Advanced Heart Failure Clinic
Part of Cardiovascular Health
Leaders in Advanced Heart Failure Assessment
In partnership with patients and their primary providers, our internationally recognized specialists evaluate people with advanced heart failure and recommend a treatment plan. If you need more advanced treatments such as a heart device, surgery, or a transplant, our world-class Advanced Heart Failure Program is ready to help.
What We Offer You for Heart Failure Evaluation
- Specialized expertise in evaluating advanced heart failure, with a comprehensive assessment including heart function tests, cardiac imaging, genetic testing, and cardiopulmonary exercise testing.
Go to Conditions Treated - Advanced treatment options including mechanical circulatory support, cardiac transplantation, and other aggressive surgical or interventional approaches.
Go to Treatments - Team-based approach including your referring providers for complete care, with expert assessments, treatment recommendations, and access to specialists in our Advanced Heart Failure Program.
Go to Your Care Team
- Clinical trials that offer access to the latest medical approaches, devices, drugs, and other treatments for end-stage heart failure.
Go to Clinical Trials - Comprehensive support services to help you, your family, and your support network focus on health and healing.
Go to Support Services - Ease of access to expert assessment with timely appointments through video visits or at our Oakland clinic.
Go to Accessing Care
Heart failure occurs when the heart doesn’t pump blood as well as it should. Sometimes called congestive heart failure, the condition worsens over time. The most severe stage of heart failure is advanced heart failure, also called end-stage heart failure.
Our Advanced Heart Failure Clinic is part of our comprehensive Advanced Heart Failure Program. Our clinic provides expert evaluations for people who may have end-stage heart failure. If your evaluation calls for intensive treatment not available at your local hospital, you have access to complete care at our Advanced Heart Failure Program.
If your heart failure symptoms are getting worse, you could benefit from an advanced heart failure evaluation. The earlier we assess your individual situation, the better.
The experts in our Advanced Heart Failure Program treat all types and stages of heart failure, including:
Systolic heart failure (heart failure with reduced ejection fraction) develops when the heart muscle is weak and cannot pump enough blood to the body. Conditions that can lead to this type of heart failure include:
- Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD or ARVC)
- Coronary artery disease
- Dilated cardiomyopathy
- Duchenne muscular dystrophy (DMD) and other types of muscular dystrophy
- Left ventricular non-compaction (LVNC)
- Sarcoidosis
Diastolic heart failure (heart failure with preserved ejection fraction) is a condition in which the heart muscle is stiff and cannot relax enough to allow the heart to fill with blood. Conditions that can cause diastolic heart failure include:
- Amyloidosis
- Hypertrophic cardiomyopathy
- Hypertensive heart disease
- Infiltrative cardiomyopathy
- Restrictive cardiomyopathy
- Scleroderma
Heart valve disease can affect any of the heart’s four valves, which send blood from one heart chamber to the next. Heart valve disease prevents proper blood flow through the heart, reducing the amount of oxygen and nutrients going to the body. Types of heart valve disease include:
- Aortic valve stenosis (narrowed valve) and regurgitation (leaking valve)
- Bicuspid aortic valve (valve with only two flaps instead of three)
- Mitral valve stenosis and regurgitation
- Mitral valve prolapse (valve that bulges backward)
- Pulmonic valve stenosis and regurgitation
- Tricuspid valve stenosis and regurgitation
Congenital heart diseases (CHDs) are problems with the heart’s structure, such as its walls, valves, or blood vessels, that develop before a baby is born. CHDs can increase your risk of developing heart failure and other heart conditions.
As world leaders in heart care, we combine expertise and leading-edge technology to deliver comprehensive advanced heart failure assessments. If you have heart failure and experience new or worsening symptoms, our Advanced Heart Failure Clinic is ready to help. The earlier you receive specialized care, the better your chances for effective treatment.
We advise doctors to refer patients to us as soon as a patient experiences:
- Ejection fraction (EF) less than or equal to 35%: EF measures how well your heart pumps oxygen-rich blood to the body. A typical heart’s EF is 50% to 70%, which means it pumps out 50% to 70% of the chamber’s blood with each contraction.
- Class 3 heart failure: Symptoms include fatigue, irregular heartbeat, and difficulty breathing during minimal activity. However, you are comfortable while resting.
- Hospitalization: If you’ve needed hospital care for heart failure symptoms at least once during the past six months, it’s time for further evaluation.
Stanford Health Care offers specialized cardiovascular genetic counseling and testing—services that are not widely available—for people at risk of inherited heart diseases. Test results help us fine-tune your care and identify other family members who may benefit from an evaluation of their risk. Whole genome sequencing is now available to patients diagnosed with inherited cardiovascular disease.
Diagnosis
At the Advanced Heart Failure Clinic, we offer specialized expertise in diagnosing advanced heart failure. We use the latest and most advanced diagnostic tests, including:
- B-type natriuretic peptide (BNP) test: This blood test shows the level of the hormone BNP. The heart’s upper chambers release BNP in response to changes in pressure that occur with heart failure.
- Chest X-ray: This test uses small amounts of radiation to create images of the structures inside your chest, including your heart, lungs, and airways.
- Cardiac magnetic resonance imaging (MRI): This imaging technology uses a large magnet, radio waves, and a computer to produce detailed images of heart structures.
- Computed tomography (CT) coronary angiogram: This minimally invasive procedure uses X-rays to generate 3D images of your arteries to check for blockages or narrowing.
- Echocardiogram (echo): This imaging study uses ultrasound (sound waves) to show details of your heart’s structures.
- Electrocardiogram (EKG): This test records the heart’s electrical activity to show irregular rhythms (arrhythmias) and other problems.
- Right heart catheterization: During this minimally invasive procedure, we insert a catheter (long, narrow tube) into a large blood vessel leading to your heart. We use this cardiac catheterization procedure to measure the pressures in your heart and main blood vessels to the lungs.
- Cardiopulmonary exercise testing (CPET): This comprehensive test evaluates how well your heart and lungs work together to deliver oxygen-rich blood to your body.
- Genetic heart disease evaluations: If your family medical history suggests a risk, our cardiac geneticists specialize in counseling and testing for inherited (passed down in families) heart conditions.
Treatments
You have access to Stanford Health Care’s extensive range of heart failure treatment options leveraging the latest technology, including:
Catheter ablation to treat arrhythmias
Implantable devices:
- Cardiac resynchronization therapy device
- Implantable cardioverter-defibrillator (ICD)
- Implantable hemodynamic monitor
- Left ventricular assist device (LVAD)
- Pacemaker
Medications to treat heart failure symptoms that will:
- Relax blood vessels
- Reduce blood pressure
- Improve blood flow
- Slow the heart rate
- Remove excess fluid from the body
- Help the heart pump more effectively
- Manage chest pain
- Lower cholesterol
- Prevent blood clots
Minimally invasive procedures for valve disease:
Surgery:
- Congenital heart disease repair
- Coronary artery bypass graft surgery
- Heart transplant
- Heart valve repair or replacement
- Septal myectomy
- Ventricular remodeling
Superior Outcomes for Heart Transplant Patients
Our goal is to assess you and recommend treatment before you need a heart transplant. However, if a transplant is the best option for you, you have access to Stanford Health Care’s Heart Transplant Program, the nation’s fourth largest and the Bay Area’s largest heart transplant program. Our expertise and innovation lead to superior outcomes, including:
- 93.6% patient survival at one-year mark vs. national average of 91.65%*
- 290% more likely to accept a heart than other centers around the country, resulting in shorter-than-expected wait times
* Scientific Registry of Transplant Recipients (SRTR) report, January 6, 2022
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies currently recruiting participants or may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
To learn more about the clinical trials we offer, contact Helen Luikart, RN, at 650-724-2883.
Your Advanced Heart Failure Consultative and Care Teams
If you currently receive heart care outside of the Stanford Health Care system, our providers partner with your local doctors to provide you with seamless care for advanced heart failure. We work together to conduct your assessments, review test results, and develop treatment plans.
Whenever possible, we connect you with treatment options that are close to home. If you need care that you cannot receive locally, our Advanced Heart Failure Program can help. Your referring provider continues to manage your care, regardless of where you receive treatments.
Your Providers
Consulting Doctor Jeffrey Teuteberg, MD
Jeffrey Teuteberg, MD, Section Chief of Heart Failure, Cardiac Transplantation, and Mechanical Circulatory Support, has specialized training and decades of experience in advanced heart failure. Dr. Teuteberg evaluates your tests, provides an accurate diagnosis, and collaborates with your referring provider about a personalized treatment plan.
If you need more intensive heart failure care, we coordinate your care with the renowned specialists in our Advanced Heart Failure Program.
Advanced Practice Provider
Advanced practice providers include nurse practitioners and physician assistants who work with cardiologists and surgeons to manage your care.
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Extended Care Team
Nurses and Nurse Coordinators
Nurses and nurse coordinators are registered nurses who coordinate your care during your heart assessment. They guide you from your first contact through follow-up and help you find counseling, financial assistance, and other support services.
Patient Care Coordinators
Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see our doctors and will guide you during the assessment.
Registered Dietitians
Registered dietitians work closely with you and your family to help you meet your nutritional needs for heart health. Our dietitians help you learn about a nutritious diet to maintain lifelong health.
Physical Therapists
Physical therapists help you maintain strength and function with movement and endurance exercises.
Research Coordinators
Doctors at Stanford Health Care participate in research efforts to advance the understanding of heart failure and its treatment. Research coordinators help screen candidates for possible participation in clinical research trials.
Support Services
Our Advanced Heart Failure Program offers a vast array of helpful support services, from diagnosis through treatment and recovery. Our support services include:
After your doctor refers you to us for an advanced heart failure consultation, we can see you quickly at our clinics in Emeryville, Oakland, Stanford or virtually. To schedule an appointment, call 650-724-4942.
For Referring Physicians
PHYSICIAN HELPLINE
Phone: 1-866-742-4811
Fax: 650-320-9443
Monday – Friday, 8 a.m. – 5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referring Physicians.
At Stanford Health Care, we strive to make it easy to refer and track your patients. You can:
- Call us at 650-724-4942.
- Quickly and seamlessly refer cardiac and vascular patients through the NEW Stanford CVH Flare app. For more information, go to stanford.flarehealth.app or call 877-606-3566.
- Contact Jesus (Jesse) Perez, our cardiovascular executive liaison, at 650-353-8063 or jesusperez@stanfordhealthcare.org.