Cardiac Cachexia, Heart Failure, and Nutrition

In this episode of heart health with Michelle, Dr. Brian Lima, MD FACS, heart transplant surgeon and heart failure expert, speaks with Michelle Routhenstein MS RD CDE CDN, a cardiology dietitian and preventive heart health nutritionist about cardiac cachexia in heart failure patients. We discuss what it is, some symptoms that arise with it, how we can differentiate it between fluid status and obese status, and also what we can do to address it for optimal quality of life and optimal heart failure management.



What is cardiac cachexia? 1:12
When does cardiac cachexia occur in heart failure? 2:37
What are the symptoms of cardiac cachexia? 3:30
How does cardiac cachexia impact the GI tract? 3:50
What are some deficiencies associated with heart failure? 4:20
How do you assess fluid gain versus weight loss in heart failure? 4:40
What is a right heart catheterization? 6:25
Can you be obese and have cardiac cachexia?7:40
How can we address cardiac cachexia to avoid its progression? 8:30
Why is addressing cardiac cachexia via nutrition important in helping with medical treatment for heart failure? 9:10
How does nutrition help with healing heart transplant and associated medical surgeries? 9:40
What are some tips to help with increasing nutrition with advanced heart failure? 10:05
When is it too late to intervene with heart failure?11:45
Why shouldn’t you wait to address heart failure? 13:01


More information about our guest:

Dr. Lima is a cardiac surgeon and recognized authority on advanced heart failure, with nearly 100 published peer-reviewed articles, book chapters, and numerous presentations at national and international conferences. He is the current Surgical Director of Heart Transplantation and Mechanical Circulatory Support for Medical City Healthcare.


Prior to this role, he successfully launched the first and only heart transplant program on Long Island for Northwell Health in New York and was previously the Surgical Director of Mechanical Circulatory Support at Baylor University Medical Center in Dallas.


Dr. Lima is the WSJ Bestselling author of “Heart to Beat: A Cardiac Surgeon’s Inspiring Story of Success and Overcoming Adversity—The Heart Way”


Undergraduate: Cornell University in Ithaca, NY
Medical School: Duke University School of Medicine in Durham, NC
General Surgery Residency: Duke University Medical Center
Cardiothoracic Surgery Fellowship: Cleveland Clinic


More information about Michelle Routhenstein, the youtube channel host/cardiology dietitian:


Heart disease management and prevention are Michelle Routhenstein's areas of expertise. She is a Preventive Cardiology Nutritionist, Registered Dietitian Nutritionist, Certified Diabetes Educator, and Cardiology Dietitian. Michelle’s goals are to inspire, empower, educate, and help individuals take a proactive role in their heart health by optimizing risk factors, improving blood flow and blood vessel health and reducing any strain on the heart so it can do its job more effectively through science based nutrition. Her work is focused on reducing the risk of heart attacks and strokes, and increasing quality of life through science based nutrition and lifestyle management.


Michelle has more than a decade of experience successfully improving her client's laboratory parameters, mitigating risk factors, and maximizing heart function to avoid and treat heart disease and its related chronic illnesses. She takes a whole person personalized approach to long term nutrition and lifestyle change by merging the science with her client's lifestyle. Michelle believes in the important of explaining the why behind all her recommendations for her clients to be an active participant in their care to truly optimize each person's heart health and increase their longevity.


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