Congestive Heart Failure/Cardiomyopathy

Along with cardiomyopathy and other diseases of the heart muscle, congestive heart failure may result from a number of other causes, including:

• Heart valve disease
• Hypertension (high blood pressure)
• Endocarditis
• Previous heart attacks
• Coronary heart disease
• Congenital heart disease or defects
• Diabetes
• Heart rhythm disorders (cardiac arrhythmias)
• Cancer therapy-associated heart failure
• Genetic diseases
• Pregnancy-associated heart failure and peripartum cardiomyopathy

Congestive heart failure limits the kidneys’ ability to eliminate excess sodium and waste products, causing the body to retain more fluid and resulting in swelling of the ankles, legs and abdomen. Fluid also may collect in the lungs, causing shortness of breath. Other symptoms of congestive heart failure include:

• Shortness of breath during exertion, at rest or while lying flat
• Weight gain
• Weakness and fatigue
• Nausea, abdominal pain and loss of appetite
• A persistent cough that can produce blood-tinged sputum
• Weight gain of more than two pounds overnight or five pounds in a week

All of these symptoms are common to many medical conditions and may not indicate heart failure. If you experience any of these symptoms or have concerns, consult your doctor.

At Brigham and Women’s Hospital, our congestive heart failure specialists provide expert evaluation and diagnosis using advanced imaging technologies. Along with performing a careful physical examination, your cardiologist may order one or more of these tests or procedures:

• Cardiac Ultrasound (Echocardiogram)
• Standard Exercise Tolerance Test
• Electrocardiogram
• Cardiac MRI
• Chest X-ray
• Cardiac catheterization
• Cardiac Biopsy
• Nuclear scan
• Positron Emission Tomography (PET)
• Cardiac CT

Lifestyle Changes

• Weight loss
• Fat and salt reduction
• Blood pressure control
• Smoking and alcohol cessation

Medication

• Dilate blood vessels and reduce the workload on the heart
• Decrease pressure inside the blood vessels
• Reduce fluid in the body
• Help the heart beat stronger and more regularly

Read about medications used in the treatment of heart failure/cardiomyopathy.

Procedures

• Cardiac Ablation
• Cardiac Resynchronization Therapy (CRT)
• Implantable Cardioverter Defibrillator (ICD)
• Percutaneous Catheter-based Interventions
  • Stents
  • Percutaneous Transluminal Coronary Angioplasty (PTCA)
  • Intra-aortic balloon pump (IABP)
  • Intravenous Ultrasound (IVUS)
  • Percutaneous ventricular assist device (PVAD)
  • Tailored therapy (oral and IV medications with hemodynamic monitoring used to optimize blood flow and improve patient's symptoms)

Surgery

• Aortic Valve Repair and Replacement
• Coronary Artery Bypass Grafting (CABG Surgery)
• Ventricular Assist Device (VAD)
• Left Ventricular Assist Device (LVAD)
• Heart Transplantation

Clinical Trials

Physicians and surgeons at BWH are leaders in the science of heart failure management and cardiac transplantation, and provide access to a range of clinical trials of experimental therapies that may benefit heart failure patients, including

• Metabolic therapy to reduce heart failure readmissions
• Iron deficiency treatment that contributes to cardiac dysfunction
• Long-acting nitrates to improve activity level in patients with heart failure and preserved heart function
• Implantable devices to monitor heart function 

Learn more about our research and clinical trials.

For patients and their family members who have familial cardiac diseases such as hypertrophic cardiomyopathy, the Heart and Vascular Genetics Program offers evaluation by a specialist and blood testing for genetic cardiac disorders.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.

The day of surgery, you care will be provided by surgeons, anesthesiologists and nurses who specialize in surgery for patients with congestive heart failure. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.

Learn more about your hospital stay and returning home.

The Center for Advanced Heart Failure/Cardiomyopathy was rated number one for heart failure in the University HealthSystem Consortium of academic medical centers. Our multidisciplinary team, the most experienced ventricular assist device and heart transplant group in New England, includes nationally-recognized specialists in:

• Cardiac imaging, including MRI and positron emission tomography (PET-CT)
• Vascular medicine, including vasoreactivity testing and assessment of ventricular-vascular coupling
• Biventricular pacing and ablation of cardiac arrhythmias
• Surgical intervention, including high-risk revascularization, valve repair and ventricular reconstruction
• Left ventricular assist device (LVAD) implantation and heart transplantation
• Specialists in electrophysiology, catheter-based interventions

Our Heart & Vascular Team
Request Heart & Vascular Appointment
Heart & Vascular Locations

Learn more about heart failure in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.

Access a complete directory of patient and family services.