Tests & Treatments for Heart Failure at University of Colorado Hospital

Tests for Heart Failure

Cardiac Catheterization

To examine pressure and blood flow in your heart, your doctor may thread a very thin, flexible tube called a catheter through a small incision and into a blood vessel in your arm, leg or groin. The catheter is then threaded into the right or left side of your heart.

When the catheter is properly placed, a dye is injected. This helps your doctor to see X-ray pictures of the heart (angiogram) and detect if there are blockages in the arteries.

Echocardiogram

An echocardiogram (ECHO) uses sound waves to create pictures of the heart.

Electrocardiogram

An electrocardiogram (ECG or EKG) is used to determine the rate and regularity of your heartbeat. The ECG is administered by attaching wires to your body. The wires detect electrical signals from the heart, which are recorded on a machine for the doctor’s review.

Holter Monitors

Holter monitors are portable ECG units worn by the patient to monitor the heart 24 hours a day.

Exercise Stress Test

This test evaluates how well your heart is functioning. During the stress test, you walk on a treadmill while a machine monitors your:

  • Heart rhythm
  • Blood pressure
  • Other vital signs

Nuclear Stress Test

An exercise stress test that includes an injection of a small amount of a radioactive substance through an intravenous line. The material reaches your heart as you are exercising. Following the exercise test, you will have X-ray pictures taken of your heart. The radioactive material helps to illuminate areas that are blocked and may not be receiving a sufficient blood supply.

Drug Tests

If you cannot perform an exercise stress test, your doctor may use drugs that dilate (widen) your blood vessels. After the drugs are injected into your veins, you will receive an injection of radioactive material to help show areas of blockage in the arteries.

Thyroid Function Test

The thyroid gland, which controls hormone production, can play a role in heart failure if it does not function properly. Your doctor can test your thyroid function with blood, imaging and other tests.

Treatments for Heart Failure

Treatment for heart failure starts with placing less stress on the heart. Doing so may require that you make lifestyle changes, including:

  • Limiting salt, fat and fluids in your diet
  • Exercising regularly
  • Maintaining an appropriate weight
  • Quitting smoking
  • Limiting or eliminating alcohol consumption
  • Reducing stress

Sometimes your doctor will prescribe medications to treat your heart failure. Among them:

  • ACE (angiotensin-converting enzyme) inhibitors reduce pressure on the blood vessels by dilating (widening) them
  • Beta blockers slow down the heart rate and can help widen blood vessels
  • Digitalis slows down the heart rate and increases the strength of the heart’s contractions
  • Drugs that control hypertension (high blood pressure)
  • Diuretics that help remove excess fluid from the body

Heart Failure Procedures

Coronary Artery Bypass Graft Surgery

Coronary artery bypass graft surgery (CABG) may be performed if the arteries bringing blood to your heart (the coronaries) become so thickened and hardened with fatty deposits called plaque that blood flow is blocked. This blockage creates a risk of heart attack and death. During CABG surgery, your surgeon grafts a healthy blood vessel to the heart and reroutes blood around the blockage.

Aortic Valve Repair/Replacement

The aortic valve lies between the left lower chamber of the heart (the ventricle), and the aorta, the largest artery in the body. The valves of your heart open and close tightly to ensure that blood flows in only one direction and does not leak backward.

The aortic valve may not function properly due to:

  • Disease
  • Narrowing (stenosis) caused by calcium deposits on the leaflets (the parts that open) of the valves
  • Incomplete closure (prolapse)

If an aortic valve malfunction seriously restricts the flow of blood to your heart, your surgeon may decide to repair or replace it with open heart surgery.

Mitral Valve Repair/Replacement

The mitral valve lies between the heart’s left upper chamber (atrium), and left ventricle. As with the aortic valve, the mitral valve may malfunction, causing leakages that diminish blood flow to the heart.

If the mitral valve malfunction seriously affects the flow of blood to your heart, your surgeon may decide to repair or replace it with open heart surgery. The vast majority of these surgeries succeed in repairing the mitral valve.

Ventricular Assist Devices

Ventricular assist devices provide mechanical circulation support for the heart. The implanted devices help the lower chambers of the heart (the ventricles) to pump blood to the lungs and the rest of the body. The devices may be used:

  • Short term to assist in recovery from surgery
  • As a bridge to assist patients waiting for a new heart
  • For patients whose hearts require long-term pumping help

University of Colorado Hospital provides a full range of ventricular assist devices (VADs) to help the right, left or both ventricles pump blood to the lungs and to the rest of the body. They are designed for:

  • Patients who are recovering from surgery and require short-term assistance of from 24 hours to six weeks
  • Bridge to Transplant: Patients who are on a waiting list to receive a heart for transplant and need an assist device as a “bridge to transplantation”
  • Destination Therapy: Patients who require ventricular assistance with a permanent implant.

Some VADS meant for short-term use are placed outside the body. Other VADs intended for long-term support are implanted in the body. All of these devices are powered by an external source (batteries or electricity). Patients with long-term VADs may be discharged from the hospital to continue their care at home.

Many VADs are air-driven (pneumatic) devices. The pump is connected to a driveline, which is attached to a battery-powered unit. The unit senses when the ventricle is full, and signals to control the heart rate. It also monitors the pump to make sure it is working correctly.

UCH provides extensive education and support for those patients who require a ventricular assist device, including:

  • Lectures
  • Home visits
  • 24-hour, seven-day-a-week pager contact

Heart Transplant Surgery

Heart transplantation is available for patients whose cardiac disease is too severe to be treated with medicine or surgery and whose life expectancy is less than one year.