What is the Heart Function Clinic?
Patients who have impaired heart function, develop heart failure. Heart failure is in essence and inability of the patient’s heart to provide enough blood flow and blood output to supply their bodily needs. As a result of this heart failure and the decreased function, the patients will develop symptoms such as fatigue, shortness of breath, swelling around feet and ankles. Heart failure is a highly morbid condition, and without adequate treatment it worsens rather than improves. As the heart continues to worsen the symptoms worsen, and as a result the patient becomes debilitated. Heart failure as a condition should be managed promptly to minimize impact the patient’s, quality of life and if possible, to reverse existing failure.
What do we offer in our Heart Function Clinic?
The heart function clinic at Edmonton Echolab is comprehensive and interprofessional clinic. To ensure that the patient with heart failure is on the recommended medication, to ensure their condition is managed. The approach for our heart function clinic begins with an assessment. The physician, as well as the pharmacist, will both speak with the patient directly to do a subjective assessment; which determines the patient’s own reports of sinus symptoms; as well as objective assessment such as, blood work, an ECG, or an echocardiogram. Once we have gathered both the subjective and the objective information that is needed, an assessment is made of how severe the patient’s heart failure is. When the severity is determined of the patient’s heart failure, the patient is placed on to evidence-based guidelines recommended first-line therapies, in order to help improve the strength and the functioning of their heart, to improve the blood flow in their body. That way, their symptoms should improve. On top of medication treatment, the patient is also enrolled into non-medication treatments, as well as on a diet and exercise. These two are very large pieces of managing heart failure, so that they will be referred to a dietitian and a physiotherapist. Similarly, they will be given other monitoring parameters that they should watch for at home as well such as, blood pressure, body weight. This way the patient can monitor on their own, whether their heart failure is improving or deteriorating. The patient is regularly followed up with, as well as additional investigations, continued medication management.
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In order to stop the patient’s worsening progression of their heart failure, and if possible to reverse their heart failure, the approach that we take is aggressive. We treat with all options available to us, both medications and otherwise, in order to optimize the patient’s therapy. For each medication the patient is placed on, the medications are titrated upwards to the maximum amount that the patient can tolerate for them bring about the best benefits for their heart. Once the patient is deemed to have been optimized, their taking all the medications that they should according to evidence take, the patient is taking it at the highest doses they can tolerate, and on top of which they are doing all of the lifestyle factors to improve their heart function and to rehabilitate their heart strength. They would be considered to be optimally managed for their heart failure and that a follow-up with them periodically to ensure that their management continues to be optimal moving forward, and that their quality of life continues to improve back up to their baseline.