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Heart Failure, Ambulatory Care

Heart failure

happens when 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.

Common symptoms include the following:

  • 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

Seek immediate care for the following symptoms:

  • 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
  • Gaining 3 or more pounds (1.4 kg) in a day (or more than your healthcare provider says you should)
  • Heartbeat that is fast, slow, or uneven all the time

Treatment for heart failure

Treatment for heart failure may include any of 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.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. 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 and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • 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.
  • 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.

Manage heart failure:

  • 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 healthcare provider 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.
  • Limit the amount of liquids you drink if you retain fluid. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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.

© 2016 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.

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.

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