Advanced Heart Failure

Heart failure is considered advanced when conventional treatments stop working and heart failure symptoms are experienced with minimal or no activity. In addition, people with advanced heart failure are often repeatedly hospitalized and have evidence of organ damage.


Our Approach to Treating Advanced Heart Failure

Our advanced heart failure specialists work as a team to evaluate, diagnose and treat advanced-stage heart failure. We work to identify the underlying cause, level of disease severity and most effective treatment options — tailoring our assessments to your specific condition and unique circumstances.

To avoid or delay the need for heart replacement (heart transplant), our specialists are committed to exploring options that can stabilize your heart. We also work with experts from other specialties to offer any procedures or devices surgery that can further optimize your heart.


Expertise in Providing Options for End-Stage Heart Failure

If end-stage heart failure is reached and a heart replacement is needed, the team at Houston Methodist has a remarkable track record performing numerous heart transplants and implanting mechanical heart pumps. In fact, we’re a leading transplant site in the U.S., performing more than 1,000 heart transplants since 1968. This often enables our experts to provide hope to people with complex conditions who otherwise would have no options.

We also have one of the largest left ventricular assist device (LVAD) programs nationwide. These heart pumps can extend the lives of those who do not qualify for heart transplant or are waiting for transplant.


Comprehensive Care for Advanced Heart Failure

To ensure you receive the most effective care tailored to your specific condition and unique lifestyle needs, our advanced heart failure team includes:

  • Cardiologists
  • Cardiothoracic surgeons
  • Specialized nurse coordinators
  • Immunologists
  • Social workers
  • Psychiatrists
  • Critical care specialists
  • Palliative care specialists

About Advanced Heart Failure

When Is Heart Failure Considered Advanced?

Heart failure is typically considered advanced after:

  • Conventional treatments stop working
  • Symptoms occur with minimal or no activity
  • Repeated hospitalizations
  • Evidence of other organ damage due to heart failure
  • Inability to handle recommended heart failure medications


A person does not have to be sick in the hospital with heart failure for it to be considered advanced heart failure. In fact, many times individuals are not hospitalized, but instead are struggling at home.

What Are the Symptoms of Advanced Heart Failure?

Advanced heart failure symptoms include:

  • Progressive breathlessness occurring either at rest, while eating, taking a shower or talking on the phone
  • Worsening fatigue
  • Reduced blood pressure
  • Inability to tolerate standard heart failure medicines
  • Persistent angina, without any options to improve blood flow to the heart’s arteries

What Causes Advanced Heart Failure?

Heart failure can have many causes, including:

  • Restrictive cardiomyopathy – when the ventricles become rigid and restrict filling
  • Dilated cardiomyopathy – when the heart muscle becomes abnormally enlarged, thickened or stiff because of a variety of diseases
  • Cardiac amyloidosis – when there are deposits of abnormal proteins (amyloids) in the heart tissue
  • Hemochromatosis – a genetic condition that causes an iron overload that poisons organs, including the heart
  • Sarcoidosis – in which there is growth of inflammatory cells in different parts of the body, including the heart

How Is Advanced Heart Failure Diagnosed?

If your doctor suspects heart failure, he or she may use the following tests to determine a diagnosis:

How Is Advanced Heart Failure Treated?

If heart failure has progressed into advanced-stage heart failure, several treatment options can be considered, including:

  • Close monitoring and adjustment of medications
  • Optimization of your defibrillator or pacemaker
  • Consideration of a percutaneous valve, if a valve problem exists
  • Consideration of using open heart surgery to open blocked arteries
  • Mechanical heart, via a left ventricular assist device (LVAD) or artificial heart
  • Heart transplant, as well as multi-organ transplant when needed
  • Supportive palliative care, which provides relief from symptoms, pain and the mental and physical stress associated with a serious illness
  • Hospice care

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