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Heart Failure

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. Not enough oxygen in your blood gets to your organs and tissues. HF can occur in the right side, the left side, or both lower chambers of your heart. HF is often caused by damage or injury to your heart. The damage is caused by other heart problems or high blood pressure. 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. HF can be worsened by heavy alcohol use, smoking, diabetes that is not controlled, or obesity.

Normal Heart CHF Heart

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

The goals of treatment are to manage and slow, or reverse, heart damage. Your healthcare providers will manage your other health conditions that may be causing your HF. Examples include high blood pressure and hyperlipidemia. Treatment may include the following:

  • Medicines help regulate your heart rhythm, lower your blood pressure, and get rid of extra fluids.
  • 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. Healthcare providers 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.

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 damage and make HF difficult to manage. 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 take illegal drugs. Alcohol and drugs can worsen your symptoms quickly.
  • 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 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 how to lose weight safely.
    Weight Checks THA
  • 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.
  • 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.
  • 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, 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. Do not use salt substitutes.
  • Drink liquids as directed. You may need to limit the amount of liquids you drink if you retain fluid. Ask how much liquid to drink each day and which liquids are best for you.
  • 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. Work with your healthcare provider to create an exercise plan that is right for you.
  • 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 911 if:

  • 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

When should I seek immediate care?

  • You gain 3 or more pounds (1.4 kg) in a day, or more than your healthcare provider says you should.
  • Your heartbeat is fast, slow, or uneven all the time.

When should I contact my healthcare provider?

  • You have symptoms of worsening HF:
    • 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
    • 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 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.

© 2017 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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