Heart failure is a major public health problem that strikes nearly 500,000 new patients
each year and can result from hypertension, coronary artery disease, heart attack
and diseases of the heart muscle. Chronic congestive heart failure is the leading
cause of hospitalization in the elderly.
The Heart Failure Program at the UF Health
Cardiovascular Center in Jacksonville is committed to providing patients
with highly specialized care and the most advanced treatment options available.
The program is staffed by University of Florida cardiologists who provide inpatient
and outpatient services. Patients with heart failure can usually be treated with
a combination of lifestyle changes and medication to remove excess fluid and improve
blood circulation, increasing the heart's ability to pump and preventing rhythm
Patients of the Heart Failure Program also benefit from the multidisciplinary expertise
of specially trained nurses, pharmacists and dietitians. The team provides each
patient with a comprehensive evaluation and individualized treatment plan.
Video: About Heart Failure
Minimally Invasive Diagnostic Procedures
Diagnostic angiography helps quantify the degree of blockage in a blood vessel,
which can lead to a heart attack. It's often performed in conjunction with cardiac
catheterization. Before the procedure, you'll be given a mild sedative and a local
anesthetic. An IV line is inserted into one of the blood vessels in your arm or
groin. A catheter is then inserted through the IV and into your blood vessel. The
catheter is carefully threaded into the heart guided by an X-ray machine. Once the
catheter is in place, contrast material is injected and pictures are taken, allowing
doctors to see if the arteries are narrowed or blocked.
In the imaging laboratories, a quantitative analysis of this procedure can be done
to calculate the volume and area of the vessel. This helps physicians diagnose the
level of vessel constriction and atherosclerotic plaque, which may be a soft, high-lipid
plaque, a hard calcified plaque or a mixture of the two.
Coronary Intravascular Ultrasound (IVUS)
Coronary intravascular ultrasound is used to evaluate blockages of the coronary
artery. During this procedure, an ultrasound transducer is attached to a catheter
and guided through the coronary arteries, where it sends and receives sound waves
to create a detailed images of the inside of the vessel. IVUS is used to provide
specific information about the coronary artery blockage, including its location,
size and shape. This information can help your physician determine the most appropriate
treatment and evaluate its success.
This test can measure the blood pressure within your heart and how much oxygen is
in your blood. It's also used to get information about the pumping ability of the
heart muscle. You'll be given a mild sedative before the test to help you relax
as well as a local anesthetic. Then a slender, flexible tube will be inserted into
the groin area, where your thigh meets your abdomen, and directed to the heart.
Once the catheter is in place, contrast material is injected and pictures are taken,
allowing your physician to see images of the inside of your heart. The procedure
is performed in our state-of-the-art digital cardiac catheterization lab.
Non-Invasive Diagnostic Procedures
Holter monitoring is a continuous recording of a patient's heart rhythm, usually
for 24 hours, during typical daily activities. It is especially useful in diagnosing
abnormal heart rhythms called arrhythmia. For this test, small conducting patches
called electrodes are placed on your chest and attached to a small digital recording
monitor that you can carry in a pocket or in a small pouch worn around your neck.
Most current holter monitors and recorders are equipped with an event recorder or
marker. When symptoms such as dizziness or palpitations occur, you simply press
a button to note the time of the symptoms. This marks the tape so that the symptoms
and electrocardiogram ECG recording can be correlated during analysis.
An echocardiogram uses ultrasound waves to create an image of the heart. It's a
safe, non-invasive procedure that helps evaluate the structure and functioning of
the heart for diagnosis of cardiac disease, abnormalities and as part of some cardiovascular
research studies. During the test, your doctor or sonographer will place a device
called a transducer on your chest and aims it at the heart. The transducer sends
and receives sound waves that bounce off the heart while a computer takes the returning
sound waves, or echoes, and turns them into pictures of the heart.
This is a recording of your heart's electrical activity during a standard electrocardiogram
(EKG or ECG) test. Before the test, electrodes will be attached to your arms, legs
and chest. An EKG is generally performed while you're lying down, although sometimes
it's performed while you're exercising or under minimal stress to monitor changes
in the heart. This type of EKG is often called a stress test. Your heart's electrical
impulses and rhythms are recorded on a strip of moving paper. Normal and abnormal
heart rhythms are recorded and averaged to detect arrhythmias, evaluate recurrent
symptoms such as palpitations, dizziness or fainting spells, assess the effectiveness
of medications and pacemakers, and help determine whether areas of your heart do
not receive enough blood supply.
Cardiac Stress Test
A stress test, sometimes called a treadmill or exercise test, determines how well
your heart can handle work. You'll be connected to an EKG machine and a blood pressure
cuff and a sensor may be attached to the finger to measure the level of oxygen in
the blood. During the test, the electrical activity of the heart is measured while
you walk on a treadmill. The pace of the treadmill will increase and the incline
will rise during the course of the exercise.
The stress test measures the heart's reaction to your body's increased demand for
oxygen. The test continues until you reach a target heart rate, unless complications
such as chest pain or an exaggerated rise in blood pressure develop with activity.
Monitoring continues after exercise for 10 to 15 minutes or until your heart rate
returns to baseline. The test shows if there is a lack of blood supply throughout
the arteries that go to your heart. Taking a stress test also helps determine if
you have heart disease, how severe it is and the kind of exercises that are appropriate
Nuclear Perfusion Imaging
A stress test with nuclear medicine imaging is a way to determine if the heart muscle
is getting adequate blood supply. The test also helps find out how well your heart
is working. To perform the test, a small amount of a radioactive tracer is injected
into the blood stream through an IV. A special camera is then used to image the
heart. A "rest" image is taken prior to the heart being stressed and a "stress"
image is taken following the stress test.
This stress test is conducted by increasing levels of exercise, combining a slow
walk with a medication that dilates the vessels, or by giving you medication while
sitting (this is reserved for those who are unable to complete a slow, flat walk
for six minutes). The camera is used to view where the radioactive tracer flowed
into the heart muscle at rest as compared to stress.
Although radiation is used, it is safely cleared from the body by natural processes.
A patient is exposed to the same amount of radiation as in a simple X-ray or CT
scan. Millions of nuclear medicine exams are safely performed each year.
Patients with heart failure can usually be treated with a combination of lifestyle
changes and medication to remove excess fluid and improve blood circulation, increasing
the heart's ability to pump and preventing rhythm disturbances.
Patients are offered a regimen that includes drugs to decrease fluid, improve the
pumping capacity of the heart, improve the shape and size of their heart and prolong
survival. Patients with advanced heart disease who are resistant to treatment might
require hospitalization for intravenous medications designed to stabilize their
symptoms. For patients who are not candidates for treatment with the various medications
available, the center has one of the few devices in the region to remove fluid build-up.
There are some patients with more advanced diseases who may be referred to the Transplant
Center at UF Health Shands Hospital in Gainesville.
Jacksonville Heart Failure Specialists
5th Floor, Ambulatory Care Center
655 West 8th Street
Jacksonville, FL 32209