Advanced Heart Failure

What is advanced heart failure?

More than 6 million Americans are living with heart failure. About 10% of them have advanced heart failure. This means regular treatments and symptom management no longer work. Someone with advanced heart failure feels shortness of breath and other symptoms even at rest. 

Advanced heart failure is stage D in the American Heart Association and American College of Cardiology A-to-D staging system. 

The New York Heart Association has another system that grades symptoms from 1 to 4. Your symptom severity can change throughout the day depending on how you feel.

Medication and a healthy lifestyle can help manage early heart failure. As the disease progresses and the heart weakens, treatment gets more complex. That’s when to have difficult, yet important, conversations with your family and your health care professional about your care. 

Are there treatment options for advanced heart failure?

When heart failure progresses to an advanced stage, difficult decisions must be made. 

• Do I want aggressive treatment? 
• Is quality of life more important than living as long as possible? 
• How do I feel about resuscitation?

For people with advanced heart failure, making good decisions requires teamwork. With shared decision-making, health care professionals and patients consider the options and what the patient wants to create the best treatment plan. Treatment options include surgery, devices and medication. 

What is shared decision-making? 

There are still many treatment options for advanced heart failure. Deciding between aggressive treatment and comfort care can be tough. The Heart Association has recommendations to help with these decisions. 

The goal is for you and your health care professional to talk about medical options and make decisions based on what you want. Shared decision-making means you don’t have to make decisions alone.

Experts recommend that you talk early and often about:

• Treatment options
• Risks 
• Benefits 
• Future scenarios 

This way, you’re prepared and not caught off guard when a big medical event requires tough decisions.

Your health care professionals give you the medical facts and figures. You let them know your goals and preferences. Together, your health care team builds a care plan that’s best for you.