Managing heart failure helps patients thrive

If Kimberly Godsey needed a reminder of the value of her work in the heart failure clinic at Montage Medical Group, she got it during back-to-back appointments in late January.

Godsey, a nurse practitioner who oversees the clinic, first encountered the two patients at Community Hospital of the Monterey Peninsula in 2022. Each had been hospitalized with some of the classic symptoms of heart failure — shortness of breath, legs and ankles swollen with fluid, and fatigue.

Today, one of the patients, a 71-year-old man, is going on cruises and singing in his church choir. The other, a 90-year-old woman, has so much energy her daughter jokes that “she’s waiting on me,” Godsey says.

“Typically, when you’re diagnosed with heart failure, you’re always going to have some form of it,” Godsey says. But if it’s managed well, with the right interventions, medications, and lifestyle changes, “many people can have a good quality of life.”

Heart failure “is a very broad diagnosis,” says Santi Yarlagadda, MD, a Montage Medical Group cardiologist who is board-certified in the disease. Generally, it means your heart can’t pump enough blood to the rest of your body. Blood can back up and fluid can build up in the lungs, making it hard to breathe. The condition gets worse as the heart grows weaker and can ultimately lead to death.

“Heart failure is normally the end result of other stressors on the heart,” Yarlagadda says, such as coronary artery disease, high blood pressure, heart attack, heart-valve disease, and rhythm disorders.

Treatment may include addressing an underlying issue, such as replacing a leaky valve, placing stents to open arteries, or an ablation procedure to remedy an irregular heartbeat. For severe cases, implantable cardioverter defibrillators or even a heart transplant might be necessary.

Medication is key to managing symptoms and risk factors, such as high blood pressure and fluid retention. Lifestyle changes are also critical, including a heart-healthy diet, reduced sodium, and regular exercise.

“There’s a lot of power in medication and a lot of power in lifestyle changes,” Yarlagadda says.

Receiving a heart failure diagnosis can be scary — and that’s where the heart failure clinic at Montage Medical Group can help. A team including Godsey, Yarlagadda, cardiologist Jayme Rock-Willoughby, DO, and physician assistant Sonia Troxell, works closely with patients referred by their primary care doctor, a cardiologist, or another specialist.

Patients start with an in-depth initial appointment to develop a treatment plan. Regular appointments follow, the frequency dependent on individual needs and changes that develop. Many patients will also be referred to Montage Health’s Cardiac Rehabilitation program that helps people learn safe ways to exercise, eat healthy, manage stress, and more.

Godsey says she may see patients as often as every week or two at first while they work on balancing medications for the best results. Eventually, she may see them about every three months unless issues arise.

“We also have a heart failure support group that meets monthly,” Godsey says. “We do a lot of education and set time aside to work on the human experience of heart failure because it’s a lot to cope with from a mental or emotional standpoint. The more positive support you have from family or friends improves your outcomes and ability to get better.”