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Treatment Options To Consider For Advanced Heart Failure And AHA CPR Kansas City

Difficult decisions must be made when heart failure (HF) progresses to an advanced stage, which requires teamwork. Shared decision-making is what is important which enables patients and doctors consider all the options and the patient’s preferences before drafting a treatment course. About ten percent of the more than 6 million Americans living with HF have advanced heart failure which is indicative of the fact that conventional heart therapies and symptom management strategies aren’t working well. An individual with advanced HF feels shortness of breath and other symptoms (persistent coughing or wheezing, buildup of excess fluid in the body, lack of appetite, nausea, tiredness and fatigue, confusion and impaired thinking, increased heart rate) at rest.

Medication and a healthy lifestyle can help manage HF in its early stages but treatment gets more complex as the disease progresses and the ticker becomes weaker. This is the time that you must have conversations with your family and your doctor about the care you wish to receive.
It should be noted that there are still many treatment options when HF progresses to an advanced stage. What is required is a partnership between you and your doctor where medical options are clearly discussed, and decisions are made depending on what you want. The American Heart Association recommends honest conversations between doctors and patients about treatment options, their benefits and risks as well as future “what-if” scenarios. The importance of this early dialogue lies in the fact that you’re not blindsided when a big medical event happens that requires tough decision-making.


Treatment Options For Advanced HF:
People have this notion that having advanced heart failure means there’s no treatment options left. It isn’t true especially in the face of the increasing number of therapies and state-of-the-art technologies for advanced HF that offers more choices than ever. This is where shared decision-making can truly help as your doctor will know your medical situation and will narrow treatment possibilities to the most suitable options for you. You go through the options together and consider how each treatment fits into your life objectives.

We can cite the example of implantable cardioverter defibrillators (ICDs), which may reduce the risk of sudden cardiac death by shocking a fluttering ticker (known as ventricular fibrillation) back to its normal heartbeat in someone who wants to live as long as possible.

Open-heart Surgery- Surgery may be an option for patients with advanced HF who are somewhat stable. An open-heart surgery involves stopping the ticker and using a heart-lung machine to circulate and oxygenate blood until the ticker is restarted after the procedure. It’s unclear though whether these major surgeries are effective in treating advanced HF.
Coronary artery bypass graft, valve surgery, pericardiectomy- are some of the high-risk surgeries for advanced HF.

Percutaneous Interventions- These are non-surgical procedures performed in a beating ticker. The ticker is assessed with special tools threaded through a small opening in the groin, which is quite unlike open-heart surgery. Options include percutaneous valve intervention and percutaneous coronary intervention, or coronary angioplasty. 

Pacemaker- A pacemaker, in cardiac resynchronization therapy coordinates the electrical signaling between the ventricles to allow them to pump together as advanced HF may cause delayed contractions of the right and left ventricles.

Temporary Therapies:
Short-term or temporary therapies are sometimes needed to help someone recover from a reversible condition, such as acute kidney failure. A discussion is important for doctors and patients to have regarding the long-term use before choosing any of the following treatments, such as

1.      Temporary mechanical support devices. Temporary mechanical support devices for advanced HF inlcude
a.      Intra-aortic balloon pump
b.      Percutaneous ventricular assist device
c.       Extracorporeal membrane oxygenation
2.      Renal replacement therapy

3.      Positive inotropic drugs

Implantable Left Ventricular Assist Device, or LVAD- It may be a temporary “bridge to transplant” for patients who are waiting for a heart donor.

Heart Transplant- A transplant replaces a failing ticker with a healthy donor one.
CPR Kansas City is an AHA certified CPR training site, offering courses for healthcare and non-healthcare providers. To sign up for a course, either register online or call on 913-998-7499.
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