The Basics of Heart Failure

Colin Hirst, MD, is an interventional cardiology fellow at Tufts Medical Center in Boston, Massachusetts. Between 2019 and 2020, Colin Hirst, MD, will serve the Tufts division of cardiology in areas of advanced heart failure and transplant cardiology.

Heart failure is a condition brought on by coronary artery disease, heart valve disease, congenital heart defects, or conditions such as high blood pressure, among other potential causes. An individual who has experienced one or more heart attacks in the past is at an elevated risk for heart failure.

In some cases, heart failure itself is not an emergency medical situation, but rather a chronic condition defined by insufficient pumping action. That said, congestive heart failure (CHF), which occurs as fluid builds up throughout the cardiovascular system, demands immediate medical attention. If left untreated, fluid can backup in the lungs and liver, as well as other parts of the body, with potentially life-threatening consequences.

Advanced heart failure, meanwhile, is a term used to describe a patient whose heart failure is no longer responding to common management techniques and treatments. About 10 percent of the more than six million Americans living with heart failure are impacted by the advanced form of the condition. Treatment options for advanced heart failure become more complex and require the support of an experienced cardiology team.

Mobility Test Accurate Predictor of Readmission after Heart Attack

Heart Model
Photo by Robina Weermeijer on Unsplash

Colin Hirst, MD, a graduate of Albany Medical College, practices interventional cardiology at Tufts Medical Center in Massachusetts. Possessing more than seven years of medical experience, Colin Hirst, MD, has been involved in several professional studies focused on such things as readmission after heart failure.

A recent study published in Circulation: Cardiovascular Quality and Outcomes revealed that simple tests could help to predict which elderly patients who had suffered a heart attack would be readmitted. Normally, about 20 percent of these individuals are readmitted to hospitals within 30 days of release following a heart attack. They are readmitted to the hospital for several reasons, including heart failure and irregular heartbeats.

Since the Center for Medicare and Medicaid Services is reimbursing hospitals at a lower rate if they do not perform well on a 30-day readmission metric, the need to cut readmissions has become increasingly important. Further, hospital readmissions are detrimental to patient health, further spurring clinicians to search for new methods of predicting readmission rates.

The current study included over 3,000 heart attack patients in US hospitals. On average, these patients were about 81 years old. Before leaving the hospital following a heart attack, patients underwent vision, thinking, hearing, and mobility tests. Of these, the only functional assessment of patient abilities was the mobility test, which timed how quickly patients successfully rose from a chair, walked 10 feet, and sat back down.

According to the results, patients who needed more than 25 seconds to complete their mobility test had two-times the risk of readmission when compared to patients who completed the test in 15 seconds or less. Researchers also noted that traditional risk factors, such as prior chronic lung diseases and arrhythmias, also increased a person's risk of readmission alongside their mobility test performance.