Heart Failure Program

For decades, Hoag’s Jeffrey M. Carlton Heart and Vascular Institute has been Orange County’s source for expert care and cardiovascular health. Our Heart Failure Program includes a world-class team of cardiologists, cardiothoracic surgeons and cardiac rehabilitation specialists are committed to a team-based approach to treating heart disease, with a focus on early detection and a dedication to delivering the most effective and patient-centered care. That dedication is why U.S. News & World Report rated Hoag among the best hospitals in the nation for Heart Failure in 2024-2025.

In Orange County, patients with heart failure understand: there’s just no place like Hoag. Connect with our team today through by calling 949-764-5384.

What is Heart Failure?

Heart failure is a serious and potentially life-threatening condition in which the heart’s ability to pump enough blood to keep the organs and tissues healthy can be greatly reduced.

While it’s called “heart failure,” that doesn’t mean the heart will stop. It just means the heart isn’t functioning as efficiently as it should — that the heart is failing at its primary job to efficiently pump oxygenated blood to the organs and tissues. That said, those with severe or very advanced heart failure can be at significantly higher risk of cardiac arrest and sudden death.

Heart failure can result from a variety of causes, including lifestyle factors and conditions like heart valve problems, high blood pressure, diabetes, coronary artery disease and more.

Visit the following links to learn more about conditions that we manage and treat in the Heart Failure Program at Hoag:

• Heart Failure Overview

• Cardiomyopathy

• Left-Ventricular Hypertrophy

• Constrictive Pericarditis

• Endocarditis

How is Heart Failure Diagnosed?

If you visit a physician or emergency room with symptoms that suggest you may be experiencing heart failure, you will usually be given a thorough physical examination.

During this examination, you’ll likely be asked a series of questions, including about your family history of cardiac issues, your personal history of heart problems or cardiac procedures, the symptoms you are experiencing and more.

Depending on the outcome of the initial exam, you may be referred to a cardiologist, or a specialist in the medical condition that is causing your heart to fail.

You may also be asked to submit to certain tests and medical exams that can further diagnose or rule out heart failure, help your doctor assess why you are experiencing heart failure or help pinpoint the most effective treatment options for you.

Seeking diagnosis and treatment for heart failure in its earliest stages is crucial to preserve patients’ quality of life, helping those with the condition avoid the most serious symptoms of heart failure while improving the flow of oxygen-rich blood to the body.

Which Medical Exams or Tests are Used to Diagnose Heart Failure?

There are several different types of tests used in the diagnosis of heart failure. These may include:

Imaging Tests

• Cardiac MRI, which uses magnetic fields and radio waves to create detailed images of the heart and coronary arteries.

• Cardiac CT scan, which creates precise images of the heart and coronary arteries by taking multiple x-rays of the heart. Types of cardiac CT scanning include coronary calcium scans to check for the buildup of calcium in the coronary arteries, and CT angiography, which evaluates the coronary arteries for narrowing or blockage.

• Chest X-ray

• Echocardiogram with 3D technology, which is an advanced, non-invasive form of echocardiography which uses sound waves to make detailed, three-dimensional images of the heart.

• Transesophageal Echocardiogram (TEE), which is a form of echocardiogram that involves inserting a special ultrasound transducer down the esophagus so it can be placed closer to the heart. This allows physicians to capture very detailed images of the heart without structures like the ribs, sternum or chest muscles getting in the way.

Blood Testing

In cases of suspected heart failure, blood testing is useful to evaluate the body for high levels of cholesterol that can lead to atherosclerosis, check liver and kidney function and more.

In addition, blood tests can check for certain chemicals in the blood that can become elevated in those with heart failure, including brain natriuretic peptide (BNP), which increases when the heart can’t pump as efficiently as it should.

Tests of the Heart’s Electrical Activity

Electrocardiogram (EKG) is a special, non-invasive test that measures the electrical activity of the heart and the regularity of the heartbeat. In many cases, it’s one of the first tests used to diagnose those who are suspected to have a cardiac condition, including heart failure. The electrocardiogram test is painless and non-invasive, with readings taken through sticky, conductive pads that are adhered to the skin of the chest.

Cardiac Catheterization

Cardiac catheterization with coronary angiography is a procedure used to create detailed images of the heart and determine whether any of the coronary arteries that supply the heart are narrowed or blocked.

During the procedure, a thin tube called a catheter is inserted into a blood vessel, usually in the leg, arm or groin. The catheter is then guided through the circulatory system to the heart. Once the catheter is in place, a special contrast dye is injected which makes the structures of the heart, including the coronary arteries, show up much more clearly on X-rays.

After the dye is injected, X-rays of the chest are taken, creating very detailed images that allow cardiologists to evaluate the heart for conditions that can result in heart failure, potentially helping determine what is causing the condition.

Tests to Measure Ejection Fraction

Ejection fraction is a medical term that refers to how much oxygen-rich blood the left ventricle — the heart’s main pumping chamber — pumps out each time the heart squeezes or contracts.

In a healthy heart with normal ejection fraction, the left ventricle fully relaxes and fills with blood, then squeezes and pumps out more than 50 percent of the blood it contains with every heartbeat.

If their left ventricle pumps out 40 percent or less of the blood it contains with each beat, a person likely has heart failure with reduced ejection fraction, also called HFrEF or systolic heart failure. That can reduce the amount of oxygenated blood available to the organs and tissues, which can cause or contribute to a range of conditions.

People can also suffer diastolic heart failure, also known as heart failure with preserved ejection fraction or HFpEF. In those with diastolic heart failure, the heart pumps at least 50 percent of the blood the left ventricle contains. But because the heart can’t fully relax and fill with blood due to the walls of the heart chambers becoming inflexible and stiff, the flow of oxygenated blood to the organs and tissues is reduced.

Tests to evaluate ejection fraction include:

• Echocardiogram

• CT Scan

• Cardiac catheterization

• Nuclear stress testing, which is a special test that creates images of the heart while the patient is performing some form of exercise.

• Multiple-Gated Acquisition (MUGA) Scans: also called radionuclide angiography or radionuclide ventriculography, a MUGA scan is a form of nuclear imaging that specifically evaluates ejection fraction and whether the heart is functioning efficiently.

Cardiac Biopsy

To diagnose certain conditions that can lead to heart failure by causing deterioration of the heart muscle (the myocardium), physicians may perform what’s called a myocardial biopsy. During this test, a needle is used to extract tiny pieces of the heart muscle. These tissue samples are then examined in a lab.

Need a Heart Failure Specialist Near You? Hoag is Committed to Delivering the Best Cardiac Care in Orange County.

Every day at Hoag’s Jeffrey M. Carlton Heart and Vascular Institute, our team of heart disease experts is setting the standard for heart failure care.

This advanced, patient-focused hub in Orange County, features the tools, talent and techniques you need to get back in the game after a heart failure diagnosis. That includes state-of-the-art diagnostic technology, and a team of board-certified cardiologists, ready to work collaboratively to improve outcomes for every patient and get you back to living life to the fullest.

That dedication is why U.S. News & World Report rated Hoag among the best hospitals in the nation for Heart Failure in 2024-2025.

So don’t wait. Contact us by calling 949-764-5384.

According to the CDC, over 6.2 million adults in the U.S. have heart failure. But those in need of heart failure treatment in Orange County can count on Hoag. The Heart Failure Program at Hoag’s Jeffrey M. Carlton Heart and Vascular Institute sets the standard for heart failure treatment and diagnosis in Orange County.

With a focus on advanced technology, prevention and early detection, coupled with a team-based approach to patient-centered care, we’re pioneering tomorrow’s most effective therapies and delivering the heart failure care Orange County residents deserve. It’s why U.S. News and World Report named Hoag a 2024-2025 High-Performing Hospital — their highest distinction — for Heart Failure care.

Learn more about how heart failure is treated at Hoag or connect with our team today by calling 949-764-5384.

What is Heart Failure?

Heart failure is a potentially life-threatening condition in which the heart becomes unable to pump enough blood to keep the organs and tissues healthy.

Heart failure is a progressive condition, meaning it can get worse over time if not diagnosed, managed and treated properly. In very advanced or severe cases, heart failure can even result in death.

There are several medical conditions, lifestyle factors and other issues that can lead to or contribute to heart failure, including heart valve problems, changes to the consistency of the heart muscle, congenital heart defects that are present at birth and more.

Visit the following links to learn more about heart failure, including causes, types, symptoms, potential complications and risk factors:

• Heart Failure Overview

• Cardiomyopathy

• Left-Ventricular Hypertrophy

• Constrictive Pericarditis

• Endocarditis

Hoag’s Heart Failure Management Tool

Check out Hoag’s easy-to-use heart failure management tool for helpful tips to manage symptoms and know when to seek medical help.

How is Heart Failure Treated?

The treatment options for heart failure can vary from patient to patient depending on several factors, including the underlying cause, the patient’s age and overall health, how much damage has been done to the heart and other considerations.

Visit here to learn more about some of the advanced methods we use at Hoag to diagnose heart failure.

The good news is that treatment options for heart failure have greatly advanced in the past few decades, including medications, implantable devices, less-invasive surgical procedures and more. Taking advantage of today’s advanced heart failure treatment options can often help heart failure patients control symptoms, slow disease progression and improve outcomes.

Treatment options for patients with heart failure may include:

Monitoring and Lifestyle Changes

Those diagnosed with heart failure will likely have to be monitored by their primary care physician and cardiologist for the rest of their life.

Lifestyle changes are often part of the recommended treatment plan after a diagnosis of heart failure. These changes may include:

• Eating a heart-healthy diet that’s low in fat, sugar, salt and carbohydrates, with plenty of fruits and vegetables

• Getting regular cardiovascular exercise, as their condition allows

• Treating any conditions that might be contributing to heart failure, including diabetes, high blood pressure or high cholesterol levels

• Taking steps to lower stress

• Quitting smoking

• Quitting certain types of illegal drugs, and drinking alcohol in moderation

Medications

Medications are usually part of the treatment plan for heart failure, helping control symptoms, treat what’s causing the condition and slow the progression of the disease. Medications that may be prescribed to treat heart failure include:

• ACE inhibitors and ARBs, which reduce blood pressure and the stress placed on the heart, which can improve the heart’s ability to pump blood.

• Beta blockers to slow the heart rate and decrease blood pressure.

• Diuretics, commonly known as “water pills” to remove excess fluid from the body and treat fluid retention, reduce swelling and help ease breathing difficulties.

• Digoxin, which can regulate the rhythm of the heart and strengthen cardiac contractions, helping the heart increase oxygen-rich blood flow to the organs and tissues.

• Blood thinners, which can help prevent the blood clots some types of heart failure can cause.

Surgically-Implanted Devices

In those with heart failure, surgically-implanted devices are often used to help regulate the function or rhythm of the heart. Types of surgically-implanted devices used to treat heart failure may include:

• Traditional pacemakers, which are implantable devices that are used to monitor and correct irregular heartbeat (arrhythmia) issues like atrial fibrillation. Traditional pacemakers are usually implanted under the skin of the chest and connected to the heart by insulated wires called “leads.”

• Leadless pacemakers: Installed through less-invasive procedures, leadless pacemakers reduce complications and promote quicker recovery by eliminating the need for wires to connect the device to the heart. Hoag was one of the first treatment centers in the U.S. to implant the Abbott AVEIR™ DR, the first dual-chamber leadless pacemaker. Read the story of a Hoag patient whose life was changed by this pioneering device.

• Implantable cardioverter-defibrillators (ICDs), which are implanted devices that monitor for and automatically correct dangerous heart rhythms by delivering a precise shock to the heart muscle.

• Left-ventricular assist devices (LVADs), which are miniaturized mechanical pumps that are implanted in the body to support the heart’s ability to pump blood. LVADs are often used in very severe cases of heart failure, improving heart function until a surgical procedure can be performed, or to provide better quality of life for end-stage heart failure patients who aren’t good candidates for transplant or surgery.

• Cardiac Resynchronization Therapy (CRT): Patients with heart failure can sometimes develop arrhythmia, which is an abnormal or irregular heartbeat. In some cases, an arrhythmia can interfere with coordination between different chambers of the heart, compromising the ability of the heart to efficiently pump blood to the organs and tissues. Cardiac resynchronization therapy, also called biventricular pacing, involves the implantation of a special kind of pacemaker that detects when the chambers of the heart are out of sync. When the CRT device detects a dangerous imbalance, it sends out electrical impulses that “reboot” the heart into a more synchronized rhythm.

Surgical Procedures

In some cases, heart failure treatment may include one or more surgical procedures to address a condition that is contributing to or causing heart failure. These procedures may include:

• Alcohol septal ablation: Alcohol septal ablation is a less-invasive technique used to treat certain conditions that can cause heart failure, including hypertrophic cardiomyopathy. During the procedure, ethanol (a type of alcohol) is injected into the artery that supplies blood to a section of heart muscle that has become thickened. That causes cells in that part of the heart muscle to die, reducing the muscle’s thickness.

• Percutaneous Coronary Intervention (PCI) is a minimally-invasive, catheter-delivered procedure that’s used to reopen arteries supplying the heart that have been narrowed or blocked by atherosclerosis — a condition called coronary artery disease, which is often present in those with heart failure. During the procedure, a physician inserts a thin, flexible tube called a catheter into a blood vessel then guides it through the circulatory system to a narrowed or blocked coronary artery. A small balloon at the end of the catheter is then inflated, forcing opening the artery. Once blood flow is restored, a mesh tube called a stent is usually inserted into the artery, holding it open and preventing it from becoming blocked again.

• Coronary Artery Bypass Grafting (CABG): Another procedure used to treat the coronary artery disease that sometimes contributes to heart failure, Coronary Artery Bypass Grafting (CABG) is a surgical technique in which blood vessels are removed from another part of the body and then surgically implanted to re-route blood flow around a blocked or severely narrowed coronary artery. Visit this link to read more about coronary artery disease from Hoag.

• Heart Valve Repair or Replacement: In some cases, heart failure can be caused by a damaged or defective heart valve — one of the four natural gates that regulate one-way blood flow through the heart. Heart valve repair, in which the damaged or diseased valve is surgically reinforced or corrected, is generally seen as preferable to heart valve replacement, in which the valve is completely removed and replaced with a mechanical or donor valve.

• Heart transplant: Used to treat very severe or terminal cases of heart failure, a heart transplant is a procedure in which the patient’s diseased or damaged heart is removed and replaced with a healthy heart from a human donor.

Cardiac Rehabilitation

Cardiac rehabilitation is a physician-monitored outpatient program that helps people with serious heart conditions improve cardiac function and quality of life through physical exercise, heart-health education, recovery support and other steps to reduce and manage symptoms. Heart failure patients who meet certain requirements may benefit from cardiac rehab.

Hoag’s Jeffrey M. Carlton Heart and Vascular Institute offers two convenient cardiac rehabilitation locations in Orange County: Newport Beach and Irvine. Our team is committed to helping patients recover more fully after a cardiac issue or heart procedure. Cardiac rehabilitation is by referral only. Learn more about cardiac rehabilitation at Hoag here.

How is Advanced Heart Failure Treated?

In Stage D, or End Stage Heart Failure, patients with this form of advanced heart failure have symptoms that do not get better with maximal medical therapy. Stage D is sometimes called Stage D HFrEF, short for heart failure with reduced ejection fraction.

The treatment options for advanced heart failure can vary based on several factors. The following treatment options may be considered: heart surgery, percutaneous mechanical circulatory assist devices, extracorporeal membrane oxygenation (ECMO), referral for heart transplant, as well as palliative or hospice care.

For Heart Failure, Patients From Long Beach to San Clemente Choose Hoag in Orange County.

When you’re facing a progressive disease like heart failure, you don’t have time for a mistaken diagnosis or treatments that don’t improve your symptoms. You need the team with the tools, techniques and technology to hit the ground running, and get you back to living life to the fullest.

For those in need of heart failure treatment in Orange County, that team can be found close to home, at Hoag. The Heart Failure Program at Hoag’s Jeffrey M. Carlton Heart and Vascular Institute is setting Orange County’s standard for advanced cardiac care, with a collaborative, patient-centered approach that puts you first.

That dedication is why U.S. News & World Report rated Hoag among the best hospitals in the nation for Heart Failure in 2024-2025.

It’s why Hoag has been honored with the American Heart Association’s GOLD PLUS Get With The Guidelines Heart Failure quality achievement award, recognizing our efforts to improve outcomes and reduce readmissions for heart failure patients.

From early detection, education and prevention to innovative treatment options in Orange County, there’s no place like Hoag. So if you’ve been diagnosed with heart failure, don’t wait. Contact Hoag today by calling 949-764-5384.