Our highly skilled cardiologists expertly treat and diagnose heart failure—a chronic, progressive condition in which the heart muscle can’t pump enough blood to meet the body's needs. In addition to caring for cardiac patients at Yale New Haven Hospital, we provide treatment to the rapidly growing number of outpatients living with heart failure in the community. We treat each patient with a personalized plan, carefully monitoring medications on an ongoing basis while minding other issues that affect cardiac health. We also educate patients and their families about lifestyle changes, prescribe and oversee exercise rehabilitation programs, and facilitate communication between the many professionals involved in outpatient care. Our physicians work as part of a multidisciplinary team to offer patients comprehensive care with the goal of prolonging their life and improving its quality. Treatment options may include medications, short- or long-term mechanical support, or heart transplant. Before treatment begins, we perform cardiac diagnostic procedures, such as stress tests, catheterization, and biopsies. We collaborate with cardiac-trained radiologists to provide noninvasive imaging studies including positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and 2D and 3D electrocardiography. At the Center for Advanced Heart Failure at Yale New Haven Hospital, we treat the full continuum of heart failure and offer a variety of medical and surgical treatment options. The center cares for patients with an LVAD (left ventricular assist device), a battery-operated mechanical pump that is surgically implanted and helps maintain the heart’s pumping ability when it can’t work effectively on its own. This is the only long-term mechanical circulatory support for patients otherwise ineligible for heart transplant. Our surgeons regularly perform heart transplants and LVAD implantations, and our heart transplant survival and post-LVAD rates are among the best in the region.

The Advanced Heart failure Program is a rapidly expanding service at the front lines of treating heart failure. Launched in 1988, the program builds upon decades of experience treating failing hearts. In 2019, we performed 49 heart transplants, putting us among the top centers of the country. Our left ventricular assist device program treats more cases than any other program in the Northeast. It provides heart pumps for patients who need support while they are waiting for a donor heart or who are ineligible for a transplant and need another permanent solution. Heart transplants are the gold standard treatment for patients with end-stage heart failure. But many face a long, difficult wait for a donor heart, and some don’t survive. Yale Medicine is one of a handful of centers in the country to push existing boundaries in heart transplant by aggressively seeking out donor hearts other centers turn down even though they may be suitable for some patients. This process, using what’s called “donation after circulatory death” (DCD) organs, is helping more of our patients get heart transplants sooner. What’s more, our one-year survival rates for heart transplants—93%—are better than the national average. Multi-organ transplants People who live with heart failure have a high likelihood of also having kidney dysfunction from a variety of causes, and this can be a limiting factor in being able to get a heart transplant. For these patients, our heart specialists collaborate with Yale Medicine’s world-class abdominal transplant team and have achieved a robust volume and successful track record in performing heart-kidney transplants. Pioneers in LVAD Yale Medicine helped to pioneer the use of left ventricular assist devices (LVADs), providing patients whose hearts are too weak to function on their own with implantable devices that can pump blood for them. Yale Medicine is one of the leaders in the Northeast in volume and outcomes with LVADs and is certified by the Joint Commission, the nation’s predominant standard-setting and accrediting body in health care. Each one of our patients is treated by a team that includes cardiologists, transplant surgeons, infectious disease specialists, nephrologists, critical care doctors, nurses, pharmacists, social workers, nutritionists, and transplant coordinators, among others. Transplant doctors at Yale are national leaders in the field. Currently, the presidents of United Network for Organ Sharing (UNOS) and the American Society of Transplantation are at Yale, and they have helped to write the guidelines for how to treat patients after solid organ transplants as the field advances. Outcomes above average Patients whose future once seemed difficult have survived for decades after a heart transplant or LVAD implant. The average one-year survival after a Yale Medicine heart transplant is 93%, which is higher than the national average. This is partly due to meticulous follow-up care that includes treatment with immunosu

Falls and fall injuries are one of the most common health problems among older adults. However, since falling is not a single disease, clinicians may not recognize falling as a treatable health problem. The consequences of untreated falls and their risk factors can be just as serious as those of other untreated chronic diseases. We have identified risk factors that increase the chance of falling. While some factors that increase risk of falling cannot be changed (such as age and previous falls), there are a number of important ones that can. These include: Any problems with walking or movement Blood pressure dropping too much when getting up (postural hypotension) Use of four or more medications or any psychoactive medications Unsafe footwear or foot problems Visual problems Environmental hazards that can cause tripping Research has shown that treating and correcting these specific health problems reduces the rate of falling by more than 30%. Yale researchers were among the first to show that falls among seniors could be prevented and that fall-prevention interventions mean that seniors are less likely to be hospitalized or need advanced medical care. This research has since been translated into protocols that are used in clinical and community settings to help prevent falls. Falls and fall injuries: Are more common than strokes and can be just as serious in their consequences Are the most preventable cause of needing nursing home placement Lead to problems with daily activities like dressing, bathing, and walking Among adults 70 years and older: Three in 10 fall each year Two in 10 who need home health care after being in the hospital will fall during the first month after coming home One in 10 suffer a serious fall injury such as a broken bone or head injury Five in 10 have problems getting up without help after they have fallen Falls cause over 90% of broken hips; only half of those who break their hip will get around as well as they did before their broken hip In the United States, 16% of all emergency department visits and almost 7% of all hospitalizations are for fall-related injuries