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Johns Hopkins Bayview News - Don't Lose Heart

Winter 2011

Don't Lose Heart

By: Kim Fabian
Date: January 1, 2011

Hope for People with Congestive Heart Failure


Hands and heart illustration
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Congestive heart failure affects an estimated 4.8 million Americans and is the most common diagnosis in hospitalized patients ages 65 and older. There are an estimated 400,000 new cases diagnosed each year—and that number is only expected to escalate as the country’s population ages and advanced treatments allow patients with heart disease to live longer.

What is Congestive Heart Failure?

When people have congestive heart failure, it means that their hearts cannot pump enough oxygen-rich blood to meet the body’s needs.

There are two types:

  • systolic heart failure, in which the heart becomes weak and enlarged due to blockages in the arteries or other causes
  • heart failure with preserved ejection fraction, in which the heart muscle becomes stiff and can’t relax during contractions

Both types cause blood to back up into the lungs and other tissues, resulting in damage to many organs and systems throughout the body. Management of the condition is important. That’s why Johns Hopkins Bayview offers a daily clinic dedicated to patients with congestive heart failure.

Support for Patients

One patient, a 62-year-old Baltimore resident, knows all too well the challenges of coping with this condition and its associated medical problems. She finds it comforting that there is a place like Johns Hopkins Bayview, where specialists understand the complexity of treating the disease. In addition to her congestive heart failure, she has a history of heart disease, heart attack, diabetes, obesity and kidney disease.

“It’s nice to have someone guide you when you’re dealing with all of these health challenges,” she says. “The clinic team is always there for me to help manage my diet and medications. Sometimes, there would be things I didn’t understand. Talking about it would always ease my mind.”

Staff at the clinic are ready to answer the many questions patients may have. “There are so many things we can do to help, but because these patients may be dealing with multiple health issues, management can be challenging and requires expert care,” says Linda Kern, PA, heart failure manager for the Division of Cardiology. “Patients need to be seen frequently to ensure that their treatments are working. Our multidisciplinary approach combines intensive patient and family education with aggressive follow-up to minimize symptoms, improve quality of life and help avoid further hospitalization. Once they are in our program, patients report that they are healthier and feel better.”

Staff at the clinic support patients through behavioral therapies, such as diet modification, exercise and smoking cessation. They also use inhibitors and diuretics, to manage symptoms and prevent complications.

Another advantage of being treated at a center like Johns Hopkins Bayview is that many faculty members are involved in clinical research. Doctors also have access to the latest treatments that have been proven to prolong the life span.

Going Beyond

“What makes us unique is that many of our faculty members are developing programs to treat patients in creative ways,” says Nisha Chandra-Strobos, M.D., chief of cardiology. “For example, we have established a partnership with Johns Hopkins Home Care that provides in-home patient monitoring with

close, nurse-guided supervision. Soon, we will offer IV therapy in the clinic to minimize patient discomfort and improve quality of life. Our collaborative approach and easy accessibility helps decrease hospital admissions, length of stay and emergency room visits.”

The congestive heart failure clinic is open Monday through Friday from 8 a.m. to 5 p.m. Staff is available daily for new consultations, urgent appointments or phone discussions to provide immediate intervention. A cardiologist also is on call each night for emergencies. Patients may self-refer or be referred by a physician, depending on their insurance coverage.

For more information or to schedule an appointment, call 410-550-4642.

The most common symptoms of congestive heart failure include:

  • fatigue
  • swelling in the ankles, legs or abdomen
  • shortness of breath
  • difficulty sleeping
  • increased urination
  • nausea, abdominal pain or decreased appetite

If you notice one of more of these symptoms, see your physician for further consultation and testing. Symptoms vary depending on the organs that are affected and the degree to which the rest of the body has compensated for the weakness of the heart muscle. If you notice signs of heart attack, such as chest pain or dizziness, call 9-1-1 immediately.

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