Heart disease is the leading cause of death in the U.S. and strikes in many forms.

These conditions include heart failure, when high blood pressure or a heart attack disrupt the heart’s ability to pump enough blood to the body. As many as one in four people develops heart failure in their lifetime.

Healthy eating habits and exercising for a half-hour at least three days a week can help ward off heart failure, said Dr. Hassan Alhosaini, medical director for advanced heart disease and pulmonary hypertension in greater Winston-Salem.

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Dr. Hassan Alhosaini

“I want to help my patients understand their disease, work with them to develop a treatment strategy, and give them as much hope as possible,” Alhosaini said. “They’re going through a vulnerable phase, but they can certainly learn how to live and cope with heart failure.”

To that end, the new Novant Health Heart & Vascular - Frontis Plaza clinic is offering diagnostic testing and treatment services under the same outpatient roof. The greater Winston-Salem clinic will also expand access to comprehensive care for patients with advanced heart disease and pulmonary hypertension.

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How do patients react when you diagnose heart failure?

They’re usually upset and confused, and listening carefully to what they need to do to improve their symptoms and outcomes. We talk about how common heart failure is, the risk factors and symptoms, and how it is diagnosed and treated.

If a patient develops symptoms like shortness of breath and fatigue, their primary care clinician refers them to the cardiology team. We perform an echocardiography (a heart ultrasound) and a battery of tests which help to establish the diagnosis.

We always aim to pursue conservative medical therapy before resorting to invasive options. However, I am very optimistic about the great technological advancements that enable us to offer advanced heart failure treatment options for patients who failed conventional medical therapy. For example, an artificial heart pump is now considered an important alternative to heart transplant, which is limited due to high demand and donor shortages.

What are some misconceptions about the condition?

When patients hear the term heart failure, they immediately equate that with heart stoppage. The name can be misleading. The heart is “failing” to deliver adequate amounts of blood flow to the body to meet its demands, however with treatment and close monitoring, patients can lead normal and productive lives.

Another misconception is not knowing that there is potential for their condition to improve, which is called heart recovery. The patient is receiving the diagnosis and thinking, “I have to stop working or be on bedrest.”

But that couldn’t be further from the truth. There is always a prospect for considerable improvement in heart function.

We have numerous treatment options that have been shown in clinical trials to improve cardiac function, quality of life and survival.

Is it fair to say that many patients don’t engage with their doctors until there’s a scary-sounding diagnosis?

Yes, and this leads to the most important question: What are the risk factors for heart failure? The most common causes are coronary artery disease, high blood pressure (also known as hypertension), diabetes, excessive alcohol use, and an inherited condition known as cardiomyopathy (heart-muscle disease, which causes the heart to lose its ability to pump).

Novant Health Heart and Vascular - Frontis Plaza
The health care team at Novant Health Heart & Vascular - Frontis Plaza

Is Novant Health’s three-month cardiac rehab recovery program necessary for every patient who experiences heart failure?

Yes. We always aspire to enroll our patients in cardiopulmonary rehab to improve their physical conditioning and mental well-being.

What’s the best way to introduce a sedentary patient to that exercise?

Patients should always consult with their doctor for an individualized plan. Start slowly until you accomplish a level of conditioning where you can hopefully hit cruise control. Early on, after the diagnosis, we focus on getting the patient started on appropriate medications. Once they have stabilized, that’s when they should pursue exercise.

How does the multispecialty approach to heart care work?

It’s the key to treating heart failure. Our team consists of physicians, nurse practitioners, physician assistants, pharmacists, nursing staff, dietitians and psychologists. We partner with the patient, their primary care physician, and their cardiologist to provide multispecialty support and effective heart failure care.

What will the new clinic enable you to do?

The new Novant Health Heart & Vascular - Frontis Plaza is an expanded space to accommodate more patients. The building houses three clinics, namely the cardiomyopathy, the pulmonary hypertension and the heart failure clinics.

It is a one-stop shop where patients undergo clinical assessment, laboratory testing, genetic testing, an echocardiogram and a cardiopulmonary exercise test. If the patient has urgent symptoms, they can receive an IV diuretic infusion at the clinic to avoid hospital admission.

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