Comprehensive Heart Failure Program | Department of Internal Medicine | UC Davis Health

While heart failure can be caused by medical conditions or family history that you cannot control, there are lifestyle choices can also contribute to heart failure, including: 

Alcohol and Drug Abuse 

Excessive use of alcohol can damage the heart. Illegal substances such as cocaine or methamphetamines can also injure the heart tissues or vessels, leading to heart failure. 

Diet 

Eating foods that are high in saturated fat, sodium, and cholesterol are linked to a higher risk of CAD and high blood pressure, which are common causes of heart failure. 

Obesity   

Extra body weight can cause fatty materials called plaque to build up in the blood vessels (arteries) that carry blood to the body and organs.  If the arteries that bring blood back to the heart get injured or blocked, it can lead to a heart attack or heart failure.  

Diabetes 

High blood sugar levels can damage to your blood vessels. Diabetes can also cause your heart muscle to become stiff. This makes it harder for your heart to pump blood and raises your risk of heart failure. 

Smoking  

Chemicals in cigarette smoke can cause the blood inside your body to thicken and form clots. The clot may eventually block blood flow to the heart, which can lead to a heart attack or sudden death.  

Lack of Regular Exercise  

Regular exercise is important to keep your heart strong and to prevent fatty materials from building up in the blood vessels.  

Heart failure is commonly caused by medical conditions that affect the heart, including: 

• Heart Attack 
• Coronary Artery Disease (CAD) 
• Heart Valve Disease  
• High Blood Pressure.  
• Cardiomyopathy or myocarditis.  
• Heart Arrhythmia.  

Arrhythmias occurs when the heart beats too fast, too slow, or in an irregular pattern. When the heart does not beat normally, it is difficult for it to pump enough blood to the rest of the body.  

• Cardiac Amyloidosis  
• Cardiac Sarcoidosis  
• Pulmonary Arterial Hypertension  
• Heart birth defects.  

This condition occurs when one or more parts of the heart do not form correctly before a baby is born. When this happens, the healthy parts of the heart are forced to work harder. As the child grows into adulthood, the added stress and work on the heart may cause it to fail. 

Your physician will ask about your medical history and do a physical exam. They may also recommend tests to diagnose the type and severity of your heart failure and rule out other health conditions. Your doctor will use information from these tests to determine the best treatment options.  

These tests may include: 

• Blood Tests to see if your other organs, such as the kidneys and liver, are functioning properly. Your doctor may order additional blood tests to measure the levels of certain molecules that are higher during heart failure.  
• Echocardiogram to see the structures of the heart and how it is functioning, using an ultrasound machine 
• Electrocardiogram (EKG or ECG) to show the pattern of your heartbeat. 
• Chest X-Ray to check the size of your heart and to see if there is extra fluid in your heart or lungs. 

• Stress Test to find out how your heart responds to physical activity. 
• Cardiac Nuclear Stress Test using radioactive dye to help measure your heart’s ability to pump blood and its electrical activity.  
• Cardiac Catheterization to get information about the heart or its blood vessels. 
• Cardiac MRI to evaluate the structure and function of the heart muscle. 
• Other tests and procedures that your doctor may recommend to diagnose your heart failure.  

Our  Comprehensive Heart Failure Program is known throughout Northern California and has been recognized as high performing by U.S. News & World Report. 

Our heart failure specialists diagnose and treat all forms of congestive heart failure. We will work closely with you to develop a personalized treatment plan based on your unique needs. Typically, the goals of treating your heart failure are to:  

• Relieve symptoms and improve your quality of life 
• Slow or stop the progression of your heart failure 
• Help you live longer 
• Lower the chances of you needing emergency room visits and hospitalization

Treatment options depend on the type, cause, and severity of your heart failure. Usually, more than one therapy will be used to relieve symptoms and stop or slow the progression of heart failure. Surgery may also be needed to treat heart failure.

Lifestyle Changes 

Treating heart failure often starts with simple lifestyle changes, which can improve or control some of the factors contributing to your heart failure. Your doctor may suggest that you:  

• Eat a heart-healthy diet (low in sodium and fat) 
• Quit smoking and avoid secondhand smoke 
• Quit or limit how much alcohol you drink 
• Stop using substances, such as methamphetamine, that harm the heart 
• Maintaining a healthy weight  
• Exercise regularly  
• Reduce stress 
• Get healthy sleep  

Medications 

There are a number of medications used to treat heart failure and reduce your symptoms. These drugs may lower your blood pressure, reduce water in your body, or help your heart muscles pump easier. Other medications may protect you from heart failure complications like stroke or heart attack. 

Most patients will need to take a combination of medications to treat their heart failure. Common medications your doctor may prescribe include:  

• Angiotensin receptor neprilysin inhibitor (ARNI) 
• Beta-blockers  
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors 
• Mineralocorticoid receptor antagonist (MRA) 
• Diuretic or water pills  
• Digoxin 
• Anti-arrhythmics 
• Weight loss medications 
• Other specialty medications designed for certain types of heart failure

Procedures, Devices and Surgery 

Medical procedures or surgery may be required to treat your heart failure depending on the underlying cause.  Common interventions include restoring the blood flow to blocked areas in the heart, repairing or replacing structures in the heart that are not working properly, or placing devices in the heart that can help treat irregular heartbeats.   

Coronary Artery Bypass Grafting (CABG) 

CABG (heart bypass surgery) uses a healthy artery to reroute (bypass) a blocked artery and improve blood flow.  This is typically a major surgery and involves the surgeon opening the chest to access the heart. However, some patients may be candidates for minimally invasive CABG, which tends to lead to a faster recovery with less pain and scarring. 

Our cardiothoracic surgery team also specializes in using robotic-assisted, laparoscopic techniques to treat CAD. We are one of only a handful of hospitals in the nation that offer a robotic-assisted bypass with angioplasty.  

Angioplasty 
This procedure is used to open blocked arteries and restore blood flow to the heart. During an angioplasty procedure, a thin flexible tube (catheter) through a small incision in the groin or neck. Once the tube has reached the blocked area, a small balloon is inflated to compress the blockage (plaque) against the walls of the artery. A small metal device, called a stent, may also be used as a permanent solution keep the plaque compressed and allow blood to flow freely to the heart. Other types of angioplasty use instruments inserted through the catheter to remove the plaque.  

Heart Valve Repair and Replacement 

Our specialists are nationally recognized for their expertise in treating heart valve disease using transcatheter techniques. This procedure is done using minimally invasive techniques that involve the physician accessing your heart through an artery or vein instead of open-heart surgery. With this approach, you have less pain and a faster recovery. 

Alcohol Septal Ablation 

This nonsurgical procedure treats cardiomyopathy that is causing heart failure. Your physician uses injectable, purified alcohol to shrink enlarged heart tissue. 

Alcohol septal ablation is less invasive than traditional treatment, which involves surgically removing thickened heart muscle. Our physicians are the only specialists in the Sacramento region that offer alcohol septal ablation to treat hypertrophic cardiomyopathy. 

Pacemakers and Defibrillator Devices  

Permanently implanted devices, such as pacemakers or implantable cardioverter-defibrillator (ICD), are used to treat underlying conditions like irregular heartbeats (arrhythmia). 

Advanced Surgical Treatments  

Heart failure may become so severe where normal treatment options no longer help. Advanced surgical and medical intervention options can help improve the heart’s pumping ability or may even involve getting a new heart.  

Impella Percutaneous Support Device 

This small heart pump helps maintain blood flow during procedures that open blocked arteries. The Impella device may also be used to temporarily support your heart while you wait for a more permanent solution to treat your heart failure.  

Extracorporeal Membrane Oxygenation (ECMO) 

ECMO is a short-term life support system. It does the work of your heart and lungs by circulating blood and oxygen through your body. It is used after surgery or when your heart and lungs need support while you regain strength. 

Ventricular Assist Devices (VADs) 

A VAD is a mechanical heart pump. It is used to support your heart by pumping blood through your body. You may have a VAD temporarily while you wait for a heart transplant. Or, some people use a VAD long term, instead of having a heart transplant. 

At our dedicated VAD program, our heart failure specialists offer the latest VADs and provide personalized care and support.  

Heart Transplantation 

If heart failure is severe and life-threatening, your physician may recommend a heart transplant. You’ll typically be placed on a waiting list for a healthy heart from a donor. Our specialists will provide medical support while you wait for your procedure.