Heart Failure: When Do You Need A Specialist?

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There are nearly 7 million patients in the United States diagnosed with heart failure. Unfortunately, studies suggest that at least 80% of people with heart failure are not receiving the advanced treatments that can improve their life and reduce their chances of death.

But that can be avoided by asking your provider for a referral to a board-certified advanced heart failure specialist, says Henry Ford cardiologist Jennifer Cowger, M.D., a nationally recognized specialist who works closely with the Heart Failure Society of America and the American College of Cardiology to educate patients to be proactive and seek out heart failure consultation. 

“If you’re diagnosed with cancer, you want to see a cancer specialist,” Dr. Cowger says. “Could you imagine if your primary care doctor said you have lung cancer but they are just going to watch your tumor for now? If you’re diagnosed with severe heart failure, you should see a specialist in that, too. Mortality from heart failure is higher than many cancers at five years. Everyone’s terrified of cancer, but heart failure kills more people and the disease is on the rise in the U.S.”

The reason behind the lack of referrals is simple: The heart failure specialty is relatively new and few hospitals have heart failure specialists on staff. But it’s particularly important to see a specialist in light of heart failure statistics. While survival is improving, nearly 30% of patients die within one year of a heart failure diagnosis and 40-50% die within five years, Dr. Cowger explains.

“We have options to treat severe heart failure that other cardiologists don’t have available at their medical practices,” Dr. Cowger says. “Unfortunately, a lot of patients aren’t getting referred in a timely manner. Too many people are coming to us too late -- with organs failing -- and we have lost that key window to help them live. If you have more than two admissions in a year or you can’t walk a local grocery store due to shortness of breath, you may want to be seen by a heart failure specialist.”

How A Heart Failure Specialist Can Make A Difference 

Importantly, heart failure specialists know when to consider intense treatments, like a Left Ventricular Assist Device (LVAD) heart pump or heart transplant. Only three hospitals in Michigan offer these options to patients, including Henry Ford Hospital in Detroit.

Advanced heart failure specialists are also trained to identify and treat less common diseases, such as sarcoidosis (a rare inflammatory condition where clusters of white blood cells form in the tissue of the heart) and amyloidosis (a rare disease where a substance called amyloid builds up in the heart).

Finally, advanced heart failure specialists have access to clinical trials testing new medications and devices for the treatment of heart failure. For example, trials are currently underway at Henry Ford with two new devices aimed at improving heart failure survival and reducing hospitalizations. Both devices are small implantable chips -- the height of a dime -- that are inserted without formal surgery or high risk. These microchips transmit data to your local heart failure cardiologists daily using cellular technology, informing him or her if you are retaining fluid or becoming dehydrated.

“The doctor gets an email: ‘Mr. Smith is retaining fluid,’ and the doctor or staff can respond to these numbers by calling the patient, checking in on symptoms, and adjusting medications,” Dr. Cowger says. “While the implantation procedure is easy, most centers do not have the team necessary to monitor these devices and make the calls needed. Options like these can keep people out of the hospital, living and breathing better.”

If you or a loved one is living with heart failure, talk to your doctor or cardiologist about seeing a heart failure specialist.


To learn more about advanced heart failure treatment at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

Dr. Jennifer Cowger is a cardiologist specializing in caring for patients with severe heart failure, as well as those who have had — or are being considered for — a heart transplant or LVAD). She sees patients at Henry Ford Hospital in Detroit. 

Categories: FeelWell