To receive the best care for heart failure, talking frankly with your
health care team is a good place to start. It’s also helpful to know
about a resource published by health experts that outlines treatment
plans recommended for patients with chronic heart failure.
Since 1980, the American College of Cardiology and the American Heart
Association have jointly published clinical guidelines to help health
care providers create good care plans for their patients. The guidelines
are based on scientific research and medical evidence. One set of
guidelines, published in 2005 and updated in 2009, is called Evaluation
and Management of Chronic Heart Failure in the Adult.
The guidelines are written for medical people, so the language is
technical and focuses on clinical information. As a patient,
understanding the basics of the guidelines can help you take a more
active role in your treatment. You’ll also be able to ask questions that
can help you receive the best care.
The guidelines offer tips for health care providers on performing a
thorough checkup to detect heart failure and to evaluate how serious it
is. They guide the provider in what symptoms to look for and what
screenings may be needed (such as lab or exercise tests) to gather more
According to the guidelines, a person who is at risk for or who has
heart failure falls into one of the following stages of the disease:
Stage A: A person who is at high risk for heart failure, but has
no problem with his or her heart structure and does not have symptoms of
Stage B: A person who has a problem with his or her heart
structure, but does not have symptoms of heart failure.
Stage C: A person who already has, or who has had in the past,
heart failure symptoms, which have to do with structural heart disease.
Stage D: A person who has end-stage heart disease; this is the
most serious stage.
Only people in stages C and D are already in heart failure. There is a
separate set of guidelines for the management of these people, called
the New York Heart Association functional classification, which should
not be confused with this staging method.
The guidelines suggest specific treatments and actions for each stage.
Once you know the stage you are in, you can learn which treatments the
guidelines suggest. For example, for people in Stage A, suggested
actions focus on treating risk factors, such as high blood pressure,
smoking and drinking. For all stages, the guidelines suggest specific
medicines and certain medical tests or procedures.
The guidelines also advise health care providers to take a
“multidisciplinary approach” to your care. This means that, rather than
working alone to treat you, your provider teams up with other health
care specialists, such as nurses, exercise physiologists and
smoking-cessation experts. Your health care team may suggest that you
participate in support groups or visit certain specialists to help you
make lifestyle changes to manage heart disease.
The guidelines are designed to apply to most patients in most cases.
They give health care providers a range of treatment options. The
ultimate decisions rest with the provider and with you. Remember that
you are the most important member of your health care team. Asking
questions about your treatment is smart and responsible. It’s your right
to know your health care team’s goals for you—and how clinical
guidelines compare with your care plan.
For more information, call 1.866.CALL.MLH.