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The pumping function of the heart is normal in people with preserved ejection fraction, but the problem is the heart’s inability to relax properly. This reduces the volume of blood able to fill the left ventricle during the diastolic, or filling, phase of each heartbeat. |
The acronym is HFpEF (pronounced Hef-Pef). You may see this in your chart or on your test results. |
Both types of heart failure result in the same symptoms – fatigue, shortness of breath, and swelling. |
If the ejection fraction is preserved or reduced, it determines treatment options. will differ accordingly. An echocardiogram (ECHO) is usually performed to determine whether the ejection fraction is preserved or reduced. |
Therapies (medications, devices) that have been shown to make people live longer with heart failure apply mainly to people with reduced ejection fraction. The management of heart failure with preserved ejection fraction focuses mainly on controlling an individual’s risk factors (high blood pressure and diabetes) and making sure they don’t retain extra fluid. This is an area of active research and recent studies have shown great promise for some medications to improve the prognosis for patients with preserved ejection fraction. |
WHAT IS ADVANCED HEART FAILURE? |
Advanced heart failure is a term that is often used by care providers to indicate that the heart failure condition has progressed and has become more severe. Patients may even be referred to an “advanced heart failure specialist” to be assessed for specialized interventions aimed at improving life expectancy and overall quality of life. |
Therapies for advanced heart failure include heart transplantation, long-term ventricular assist devices, long-term intravenous diuretic therapy, some forms of dialysis and palliative medical therapy. |
There is no single or universal definition of ‘advanced heart failure.’ In general, this state is associated with different markers or signs of deteriorating health and worsening prognosis. Some characteristics of advanced heart failure typically include: multiple hospital admissions for heart failure in the past year, severe limitation of daily activities due to heavy symptom burden, usually including significant fatigue and shortness of breath, difficulty controlling fluid build-up (edema) with increasing diuretic requirements, difficulty tolerating medications because of low blood pressure or worsening kidney function, increasing number of shocks from an Implantable Cardioverter Defibrillator (ICD), abnormal bloodwork indicating worsening strain on the heart (rising BNP levels or troponin levels) or worsening organ function (rising creatinine or liver function tests, low sodium levels), progressively worsening heart function or elevated pressures in the heart and lungs as indicated by an ECG, poor performance on formal exercise testing. |
WORKING WITH HEART FAILURE |
Working contributes not only to our financial well-being but to personal and professional fulfillment. Your ability to work may be disrupted by the impacts of your heart function. |
Whether or not you are able to return to work depends on your symptoms and the severity of your condition. It also depends on how physically and emotionally demanding your job is. If your symptoms are under control and your working conditions are manageable, full-time, or part-time work can be an important part of your life. |
Talk to your health care provider about returning to work. They will be able to talk to you more about your specific situation and advise you on the appropriate level of work for you. |
Some people find it more stressful to be away from work or to manage without a regular income. If you do return to work after a period of absence, be sure to pace yourself. |
You may need to change your working hours or engage in less strenuous activities. If you are concerned about your ability to perform your job, consult your doctor to see if a medication change would be possible or helpful, and/or with your employer to see if other work can be arranged. |
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