Heart Failure occurs when the heart muscle begins to weaken and does not efficiently pump oxygen-rich blood to the body as well as it should.  This weakening, or failure, generally happens slowly over time and occurs when the heart is affected by the hardening or narrowing of the coronary arteries or coronary artery disease (CAD).  Many times high blood pressure, pulmonary hypertension and cardiomyopathy are related illnesses that can also accompany various stages of heart failure.   

Heart failure begins to occur when the heart muscle has to work overtime and pump faster to get sufficient blood flow to vital areas of the body.  This additional work causes the heart muscle to become enlarged.  A patient may go years without any symptoms of heart failure as it has a slow onset and progression. The weakening of the heart eventually results in a build up of congestion, or fluids, in the heart, lungs and other tissues in the body which is known as congestive heart failure (CHF).

At times patients with CHF or advanced CHF may need a left ventricular assistance device (LVAD) or heart transplant surgery to partially or completely repair the function of a failing heart.  Cardiology Associates has an experienced team to treat patients with CHF as well as those with more advanced heart failure who may be pre or post transplant.  

Dr. Ken Burnham, a fellowship trained cardiologist, with a sub-specialty fellowship in heart failure and cardiac transplantation along with the full team of cardiovascular specialists, electrophysiologists and trained clinical staff at Cardiology Associates are experienced in treating heart failure patients using a sophisticated level of expertise and knowledge of treatment protocols ensuring the best possible patient outcomes.

What are symptoms of CHF or advanced heart failure?

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  • Shortness of breath

  • Fluid retention (edema)

  • Unusual fatigue

  • Persistent coughing/wheezing

  • Gastric/Stomach pains

  • Loss of appetite

  • Nausea

  • Increased heart rate


What are the risk factors for CHF or advanced heart failure? 

  • Previous heart attack

  • Coronary Artery Disease

  • Hypertension (high blood pressure)

  • Arrhythmia (irregular heart beat)

  • Heart valve disease (especially of the aortic and mitral valves)

  • Cardiomyopathy (damage of the heart muscle)

  • Congential heart defects

  • Myocarditis

  • Alcohol and drug abuse

How is CHF or advanced heart failure diagnosed?

If you or a family member experience any of the symptoms noted above you should see a physician.  It is also important to have regular check-ups even if symptoms are not present.  After a physical examination and review of a the patient's history and current medications your physician may order additional tests or procedures to determine the nature of why the heart has weakened. 

These tests may include:

A few of the tests above will indicate a patient's ejection fraction (EF) percentage.  It is important to be aware of your EF as it is an important measurement to determine how well you heart is pumping blood.  An EF of 65% indicates that 65% of the blood in the left ventrical of the heart is pushed out to the body with each beat.   A normal EF is typically between 50-70%, however,  it is possible to have a normal EF and still have heart failure.  

An EF of 40% or below may be an indication of heart failure or cardiomyopathy.   An EF of above 70% can be an indication of hypertrophic cardiomyopathy. 

How is CHF or advanced heart failure treated?

Once the severity and cause of the heart failure is identified your physician may treat it with medications, lifestyle modifications or, in more advanced cases, recommend a specialized ICD or pacemaker which are designed to help manage heart failure.  This is also known as cardiac resynchronization therapy (CRT).

Current Heart Failure Patient Information

OVER-THE-COUNTER MEDICATIONS: Click button below for a list of approved over-the-counter medications for Cardiology Associates heart failure patients. If you have questions prior to taking any medications, please contact our office at 251-607-9797.


Heart Failure Specialist


Kenneth M. Burnham, MD, FACC

Advanced Heart Failure and Transplant

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