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All of sudden, it seems, we are hearing about heart failure.

People we know, or grandparents and parents of friends, who attribute their tiredness, shortness of breath or even swelling around their ankles to signs of getting older, are being told--when they finally mention these symptoms to a physician--that they may be suffering from heart failure.

Experts say that heart failure remains a growing problem in the United States and is the only cardiovascular disease that is increasing in prevalence, even as the overall incidence of heart disease is slowly dropping. With an aging population, including Baby Boomers who are beginning to reach retirement age, it is estimated that roughly 550,000 people in this country will develop heart failure this year.

“Heart failure can affect all of us eventually because we are living longer,” says Paul Mather, M.D., director of the Advanced Heart Failure and Cardiac Transplant Center at the Jefferson Heart Institute at Thomas Jefferson University Hospital, Philadelphia, which was created to meet the rising demand for specialized heart care.

Simply stated, heart failure is a condition in which the lower chambers of the heart are not able to pump blood effectively. If a heart muscle has been damaged by long-term high blood pressure, heart disease, heart valve or heart muscle problems, it becomes more difficult for the heart to pump effectively.

“When diagnosed early, heart failure can be treated effectively with medications and lifestyle accommodations.” says Dr. Mather, who is also associate professor of Medicine at Jefferson Medical College of Thomas Jefferson University. “Furthermore, heart failure usually develops slowly.”

When heart failure progresses to an advanced stage, the treatment required is aggressive. “Advanced heart failure is a critical, multi-organ disease process that affects people from head to toe, and that has to be dealt with through a unified, multidisciplinary approach to the disease process,” Dr. Mather says.

That is the advantage of an advanced heart failure center—to provide specialized care. “An advanced heart failure center can offer one-stop shopping for patients’ cardiac needs,” says Dr. Mather, noting the availability of Jefferson’s other medical specialties.

According to Daniel Marelli, M.D., surgical director of the Heart Transplant Program at the Advanced Heart Failure and Cardiac Transplant Center at Jefferson, the rising prevalence of heart failure has spurred a trend in the last five to 10 years to develop heart failure centers to help address the increasing patient volume and the need for specialized care.

“We can provide standard, tailored, aggressive heart failure therapy,” Dr. Mather  says, which includes a wide range of specialized treatment and testing, such as cardiopulmonary exercise testing to evaluate a patient’s oxygen consumption, hemodynamic monitoring, aggressive heart muscle support and treatment, intermittent IV infusions of drugs and advanced device therapy, in addition to psychosocial support, dietary information, and disease education for both the patient and family.

The Center could also help a referring physician to decide if a patient might benefit from a newer treatment, such as biventricular pacing, which involves implanting a device into the patient’s chest to pace the left and right ventricles and synchronize their contractions to increase the heart’s pumping power.

Thomas Jefferson University Hospital successfully initiated a UNOS (United Network for Organ Sharing)-certified heart transplant program in 2004.
“Though the cornerstone of what I offer is heart transplant,” says Dr. Marelli, who is also associate professor of Surgery at Jefferson Medical College of Thomas Jefferson University, “patients are constantly evaluated to see if there are other potential options, ranging from drugs to different types of surgery, such as high-risk heart valve surgery, coronary artery bypass surgery and re-operation, which might involve a new bypass or replacing an already replaced heart valve. We might also consider investigational treatments and devices such as heart assist pumps that help the heart pump blood.”

The Advanced Heart Failure Center may function as a patient’s primary cardiology resource as well.

“For the average physician, heart failure can be an expensive and time-consuming disease process,” Dr. Mather says. “The Center has four coordinators, three cardiologists and three cardiothoracic surgeons focused exclusively on heart failure, following individual patients closely. Because these patients require more tailored therapy, we have the staff to enable nurse coordinators to check in with these patients by telephone to ask, for example, if they are weighing themselves daily, and monitor exercise programs and medications.”

Both physicians recommend that if a person begins to feel physically different, she or he should consult a physician.

“It is important to remember,” Dr. Mather concludes, “that heart failure is not a death sentence.”

To make an appointment with the physicians at the Advanced Heart Failure and Cardiac Transplant Center at the Jefferson Heart Institute, call 1-800-JEFF-NOW.