Dr. Howard Grill - Heart Failure Clinic

Author: Excela Health

Here's Jennifer Miele with another Excela Health-e-minute. Patients who are diagnosed with heart failure work with their primary care doctor and their cardiologist to try to stay healthy. But when heart failure escalates Excela's heart failure clinic can offer rapid expert care that keeps them out of the hospital and gets them back to health. Hello, I'm Dr. Howard Grill. I'm the Medical Director of the Cardiac Catheterization Laboratory as well as Director of the Congestive Heart Failure Clinic, here at Excela Health.

Heart failure is one of those processes where things can change pretty rapidly. If you're a patient that's trying to get in to see your cardiologist or your primary care physician and even if they're pretty fast about seeing you even if they can see you in a week, well, if you have heart failure in a day or two you might be more and more uncomfortable, and as time goes on the chance of being able to get you back to baseline with just oral medications can sometimes be more difficult. At that point, if you have to go to the emergency room and be admitted it can be a somewhat frustrating process and so our goal is to provide a service where we can get people with heart failure that are perhaps slipping into a little more heart failure or not feeling as good as they should in to the office very quickly and hopefully adjust their medications that they're taking. And by quickly I mean, 24 hours, so we can make adjustments, bring them back the next day or 48 hours later, do whatever it takes to keep them out of the emergency room and out of the hospital. There's two types of heart failure and we see both types in the heart failure clinic.

One type is when the heart muscle is weakened and unable to pump the blood through the body adequately and because of that weakness some of the blood backs up and you get an increased pressure and fluid leaks into the lung, causing shortness of breath and the other type of heart failure called diastolic heart failure. The actual pumping action of the heart is normal, but the heart can be thickened or not relaxed properly and so, even though it's pumping normally, during the phase when it's relaxing the pressure is still too high and fluid can back up into the lungs that way as well. The people in the heart failure clinic are well equipped to take care of both types. If you have heart failure there are certain criteria. For example, for a referral for things like an automatic defibrillator which can improve life span in patients with heart failure and if you come to heart failure clinic and that has not been addressed for whatever reason, we're going to make sure that's addressed and send you to our electrophysiologists to have you evaluated for that aspect of treatment as well. If it requires intravenous therapy with intravenous diuretics, we can do that as well. Have them stay in the office to see the results of the intravenous therapy for half an hour or an hour; have them go home and come back the next day.

It's beneficial not only in trying to decrease re-admissions to the hospital, but also we think we're doing something fairly unique in our heart failure clinic, which is during that initial visit, we're not only seeing the patient from a medical standpoint, but we've also set aside a half an hour for teaching. While the patient's there, they're going to get teaching in how to manage their diet, they're going to get teaching in how to do their daily weights, they're going to get teaching on when they should be calling heart failure clinic in terms of how they're feeling and how their weights are going and we're also going to have access to provide consultation or send the patient for consultation; for dietary, for cardiac rehab and any of the ancillary services that would be of benefit to them. The gold air is really to keep people out of the hospital and to allow them to become a greater participant in their own health care and understand the process and work with us to keep them healthier. Our goal is to work along with the various other specialties for work along with the primary cardiologist and to work along with the primary care physician to help all aspects of the patient care with our focus being on heart failure. So we really hope to be a one-stop shop to get all their needs for their heart failure problem taken care of and improve their health that way.

Dr. Howard Grill - Heart Failure Clinic

The Excela Health heart failure clinic is located in Medical Commons One behind Excela Westmoreland Hospital for more information or to request an appointment. Here's the number to call:1-877-771-1234.

Dr. Howard Grill - Heart Failure Clinic

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