Heart Failure Program
Broward Health’s Heart Failure Program offers high-quality, compassionate care for patients experiencing heart failure. Our multi-disciplinary team of specialists helps patients improve their quality of life through early detection, advanced treatment options, lifestyle changes, medication management, and much more.
Under the direction of a heart failure cardiologist, our team includes nurse practitioners, dietitians, pharmacists, case managers patient educators, and other caregivers. Working together, we offer patients personalized, comprehensive care to help them achieve positive, long-term outcomes.
If you or someone you love is struggling with heart failure, our Heart Failure Program is a great source of information, education and support. Our team of specialists work one-on-one with patients to help them understand and manage heart failure.
Our Heart Failure Education and Support Group
Living with heart failure isn't always easy, and many patients must change their lifestyle habits as a result.
Broward Health is proud to offer a free, monthly support group for patients living with or at-risk for heart failure and their loved ones. The group meets virtually on the third Tuesday of each month from 2 to 3 p.m. Patients may register at BrowardHealth.org/Events or call 954.759.7400. Prior to the meeting, a WebEx link will be emailed to participants.
Our Cardiac Rehabilitation Program
Cardiac Rehabilitation is a medically supervised program consisting of exercise, education, counseling and training that helps patients with heart disease achieve and maintain a healthy lifestyle. The Cardiac Rehabilitation program at the Broward Health Wellness Center includes three, 60-minute sessions each over a three-month period. Using state-of-the-art equipment, patients enjoy a personalized exercise program tailored to achieve their individual fitness goals, Our Cardiac Rehab is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Please contact us at 954.712.4275.
What is Heart Failure?
Your heart is a muscle that pumps blood throughout your body. If you have heart failure, your heart cannot pump blood efficiently and your body may not get all the blood and oxygen it needs to function normally.
When your heart can’t function properly, some blood and fluid may back up in your lungs, feet, and other parts of your body. While there’s no cure for heart failure, the condition is treatable through proper medications, lifestyle changes, and support.
Types of Heart Failure We Treat:
Left-sided heart failure (Failure to properly pump out blood to the body)
There are two types of left-sided heart failure:
- Heart failure with reduced ejection fraction (HFrEF), also called systolic failure: The left ventricle loses its ability to contract normally. The heart can’t pump with enough force to push enough blood into circulation.
- Heart failure with preserved ejection fraction (HFpEF), also called diastolic failure: The left ventricle loses its ability to relax normally (because the muscle has become stiff). The heart can’t properly fill with blood during the resting period between each beat.
Right-sided heart failure (Back-ups in the area that collects "used" blood)
The heart's pumping action moves "used" blood that returns to the heart through the veins through the right atrium into the right ventricle. The right ventricle then pumps the blood back out of the heart into the lungs to be replenished with oxygen.
Right-sided or right ventricular (RV) heart failure usually occurs as a result of left-sided failure. When the left ventricle fails, increased fluid pressure is, in effect, transferred back through the lungs, ultimately damaging the heart's right side. When the right side loses pumping power, blood backs up in the body's veins. This usually causes swelling or congestion in the legs, ankles and swelling within the abdomen.
What Causes Heart Failure?
Heart failure can be caused by many factors, including:
- Heart attack (or myocardial infarction)
- Plaque buildup in the arteries of your heart (or coronary artery disease)
- Viruses infecting the heart
- Abnormal genes that get passed down in a family (familial cardiomyopathy)
- High blood pressure
- Faulty heart valves
- Abnormal heart rhythm (arrhythmia)
- Heart defects present at birth (congenital heart disease)
- Pregnancy
- Alcohol or drug use
- Some cancer drugs
- Obstructive sleep apnea
Symptoms of Heart Failure
Patients with heart failure may have the following symptoms:
- Shortness of breath, when lying down, at rest or with exertion
- Increased swelling of legs, feet, and ankles
- Persistent dry hacking cough or wheezing
- Sudden weight gain (fluid build-up)
- Loss of appetite or nausea
- Discomfort or swelling in the abdomen
- Increased trouble sleeping
- Increased heart rate
- Impaired thinking
- Loss of muscle
- Overall feeling of being tired or run-down
Common Tests for Heart Failure
To determine whether you have heart failure, our healthcare team may perform the following diagnostic tests and procedures.
- Physical examination
- Blood tests
- Chest x-ray
- Electrocardiogram (EKG or ECG)
- Echocardiogram
- Exercise stress test
- Cardiac catheterization
- Magnetic resonance imaging (MRI)
Heart Failure Treatment
Treating heart failure usually includes a combination of medications, lifestyle changes, and devices or surgical procedures.
Medications
At Broward Health, our physicians prescribe various medications to improve your heart function and quality of life.
Medications may include:
- Angiotensin-converting enzyme (ACE) inhibitors: This medication helps relax your veins and arteries to lower your blood pressure. Examples of this medications include:
- Captopril (Capoten)
- Enalapril (Vasotec)
- Fosinopril (Monopril)
- Lisinopril (Prinivil, Zestril)
- Quinapril (Accupril)
- Ramipril (Altace)
- Angiotensin II receptor blockers (ARBs): These medications are prescribed If ACE inhibitors are not tolerated, including:
- Candesartan (Atacand)
- Losartan (Cozaar)
- Valsartan (Diovan)
- Angiotensin-receptor neprilysin inhibitors (ARNIs): This medication relaxes blood vessels, improves blood flow and reduces stress to the heart.
- Sacubitril/valsartan (Entresto)
- Sacubitril/valsartan (Entresto)
- Beta blockers: This medication slows your heartbeat, allowing your heart to work more efficiently:
- Carvedilol (Coreg)
- Metoprolol succinate (Toprol XL)
- Bisoprolol (Zebeta)
- Aldosterone antagonists: These medications reduce sodium and water retention by blocking the effects of the hormone aldosterone.
- Spironolactone (Aldactone)
- Eplerenone (Inspra)
- Diuretics (“water pills”): These medications help your body eliminate excess fluid and salt
- Furosemide (Lasix)
- Bumetanide (Bumex)
- Torsemide (Demadex)
- Chlorothiazide (Diuril)
- Hydralazine and isosorbide dinitrate dilates your blood vessels, allowing your heart to work more efficiently. This medication specifically benefits African-Americans with heart failure.
Other medications might be prescribed depending on your condition, including
- Cholesterol lowering drugs (statins)
- Anticoagulants (blood thinners)
- Antiarrhythmics, which help maintain normal heart rhythm
Lifestyle Changes
Important life changes will help your heart work more efficiently, including.
- A heart-healthy diet
- Regular exercise
- Avoid tobacco or drug use
- Avoid or limit excessive amounts of alcohol
- Keep track of any symptoms
- Monitor your blood pressure
- Practice healthy sleep habits
- Obtain recommended vaccines to prevent illnesses, such as pneumonia or the flu
- Track your daily fluid intake
Cardiac Rehab
Cardiac rehab is a medically supervised program that includes exercise training, education on heart-healthy living, as well as counseling to reduce stress. The program’s goal is to stabilize, slow or even reverse the progression of heart failure, which can reduce a patient’s risk for heart disease, a future cardiac event, or even death:
Broward Health’s cardiac rehab programs usually provides:
- A medical evaluation to determine your needs and limitations
- A personalized physical activity program
- Counseling and education to help you understand your condition and how to manage it
- Support and training to help you return to work or your normal activities
- Counseling on modifying risk factors through diet and nutrition
- Counseling on the use of prescribed medications
Devices and Surgical Procedures
Patients may need devices or surgical procedures to treat heart failure. Procedures may include:
- Implantable Cardioverter-Defibrillator (ICD): A surgically placed device, which can treat life-threatening heart rhythms to help prevent sudden cardiac death.
- Cardiac Resynchronization Therapy (CRT): (Also known as biventricular pacing). This therapy coordinates timing of the upper heart chambers (atria) and the lower heart chambers (ventricles).
- CRT can improve a patient’s heart function, which reduces hospitalization risks and increase chances of survival.
- Percutaneous coronary intervention (PCI): (Also known as angioplasty) A procedure to reopen blocked blood vessels.
- Cardiac bypass surgery: This surgery restores flow through the heart’s arteries by rerouting the blood supply around a blocked section of an artery.
- Valve surgery: This surgery repairs or replaces a heart valves. In some patients, heart valve replacement may occur without surgery. Candidacy for this kind of procedure is highly individualized.
Treating Advanced Heart Failure
Patients with severe, progressive heart failure may require more advanced treatment options. Our heart failure team determines when more in-depth treatments are needed, and guide patients through the process. Advanced treatment options include:
- Heart Transplantation
- During heart transplantation, a patient’s diseased heart is replaced with a healthy heart through organ donation.
- Left Ventricular Assist Device (LVAD)
- An LVAD is a mechanical heart pump attached to the left side of the patient’s heart, which helps blood pump throughout the body. LVADs are used for patients awaiting heart transplants. LVADs can also be used as a more permanent treatment option, with some patients using a heart pump for many years.
- An LVAD is a mechanical heart pump attached to the left side of the patient’s heart, which helps blood pump throughout the body. LVADs are used for patients awaiting heart transplants. LVADs can also be used as a more permanent treatment option, with some patients using a heart pump for many years.
About the Director
Yordanka I. Reyna, MD, FACC
Director of Broward Health's Heart Failure Services
Dr. Reyna is a cardiologist, specializing in advanced heart failure and cardiac transplantation. Her clinical specialty and interests are cardiomyopathies, heart failure, cardiac transplantation, mechanical circulatory support, pulmonary hypertension, echocardiography, cardiac care of women, and cardiopulmonary stress testing. Dr. Reyna has extensive teaching experience educating medical students, residents, and fellows. She currently serves as an Internal Medicine and Cardiology faculty member at Broward Health. As an investigator, she has also participated in numerous clinical studies on medications and therapies for heart failure and pulmonary hypertension. Dr. Reyna is board certified by the ABIM in Internal Medicine, Cardiology, Advanced Heart Failure Transplant Cardiology and Echocardiography.
Dr. Reyna attended the University of Miami in Coral Gables, Florida graduating with a Bachelor of Arts degree in Biology. She then attended medical school at Ross University School of Medicine and graduated with highest honors. She completed her Internal Medicine residency training at Cleveland Clinic Florida, where she was awarded the Outstanding Resident Award. Subsequently, her Cardiology fellowship was also completed at the Cleveland Clinic where she served as Chief Cardiology Fellow. She finalized her training with an Advanced Heart Failure and Cardiac Transplantation Fellowship at Cleveland Clinic in Ohio.