Heart Failure: When Do You Need a Specialist?

Many people with heart failure aren't receiving the advanced treatment they need.

“Data shows that recommended therapy is not fully optimized or is underutilized,” says Cynthia Kos, D.O., a heart failure and transplant cardiologist at Hackensack Meridian Health in Neptune.

The reasons for this range from cost and access to care to doctor prescribing habits and how consistently patients take their medications. In one study, just 1% of eligible patients were getting the right dose of all their recommended medications.

This treatment gap is where an advanced heart failure specialist comes in. The right specialist makes sure you’re on the best therapy available and, if your heart failure is advanced, connects you to treatments and a transplant network that only certain programs offer.

Here’s how to know if you need to see a heart failure specialist, plus how they can help you.

Signs You Need a Heart Failure Specialist

Heart failure is a progressive disease that moves through four stages: A, B, C and D. 

• Stage A means you’re at risk but have no symptoms.
• Stage B means you have structural heart disease or increased pressure in your heart but no symptoms.
• Stage C means you have structural heart disease and you’re having symptoms.
• Stage D is advanced heart failure, where you have severe structural heart disease with symptoms that disrupt your daily life or require hospitalization. 

Stage A and Stage B can usually be managed by your primary care provider or cardiologist.

Stage C — when structural changes to the heart have set in, and you start having symptoms like fatigue or shortness of breath — is when you need to see an advanced heart failure specialist. 

“Our goal is to begin our involvement before you reach Stage D,” says Dr. Kos. Stage D is when your treatment options narrow, which is why seeking expert care early is so important. 

Your heart failure specialist helps manage your medications and considers whether heart failure procedures could help you. They don’t replace your current care team — they add expertise that complements your existing treatment and helps coordinate more comprehensive care.

If you’re living with heart failure, Dr. Kos says the most important thing is to act. “Treat a suspected heart failure diagnosis with the same level of urgency as any other major medical emergency by seeking a professional assessment without delay,” she says.

How a Heart Failure Specialist Can Help

Expert care matters most at Stage D, when you’re in a critical spot. An LVAD (left ventricular assist device) or heart transplant are the two options that can extend your life, and they’re available only at select hospitals that meet rigorous requirements. 

Two hospitals at HMH — Hackensack University Medical Center and Jersey Shore University Medical Center — offer LVAD procedures, either as a bridge while you wait for a transplant or as a long-term therapy to prolong your life.

We also offer a full range of advanced heart-support devices and take part in clinical trials that test the latest heart failure therapies.

If you need a heart transplant, our advanced heart failure specialists work closely with regional transplant centers to build a personalized plan timed to your needs. 

Whatever the path, Dr. Kos keeps one principle front and center: “The best treatment plan is the one that gives a patient the most years of quality life.”

Next Steps & Resources:

• Meet our source: Cynthia Kos, D.O.
• Make an appointment online with a heart failure specialist near you or call 800-822-8905. 
• Learn more about our heart failure care.