By Peter Shactman, PA-C
CONGESTIVE HEART failure (CHF) is a complex medical illness in which the heart develops pumping inefficiency. Commonly, this is caused by heart muscle injury due to a heart attack or high blood pressure. Sometimes heart failure may be caused by diseases of the heart valve or other rare conditions.
When the heart loses pumping efficiency, excess fluid retention or congestion typically follows, hence the term “congestive heart failure.” Some common symptoms of CHF include increased shortness of breath at rest or during exertion, increased swelling of the limbs, needing to prop up on more pillows to sleep, frequent coughing, and exercise intolerance or being easily fatigued. Often, heart failure is a slowly progressive disease and symptoms may worsen over time.
Congestive heart failure may cause a serious decrease in a patient’s quality of life and may result in frequent admissions to the hospital. While there are many excellent medical and procedural treatments available for heart failure, it takes a well-coordinated team of providers from different disciplines to make sure each patient is getting the right kind of treatment at the right time.
created its CHF Clinic
four years ago to improve the quality of care for a select group of CHF patients at highest risk for hospital admissions or other setbacks. The clinic’s multidisciplinary approach, led by physician champion Dr. Brian Porter,
revolves around the work of Peter Shactman, PA-C
, a clinician dedicated to the daily management of CHF Clinic patients; a nurse who helps monitor complex care plans and makes frequent calls to track patients’ care; as well as palliative care providers, a registered dietician, social workers, care coordinators and visiting nurses from Rockingham Visiting Nurse Association & Hospice when added support is needed. Using state of the art technology, patients are monitored frequently for signs of impending illness. Since the onset of the CHF Clinic, Core has consistently seen reduced hospital admissions and increased quality of life scores as reported by patients.
In the initial CHF Clinic visit, providers begin by educating the patient about their disease process and the steps they can take for self-care, as well as how to recognize the warning signs that need intervention. Weekly nursing calls help ensure that patients are monitoring their weight daily, following a low sodium diet, and watching their fluid intake. Patients also have the opportunity to participate in a two-day nutrition class led by a licensed nutritionist.
“The goal is to help patients live their healthiest and best life possible,” said Porter. “We do this by providing ongoing support and coaching, optimizing state-of-the-art medical treatments, and coordinating with a diverse team of experts in different disciplines. Our research shows that patients who receive treatment in the Congestive Heart Failure Clinic experience better quality of life and are much less likely to be admitted to the hospital.”
Patients in the clinic meet with a palliative care nurse practitioner to review their quality of life goals. According to Porter, “In the clinic, in addition to treating and managing heart disease, we want to make sure we are addressing each patient’s hopes and goals for the future. Working closely with palliative care providers is the best way to accomplish that.”
“Core Cardiology has literally been a life saver for me,” said Ronald Cross, a patient who says he has benefited greatly from the CHF Clinic. “They have followed my progression from by-pass surgery through all of my care needed for 32 years. I cannot imagine what I would have done without them constantly checking on me, asking me the right questions, and always making sure I felt like I was the most important patient they had. I am grateful for everyone at Core Cardiology, along with all the other Core physicians that I see at Exeter Hospital.”
Through Core Cardiology’s Congestive Heart Failure Clinic,
providers are able to tailor a treatment plan specific to each patient’s needs, and patients learn how to manage their condition to live their healthiest life possible.
Pictured above L to R: Sandy, RN, Peter Shactman, PA-C and Dr. Brian Porter