Congestive Heart Failure/Cardiomyopathy

Congestive heart failure (or simply, “heart failure”) is a medical condition in which the heart fails to sufficiently pump oxygenated blood needed by the body's other organs. The heart continues to pump, but not as efficiently as a healthy heart. This condition, which affects nearly six million Americans, may lead to symptoms such as shortness of breath, swelling of the legs and ankles, fatigue and weakness, loss of appetite and a persistent cough. Common causes of heart failure include high blood pressure, adult congenital heart disease, coronary artery disease and valvular heart disease.

Cardiomyopathy, which describes any disorder that affects the heart muscle, also can be a contributing cause of heart failure. Three forms of cardiomyopathy are:

  • Hypertrophic cardiomyopathy is an uncommon, often familial, condition that involves abnormal thickening of the left ventricle and stiffening of the heart, due to a genetic mutation in key proteins involved in heart muscle contraction.
  • Dilated cardiomyopathy, the most common type of cardiomyopathy, refers to a markedly enlarged heart with an impaired ability to pump blood. This also can be caused by genetic mutations or other secondary factors, such as viruses or toxins.
  • Restrictive cardiomyopathy occurs when the heart muscle becomes stiff due to progressive fibrosis or accumulation of abnormal substances and is unable to properly fill with blood.

Learn more about cardiomyopathy.

Understanding the Basic Genetics of Hypertrophic Cardiomyopathy

Screening family members for Hypertrophic Cardiomyopathy

Cardiovascular specialists at the Center for Advanced Heart Failure/Cardiomyopathy Program at Brigham and Women’s Hospital (BWH) Heart & Vascular Center offer comprehensive inpatient and outpatient clinical services to adults with cardiomyopathy and congestive heart failure, including a broad range of innovative diagnostics, leading-edge medical therapies and replacement therapies for the failing heart, including heart transplantation and mechanical circulatory support. The Heart & Vascular Center has a specialized Hypertrophic Cardiomyopathy Clinic. Treatment plans for each heart failure patient are individualized with the goal of improving both length and quality of life.

Read heart failure treatment Q & A

Read heart failure FAQs

Watch this video with Mandeep Mehra, MD about the evolution of heart failure treatment.

Read about Matt Fogg, BWH patient, who we brought from heart failure to recovery.

Congestive Heart Failure/Cardiomyopathy Topics

Symptoms of Congestive Heart Failure/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.

Diagnosis of Congestive Heart Failure/Cardiomyopathy

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:

Congestive Heart Failure/Cardiomyopathy Treatment

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

Surgery

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.

What You Should Expect

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.

Multidisciplinary Care

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
Resources

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.

Visit the Brigham and Women’s Hospital HealthHub Blog, which features information on a variety of topics, including heart disease.

Carolyn Ho, MD, Medical Director of the Cardiovascular Genetics Center at Brigham and Women’s Hospital (BWH), discusses the role of genetics in the development of heart diseases such as hypertrophic cardiomyopathy. Read the Advancing Care for Inherited Heart Disease video transcript.

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