top of it,” says Mr. MacDonald. “I know I am in the right place.”