Congestive Heart Failure

Congestive Heart Failure

Treatment Options for Heart Failure

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Duke's nationally recognized approach to congestive heart failure treatment effectively manages symptoms and reduces hospitalizations. Our heart failure specialists provide the care you need, when you need it, to ensure you have the best quality of life possible.

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Comprehensive Approach to Heart Failure

Congestive heart failure requires advanced treatment and long-term care. As one of the nation’s leading heart centers, we have the resources and expertise to provide successful evaluation and long-term management of congestive heart failure symptoms and related conditions. Our approach is hands-on and comprehensive. We offer the most current therapies and continually seek out new and better ways to tailor your care to your cardiac needs.

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Duke Health offers locations throughout the Triangle. Find one near you.


Heart failure may be managed using one or more of the following therapies, which aim to improve how your heart and/or valves function, and how your blood flows to your heart and the rest of your body.


Medication is the first choice in treatment for conditions that lead to congestive heart failure, such as hypertension, and heart failure symptoms, including fluid retention. Our expert team selects the right medications to optimize your quality of life and potentially improve your heart function.

Angioplasty and Stenting

Coronary artery blockages detected during cardiac catheterization may be treated by an interventional cardiologist using balloon therapy and stents. The cardiologist inflates a small balloon at the tip of the catheter to open the narrowed artery. A small, cylindrical mesh tube called a stent is placed in the artery to keep it open. Some stents are coated with a drug that is released slowly to prevent further narrowing of the artery. This procedure is also referred to as percutaneous coronary intervention (PCI).

Heart Bypass Surgery

In heart bypass surgery, also known as coronary artery bypass graft (CABG) surgery, a surgeon uses a vein or blood vessel from your leg, arm, or under your chest wall to re-route blood flow around a blocked artery. Depending on your condition and anatomy, heart bypass surgery is performed through either a mid-chest incision or smaller left-chest incisions. The minimally invasive methods often result in smaller incisions, less blood loss, and faster recovery. In both surgical approaches, a heart-lung bypass machine may be used to maintain blood flow through your body. Your surgeon will choose the procedure that is most appropriate for you.

Heart Valve Surgery

Duke offers heart valve repair and replacement surgeries. When appropriate, our heart surgeons use minimally invasive approaches to repair or replace diseased or defective heart valves, including transcatheter aortic valve replacement (TAVR) and mini-thoracotomy, a small-incision surgical technique used to repair and replace heart valves.

Ventricular Assist Device (VAD)

These devices are implanted to support heart function and can be used as short- or long-term therapy to improve symptoms of heart failure and increase survival. You may be eligible to participate in clinical trials evaluating the newest VAD technologies, which gives you access to novel devices before they are widely available.

Heart Transplant

People with advanced heart failure may be candidates for a heart transplant. We use innovative technology and clinical trials to support our extended-criteria transplant program, which provides opportunities to patients who would not otherwise have been candidates for heart transplantation.

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Cardiac Tests

Electrocardiogram (ECG)

Small electrodes are placed on your skin to record your heart’s electrical impulses. The tracings may help identify risk for or prior heart muscle damage.

Stress Test

A stress test is an ECG that’s performed while you walk on a treadmill or ride a bike, or when a chemical is used to stimulate your heart. It is used to monitor changes in your heart’s function when it’s under stress that may indicate coronary artery disease.


An ultrasound probe is moved over the surface of your chest to capture moving images of your heart. This allows us to determine your heart’s chamber dimensions, shape, valve structures, and overall function.

Stress Echocardiogram

A stress echocardiogram is performed while you walk on a treadmill or ride a bike, or when a chemical is used to stimulate the heart. It is used to monitor changes in your heart’s function while it’s under stress that may indicate coronary artery disease.

3-D Transesophogeal Echocardiogram

An ultrasound probe passed through your esophagus is used to capture sound waves that create highly detailed, close-up 3-D images of your heart’s chamber dimensions, shape, valve structures, and overall function.

Cardiac Catheterization

Catheters are guided through a blood vessel to your heart to look for blockages and overall heart function. Contrast dye is injected and X-rays are taken to capture images of your heart, coronary arteries, and other blood vessels.

CT Coronary Angiography

A contrast agent is injected into your arm and a CT scan produces highly detailed 3-D images of your coronary arteries to help identify anatomy and blockages.

Cardiac MRI

Radio waves, magnets, and a computer create still and moving images of your overall heart structure, heart muscle function, blood vessels, and surrounding structures.

Single-Photon Emission Computerized Tomography (SPECT) Scan

3-D images of your heart and arteries are created after a radioactive substance is injected into your blood vessels.

Nuclear Cardiac Testing

Radioactive dye is used during imaging to create pictures of blood flow through your heart. This test may be done at rest or with exercise. It helps to evaluate overall heart function.

Blood Tests

Blood tests measure cholesterol, triglycerides, and other fats in your blood that can affect your heart. Your blood glucose levels and hemoglobin A1c may be checked for signs of diabetes or pre-diabetes. Thyroid function and other tests look for associated endocrine abnormalities. Tests may also measure blood levels of C-reactive protein, which can indicate the presence of inflammation in your body.

Electrophysiology Testing

Catheters are threaded into your heart to record its electrical activity.

Endomyocardial (Heart) Biopsy

A sample of heart tissue may be taken during cardiac catheterization or a separate procedure and analyzed in the lab for signs of diseases that can cause congestive heart failure, including cardiomyopathy (thickening of the heart muscle) and myocarditis (inflammation of the heart). Biopsy may also be used to look for signs of rejection in a transplanted heart.

Choose Duke for Your Congestive Heart Failure Treatment

Recognized Commitment to Quality Care
The American Heart Association has recognized Duke University Hospital with a 2018 Get with the Guidelines -- Heart Failure Gold Plus Achievement Award. Our efforts to redesign care ensure our heart failure patients have the best chance to get and stay well.

Prompt, Expert Treatment
Your condition will be monitored closely by our team of specialists -- in and outside of our offices -- to ensure your needs are promptly met and potential problems are identified early before they reach a critical stage. If you need immediate relief, you can access our Advanced Heart and Lung Failure Clinic, which has infusion capabilities. Our goal is to help you avoid an emergency room visit or overnight hospital stay.

Access to Clinical Trials
Because we are a member of the National Institutes of Health's Heart Failure Clinical Research Network, you may have access to major heart failure clinical trials, and your treatment options will include the most current advances and technologies, including studies of stem cell therapy and other advances.

Cardiac Rehab for Heart Failure
Our heart failure rehabilitation program teaches you how to live with your disease. If you receive an implanted device, you’ll participate in our specialized clinic that ensures the device is continually fine-tuned for optimum performance.

LVAD and Heart Transplant Specialists
Duke is among the top programs in the nation for the number of procedures performed for two of the most common advanced heart failure treatments: left ventricular assist device (LVAD) implantation, and heart transplantation.

Best Heart Hospital in NC
When it comes to your heart care, you want the very best. Duke University Hospital's nationally ranked cardiology and heart surgery program is ranked the best in North Carolina by U.S. News & World Report for 2019–2020.
Reviewed: 08/30/2018