Understanding Advanced Heart Failure and Left Ventricular Assist Devices

What is advanced heart failure?

Heart failure happens over time. In its early stages, your heart may be weaker. It may not be weak enough to cause any symptoms yet. But as the condition gets worse, you may start to suffer from extreme tiredness (fatigue) and shortness of breath. These symptoms may occur only when you exercise or do things like climbing stairs.

Lifestyle changes and medicine can often help ease the symptoms of heart failure. You may feel better for a time. But your heart may continue to get weak. Over time, you may develop advanced heart failure. That’s when you have symptoms even at rest. Treatments with medicine may no longer work well enough.

What are the symptoms of advanced heart failure?

In advanced heart failure, daily activities like dressing may become hard to do. You may feel extreme fatigue. You may also have swelling in your legs, ankles, feet, and belly (abdomen). Swelling happens because fluid builds up in your body.

Other symptoms of advanced heart failure include:

• Trouble breathing while sleeping, at rest, or with small amounts of activity.

• Chest congestion.

• Weight gain from fluid buildup.

• Weight loss from a lack of appetite.

• Chest pain.

• Lightheadedness.

• Heart palpitations or flutters, or racing heartbeat.

• Abnormal heart rhythms (arrhythmias).

• Depression.

• Dizziness or confusion that is new or getting worse.

• Low blood pressure.

How can an LVAD help with advanced heart failure?

Advanced long-term (permanent) heart failure can be cured only with a heart transplant. But you may have to wait some time for a donor heart. Or you may not be able to have a heart transplant because of your age or other health problems, such as kidney disease. In these cases, an LVAD can help you feel better and be more active. It may extend your life.

An LVAD can ease your symptoms while you are waiting for a transplant. This is called a bridge to transplantation. If you can’t have a transplant, you may use an LVAD as long-term treatment for your heart failure. This is called destination therapy.

Is an LVAD right for you?

Before you can have an LVAD implanted, your health care provider will talk with you about the benefits and risks. They will have to figure out if an LVAD is right for you. You'll need some tests to check on your heart and overall health. You also need to be healthy enough to have the surgery.

Living with an LVAD can be challenging. It needs a lot of follow-up care. You'll need periodic checkups and tests. You'll also have to make some lifestyle changes. A care team will help you make the transition to living with an LVAD.