A manifesto of collaborative longitudinal cardiovascular care in heart failure

Anuradha Lala1,2, Ashwin K Ravichandran3, Christopher V Chien4

  • 1Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai, New York, USA. Anu.lala@mountsinai.org.

Heart Failure Reviews
|October 7, 2020
PubMed

Insights

Coordinated cardiovascular care is essential for patients with heart failure. Enhanced collaboration among specialists can improve patient and clinician satisfaction and outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Heart Failure Management

Background:

  • Patients with heart failure require care from multiple cardiovascular subspecialties.
  • Current care coordination presents challenges for both patients and clinicians.

Discussion:

  • A multidisciplinary approach involving primary care, general cardiology, electrophysiology, interventional cardiology, cardiothoracic surgery, cardiac imaging, and heart failure specialists is proposed.
  • Care delivery is stratified into two phases: cardiomyopathy and advanced heart failure, each with distinct therapeutic considerations.

Key Insights:

  • Fragmented care in heart failure can negatively impact patient experience and clinical results.
  • Organized, collaborative efforts among cardiovascular subspecialties are crucial for optimizing patient management.

Outlook:

  • Further investigation is needed to validate the benefits of multidisciplinary coordinated care in heart failure.
  • Implementing a structured, collaborative model may enhance patient and clinician satisfaction and improve overall outcomes.

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
176
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
122
Longitudinal Studies01:26

Longitudinal Studies

Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
368
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
148
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
332
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
547