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Heart Failure

What is heart failure?

Heart failure means your heart has become too weak to pump enough blood to your organs and tissues. Heart failure is often the result of damage or injury to your heart caused by other heart problems and high blood pressure. Heart failure is a long-term condition that tends to get worse over time. It is important to manage your health to improve your quality of life. Heart failure can be worsened by heavy alcohol use, smoking, diabetes, and obesity.

Normal Heart CHF Heart

What are the risks of heart failure?

Heart failure, and conditions that cause heart failure, increase your risk for a blood clot or stroke. It also increases your risk for respiratory (lung) failure. Your kidneys may not receive enough oxygen to filter your blood properly. This can lead to fluid retention (a build up of fluid in your body). Fluid in your heart can also back up as it fails and cause fluid retention. In addition to physical symptoms, many heart failure patients have depression or anxiety. With or without treatment, your symptoms could worsen suddenly and become life-threatening.

What are the signs and symptoms of heart failure?

  • Shortness of breath

  • Fatigue or lack of energy (often worsened by physical activity)

  • Swelling in your ankles, legs, or abdomen

  • Coughing or wheezing

  • Recent weight gain or weight loss

  • Confusion or poor ability to concentrate

How is heart failure diagnosed?

Tell your caregiver about your health history and the medicines you take. He will ask questions about your shortness of breath and other symptoms. Your caregiver will make a diagnosis based on your physical exam, symptoms, and tests. Ask him about the following and other tests you may need:

  • Blood tests are used to check for any damage to your heart. Blood tests also give caregivers information about your kidney, liver, and thyroid function.

  • An EKG test records your heart rhythm and how fast your heart beats.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

  • Imaging tests may include a chest x-ray, a CT scan, or an MRI. You may be given dye before a CT scan or MRI to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

How is heart failure treated?

The goals of treatment are to help you feel better and live longer. Treatment may include the following:

  • Heart medicines help regulate your heart rhythm, lower your blood pressure, and get rid of extra fluids.

  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.

  • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

    • Tell your caregiver about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your caregiver tells you to. Tell your dentist and other caregivers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • You will need regular blood tests so your caregiver can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your caregiver right away if you forget to take the medicine, or if you take too much.

    • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

  • Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. The program includes exercise, relaxation, stress management, and heart-healthy nutrition. Caregivers will also make sure your medicines are helping to reduce your symptoms.

  • Oxygen may help you breathe easier if your oxygen level is lower than normal. A CPAP machine may be used to keep your airway open while you sleep.

  • Surgery can be done to implant a pacemaker in your chest to regulate your heart rhythm. Other types of surgery can open blocked heart vessels, replace a damaged heart valve, or remove scar tissue.

How can I manage my condition?

  • Weigh yourself every morning using the same scale, in the same spot. Do this after you use the bathroom, but before you eat or drink anything. Wear the same type of clothing. Do not wear shoes. Record your weight each day so you will notice any sudden weight gain. Swelling and weight gain are signs of fluid retention. If you are overweight, ask your caregiver how to lose weight safely.

  • Check your blood pressure and heart rate every day. Ask for more information about how to measure your blood pressure and heart rate correctly. Ask what these numbers should be for you. Check your blood sugar as directed if you have diabetes. You will have fewer symptoms if you manage other health conditions such as high blood pressure, COPD, or diabetes.

  • Get a flu shot every year. You should also get a pneumonia vaccine. Vaccines protect you from these infections, which can be severe for those with heart failure.

  • You may need to limit the amount of liquids you drink if you retain fluid. Ask your caregiver how much liquid to drink each day and which liquids are best for you.

What lifestyle choices can help me feel my best?

  • Stay active. If you are not active, your symptoms are likely to worsen quickly. Walking, bicycling, and other types of physical activity help maintain your strength and improve your mood. Physical activity also helps you manage your weight.

  • Eat heart-healthy foods and limit sodium (salt). An easy way to do this is to eat more fresh fruits and vegetables and fewer canned and processed foods. Replace butter and margarine with heart-healthy oils such as olive oil and canola oil. Other heart-healthy foods include walnuts, fatty fish like salmon and tuna, whole-grain breads, low-fat dairy products, beans, and lean meats. Ask your caregiver how much salt you can eat each day. Avoid salt substitutes.

  • Limit alcohol. Ask your caregiver if it is safe for you to drink any alcohol. If it is safe, you must limit the amount you drink. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

  • Do not smoke. If you smoke, it is never too late to quit. Smoking makes shortness of breath and other symptoms worse. Ask for information on programs that can help you quit.

When should I contact my caregiver?

  • You have symptoms of worsening heart failure:

    • Shortness of breath at rest, at night, or that is getting worse in any way

    • Weight gain of 5 or more pounds (2.2 kg) in a week

    • More swelling in your legs or ankles

    • Abdominal pain or swelling

    • More coughing

    • Loss of appetite

    • Feeling tired all the time

  • You feel hopeless or depressed, or you have lost interest in things you used to enjoy.

  • You often feel worried or afraid.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have any of the following signs of a heart attack:

    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

    • Discomfort or pain in your back, neck, jaw, stomach, or arm

    • Trouble breathing

    • Nausea or vomiting

    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

  • You gain 3 or more pounds (1.4 kg) in a day (or more than your caregiver says you should).

  • Your heartbeat is fast, slow, or uneven all the time.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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