Advanced Heart Failure Symptoms & Treatment | MedStar Health
A team of MedStar Health advanced heart failure specialists stand together for a group photo.

Expert care when heart failure progresses

Advanced heart failure is a form of heart failure that has progressed to the most serious stage. Heart failure gets worse over time. Based on a patient’s risks and symptoms, the American College of Cardiology and the American Heart Association classify the progression of this disease as:

  • Stage A: High risk of developing heart failure
  • Stage B: Left ventricle is not performing well or is structurally abnormal
  • Stage C: Current congestive heart failure diagnosis or previous symptoms 
  • Stage D: Diagnosis of heart failure with reduced ejection fraction and have advanced symptoms do not get better with treatment.

Though this condition is serious, there is hope for patients with this disease if patients receive timely and effective care. There is a “Golden Window of Opportunity” when heart failure patients should be referred for advanced care before it is too late (American Heart Association scientific statement October 2021). The clinical signs and symptoms that indicate when a patient should be referred for advanced heart failure care are: 

  • Inability to tolerate guideline directed medical therapy
  • Frequent hospitalizations 
  • Recurrent heart rhythm issues or ICD shocks
  • Worsening kidney function

Our Advanced Heart Failure Program team provides diagnosis, a comprehensive scope of medical and surgical options treatment options, and ongoing patient support for heart failure patients as described on the above page link.

Symptoms of advanced heart failure

The symptoms of advanced heart failure are similar to those of heart failure in an earlier stage. These include:
  • Shortness of breath
  • Dry, hacking cough
  • Chest pain

  • Fatigue
  • Irregular heartbeat, also known as arrhythmia

  • Swelling in the legs, feet, or abdomen
  • Weight loss without diet or exercise changes

These symptoms may be worse or better from day to day or even at different times of the day. The main difference from less-advanced heart failure is that these symptoms may appear with ordinary activity or even during rest.

Causes of advanced heart failure

Everyone loses some ability for the heart to pump blood as we age. However, heart failure is a result of medical conditions that either damage the heart outright or make it work harder. Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity contribute to heart failure. Medical conditions that may lead to heart failure are:

Risk factors of advanced heart disease

Certain medical conditions can increase your risk for health failure, including:

Lifestyle factors such as smoking, obesity, a high fat diet, high cholesterol, and lack of physical activity increase your risk of heart failure.

You can take important steps to prevent heart failure by engaging in regular physical activity, maintaining a healthy body weight, not smoking, eating fruits and vegetables, moderate alcohol intake, and maintaining a healthy weight.

Diagnosis and testing

Diagnosing advanced heart failure is the first step to developing a treatment plan. Our specialists may recommend one or more diagnostic and imaging procedures.

Angiogram (Angiography)

An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.

Cardiac Catheterization

Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

Chest X-ray

Chest X-rays use a small dose of radiation to create pictures of the structures inside the chest, including the lungs, heart, and chest wall.

Computerized Tomography (CT) Scan

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

Echocardiogram

An echocardiogram uses high-frequency sound waves to create images of your heart.

Electrocardiogram (ECG)

An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.

Heart Biopsy

In this biopsy, your doctor will remove small samples of your heart muscle tissue to monitor function or diagnose a problem.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets, and computer technology to create images of your heart and blood vessels.

Stress Tests

Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.

Technetium Pyrophosphate

Uses a radioactive form of PYP that is often used to diagnose cardiac amyloidosis.

Treatments

We offer a wide spectrum of treatments for patients with advanced heart failure. These include CardioMEMS™ remote patient monitoring, Barostim™ heart assist device, inotropic therapy, interventional heart failure treatment, as well as, ventricular assist devices, Extracorporeal Membrane Oxygenation (ECMO) and heart transplants. Along the way, patients have access to palliative care to relieve symptoms and stress.

Learn More About Advanced Heart Failure Treatments

Our locations

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MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Union Memorial Hospital

201 E. University Pkwy.
Baltimore, MD 21218

MedStar Southern Maryland Hospital Center

7503 Surratts Rd.
Clinton, MD 20735

MedStar Good Samaritan Hospital

5601 Loch Raven Blvd.
Baltimore, MD 21239

MedStar Health: Cardiology Associates at Annapolis

2002 Medical Parkway
Suite 500
Annapolis, MD 21401

MedStar Health: Heart and Vascular at Glen Burnie

808 Landmark Drive
Suite 120
Glen Burnie, MD 21061

410-766-8677

MedStar Health: Cardiac Electrophysiology at Reston Town Center

1830 Town Center Drive
Suite 405
Reston, VA 20190

Ask MedStar Heart & Vascular Institute

Have general questions for our heart and vascular program? Email us at AskMHVI@medstar.net. If you have clinically-specific questions, please contact your physician’s office.