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Miami Transplant Institute

Adult Heart

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Having heart failure indicates to us that your heart is not able to function properly.  Patients are referred for heart transplantation when either medical therapy or surgery can not significantly improve their heart function.  There are many types of heart disease, which may cause end-stage cardiomyopathy.

The Heart

Heart failure is not a disease, but the result of conditions that cause the heart muscle to weaken and decrease its pumping ability. The most common reasons for advances heart disease leading to heart failure and transplantation is severe coronary disease and cardiomyopathy.

While coronary artery disease and cardiomyopathy are the most common reasons for transplantation, other disorders of the cardiovascular system can weaken your heart function such as valve disease, congenital heart defects, hypertension, bacterial or viral disease, rheumatic fever, and hereditary defects.

Normally, blood circulates through the heart by way of its four chambers.  Two chambers are on the right side of the heart and two chambers are on the left side.  Each side of the heart has an atrium and a ventricle.  The role of the four chambers is to pump blood by relaxing and contracting.  When heart failure exists, the chambers cannot contract and relax well.

The left ventricle is the main pumping chamber of your heart and responsible to pump oxygen rich blood to the rest of your body and vital organs.  When cardiomyopathy develops, there is a weakening of the heart (cardiac) muscle.

People with cardiomyopathy have poor pump performance, an enlarged heart, and thickening of the muscle walls of the heart.  In addition fluid may build up in the lungs, resulting in shortness of breath with simple activities as bathing, or walking.

The main reason you are referred for a transplant evaluation is that your heart disease is no longer responsive to standard medical treatment or surgery.  Transplantation offers you the potential of living an independent, normal and active life.

It is important that if the transplant team determines that you are a good candidate for transplantation you will be responsible for your new heart.  This means a lifetime management of healthy diet and lifestyle, medications, and medical follow-up.

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Heart Failure

The cardiovascular system is your body's "plumbing" system. It is a network of veins, arteries and capillaries that carry blood to and from the heart. If you have heart failure, damage to your heart causes the entire cardiovascular system to weaken.  When the heart is failing, blood does not flow as it should. Heart failure worsens over time.

Causes

Heart failure affects the condition of all your body's other systems and organs. If the heart failure patient has other diseases, it can be harder to treat. Heart failure can greatly interfere with leading a normal life

Heart failure is described by where it happens and what it causes:

  • Right heart failure is when the right side of the heart doesn't pump correctly. This results in backup of fluid in the body.
  • Left heart failure is when the left side of the heart doesn't pump correctly. This results in backup of fluid in the lungs.
  • Systolic heart failure is when the heart's forward (or squeezing) blood pumping ability is impaired.
  • Diastolic heart failure is when the heart's relaxing ability after each heartbeat is impaired.
  • Congestive heart failure is when the heart doesn't pump correctly and there is high pressure in the heart and veins.

Diagnosis

Your doctor at will do a variety of tests to make sure you have heart failure. An echocardiogram and/or electrocardiogram (EKG) are often used. Your doctor may also order a stress or treadmill test where he will measure your heart's response to exercise. If you are unable to walk on a treadmill, your doctor can use certain medications to create the same effects on the body.

Treatment

Treatment for heart failure is usually medication. In severe cases you may have to stay in the hospital while medicine is given to you by IV. Sometimes only surgery can benefit the patient and control the heart failure, especially if it is due to a heart valve abnormality.

For more information, visit the Uhealth site.

Related Links

Uhealth Heart Failure Program

American Heart Association

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Cardiomyopathy

Your heart's muscular wall is called the myocardium. Cardiomyopathy occurs when the myocardium loses its normal tone and function and cannot function properly.
There are a large number of different mechanisms by which this can occur.

People with cardiomyopathy are often at higher risk for conditions including arrhythmia   (irregular heartbeat) or sudden cardiac death.

Causes

Cardiomyopathy can be caused by:

  • various inherited conditions
  • untreated high blood pressure for a long time
  • heart valve and tissue problems
  • pregnancy
  • diseases (like thyroid disease and diabetes)
  • drug or alcohol abuse
  • viral infections

Types

There are 3 basic types of cardiomyopathy:

Dilated cardiomyopathy is the most common type. The heart cavity is enlarged (dilated) and becomes weak.

Hypertrophic cardiomyopathy is when the heart muscle itself is thicker than it should be. This can obstruct the blood flow of the heart and causes symptoms like dizziness, fainting, and shortness of breath.

Restrictive cardiomyopathy is the least common type of cardiomyopathy in the United States. It occurs when the myocardium of the ventricles becomes too stiff. This prevents the heart from filling properly with blood in between heartbeats.

Diagnosis

To diagnose cardiomyopathy, your doctor at Vanderbilt Heart will examine you, learn about your health history and ask questions about your symptoms. He or she may want to do blood tests, chest X-rays, an echocardiogram and or electrocardiogram (EKG).

Your cardiologist may also perform a cardiac catheterization and angiogram. A cardiac MRI scan may also be required.

Treatment

Treatment for cardiomyopathy ranges from medication to surgery, depending on the type of cardiomyopathy and how bad it is. In the most severe cases, you may need a heart transplant.

Related Link

UHealth Heart Failue

American Heart Association

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Adult Lung and Heart-Lung Transplant

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