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WHAT YOU NEED TO KNOW:
What is heart failure?
Heart failure (HF) is a condition that does not allow your heart to fill or pump properly. Your heart cannot pump enough oxygen in your blood to your organs and tissues. Fluid may not move through your body properly. Fluid builds up and causes swelling and difficulty breathing. This is known as congestive heart failure. HF may start in the left or right ventricle. HF 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.
What are the signs and symptoms of HF?
The signs and symptoms depend on how severe your HF is. You may have any of the following:
- Difficulty breathing with activity that worsens to difficulty breathing at rest
- Shortness of breath while lying flat
- Severe shortness of breath and coughing at night that usually wakes you
- Chest pain at night
- Periods of no breathing, then breathing fast
- Fatigue or lack of energy (often worsened by physical activity)
- Swelling in your ankles, legs, or abdomen
- Fast heartbeat, purple color around your mouth and nails
- Fingers and toes cool to the touch
How is HF diagnosed?
Tell your healthcare provider about your health history and the medicines you take. He or she will ask questions about your shortness of breath and other symptoms. Your healthcare provider will make a diagnosis based on your physical exam, symptoms, and tests. You may need any of the following:
- Blood tests are used to check for heart problems such as coronary artery disease or decreased blood flow. Blood tests also give healthcare providers information about your kidney, liver, and thyroid function. The results can also show an infection.
- An EKG test records your heart rhythm and how fast your heart beats. It shows healthcare providers if you have heart block or have had a heart attack.
- Echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart. This test may show if there are problems with your heart valves. It may also show if the chambers of your heart are working properly.
- X-ray, CT, or MRI pictures may be taken of your heart and lungs. The pictures may show the cause of your HF, or blood clots or fluid in your lungs. You may be given contrast liquid before a CT scan or MRI to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
How is HF treated?
HF is often caused by damage or injury to your heart. The damage may be caused by other heart problems, diabetes, or high blood pressure. The damage may have also been caused by an infection. Your healthcare providers will help you manage any other health conditions that may be causing your HF. The goals of treatment are to manage, slow, or reverse heart damage. Treatment may include the following:
- Medicines may be given to help regulate your heart rhythm and lower your blood pressure. You may also need medicines to help decrease extra fluids. Medicines, such as NSAIDs, may be stopped because they are causing your HF to become worse.
- Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. In the program you will learn about exercise, relaxation, stress management, and heart-healthy nutrition. Cardiac rehab may be recommended if your HF is not severe.
- 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 or another device 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.
What can I do to manage HF?
Your quality of life may improve with treatment and the following:
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
- Do not drink alcohol or use illegal drugs. Alcohol and drugs can increase your risk for high blood pressure, diabetes, and coronary artery disease.
- Eat heart-healthy foods and limit sodium (salt). Eat more fresh fruits and vegetables. Eat 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, whole-grain breads, low-fat dairy products, beans, and lean meats. Fatty fish such as salmon and tuna are also heart healthy. Ask how much salt you can eat each day.
- Manage any chronic health conditions you have. These include high blood pressure, diabetes, obesity, high cholesterol, metabolic syndrome, and COPD. You will have fewer symptoms if you manage these health conditions. Follow your healthcare provider's recommendations and follow up with him or her regularly.
- Drink liquids as directed. You may need to limit the amount of liquids you drink if you have fluid buildup. Ask how much liquid to drink each day and which liquids are best for you.
- Maintain a healthy weight. Being overweight can increase your risk for high blood pressure, diabetes, and coronary artery disease. These conditions can make your symptoms worse. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight.
- Stay active. Activity can help keep your symptoms from getting worse. Walking is a type of physical activity that helps maintain your strength and improve your mood. Physical activity also helps you manage your weight. Work with your healthcare provider to create an exercise plan that is right for you.
- Weigh yourself every morning. Use the same scale, in the same spot. Do this after you use the bathroom, but before you eat or drink. Wear the same type of clothing each time. Write down your weight and call your healthcare provider if you have a sudden weight gain. Swelling and weight gain are signs of fluid buildup.
- Get vaccines as directed. Get a flu shot every year. You may also need the pneumonia vaccine. The flu and pneumonia can be severe for a person who has HF. Vaccines protect you from these infections.
Call your local emergency number (911 in the US) if:
- You have any of the following signs of a heart attack:
- Squeezing, pressure, or pain in your chest
- You may also have any of the following:
- Discomfort or pain in your back, neck, jaw, stomach, or arm
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or a sudden cold sweat
When should I call my doctor?
- Your heartbeat is fast, slow, or uneven all the time.
- You have symptoms of worsening HF:
- Shortness of breath at rest, at night, or that is getting worse in any way
- Weight gain of 3 or more pounds (1.4 kg) in a day, or more than your healthcare provider says is okay
- More swelling in your legs or ankles
- Abdominal pain or swelling
- More coughing
- 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.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers 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.
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