 |
Understanding
Heart Failure:
Answers to Common Questions
Patient
Education Handout associated with
UMHS Clinical Care Guideline
|
This
information is not a tool for self-diagnosis or a substitute for medical treatment.
You should speak to your health-care provider or make an
appointment to be seen if you have questions or concerns about this information
or your medical condition.
Translations available in:
Arabic, Chinese, French, Korean, Russian, Spanish
What
is heart failure?
Heart failure
occurs if the heart muscle is unable to ("fails to") pump enough
blood to meet the body's needs. The blood begins to back up because the heart
is not pumping well and the veins, tissues, and lungs become congested with
fluid. At first, pressure in the heart rises and blood and fluid back up into
your lungs. You will feel short of breath and get tired easily. If the condition
gets worse, the higher pressure causes a buildup of fluid in your veins. Your
feet, legs, and ankles will begin to swell. The body cannot get rid of this
fluid.
Heart failure
is one of the most common causes of heart-related illness and death in the
US.
How does
it occur?
Heart failure may result from one or more of the following:
-
coronary
artery disease (blockage in the coronary arteries)
-
an infection
that may affect your heart
-
heart
attack
-
high
blood pressure
-
damage
to the valves inside the heart
-
drinking
too much alcohol
-
Often no cause can be
found for heart failure.
The following factors
may worsen or trigger heart failure in people with weakened hearts:
-
severe
anemia (low levels of red blood cells or hemoglobin, the oxygen-carrying
chemical in the blood)
-
hyperthyroidism
(an overactive thyroid gland)
-
hypothyroidism
(an underactive thyroid gland)
-
high
fever
-
rapid
heartbeat
-
too
much salt in the diet
-
drinking
too much fluid
-
being
overweight
-
working
your body too hard
-
emotional
stress.
What are the symptoms?
The main symptoms of heart failure are:
-
tiredness
-
shortness
of breath or trouble breathing, at first during exercise and later with
any activity or even when you are resting
-
waking
up at night with trouble breathing or having a hard time lying flat in bed
because of shortness of breath
-
swollen
ankles and feet and weight gain due to too much fluid in the body
-
loss
of appetite.
How is it diagnosed?
Your health care provider will ask about your symptoms and examine you.
You may have some tests, such as:
-
chest
x-ray to look for fluid in the lungs and to see the size of your heart
-
electrocardiogram
(ECG), a recording of the electrical activity of your heart
-
blood
tests
-
urine
tests
-
echocardiogram,
a sound-wave test that can show heart size, heart function, and possible
heart valve disease.
How is it treated?
The goals of treatment are:
-
Reduce
the workload on your heart.
-
Get
rid of extra water in your body.
-
Improve
the ability of your heart to pump.
-
Treat
any problems that make your condition worse.
Limits on your activities
will depend on how severe your heart failure is. Most people benefit from
a gentle exercise program.
Medicines your health
care provider may prescribe for heart failure are:
-
ACE
(angiotensin-converting enzyme) inhibitor drugs and ARB's (angiotensin receptor
blockers), which lower blood pressure and reduce the work the heart has
to do, and which also block the harmful effects of certain hormones on the
heart.
-
Beta
blockers, which lessen the effects of the high levels of adrenaline caused
by heart failure. If beta blockers are given in too high a dose, they may
make heart failure worse. Your health care provider will increase your dose
gradually over a few weeks. Although you may not feel better from these
drugs, your heart may get stronger after several months of treatment.
-
Digitalis
drugs, which slow your heart rate and help your heart to pump better.
-
Diuretics,
which help you get rid of extra fluid in your body by urinating more.
-
Drugs
other than ACE inhibitors that lower blood pressure to reduce the heart's
workload.
-
Spironolactone,
a diuretic that also may keep the heart muscle from getting worse by blocking
the effects of a hormone called aldosterone.
-
Medicines
that replace potassium lost from increased urination. (Potassium is a mineral
that helps maintain normal heart rhythm.)
Ask your health care
provider about possible side effects of these drugs. Report any side effects
to him or her right away. Take all the medicine prescribed, even when you
feel better.
Defibrillators and Pacemakers
Certain devices such as defibrillators and pacemakers
may also be recommended by your physician to help your heart pump better
and to shock your heart if it goes into an abnormal rhythm.
Diet
Your health care provider will also put you on a low-salt (low-sodium) diet.
For example, many patients are asked to eat no more than 2000mg of sodium
per day. Ask your physician how much sodium is right for you. Too much sodium
causes your body to retain water, which increases the workload on your heart.
You should be careful about taking nonprescription drugs because some are
high in sodium. Ask your provider which nonprescription medicines are safe
to use.
Your physician may also ask you to limit your daily fluid intake. Ask your
physician how much fluid per day you should be drinking. To follow this,
you will need to read the food labels on food containers, and keep track
of your daily intake.
How long do the effects
last?
Even with treatment, heart failure is a serious disease. It usually means
a somewhat shortened life span. However, the proper mix of medicines, reduced
salt in your diet, and reduced physical activity will greatly improve your
symptoms. Proper treatment can usually allow you to return to relatively normal
living.
The disease that caused your heart failure will continue to need close medical
attention.
How can I take care
of myself?
Learn to live within the limits of your condition. The following guidelines
may help:
-
Follow your health care provider's advice on how much sodium you should eat in your daily diet
-
Get
enough rest, shorten your working hours if possible, and try to reduce the
stress in your life. Anxiety and anger can increase your heart rate and
blood pressure. If you need help with this, ask your health care provider.
-
Check
your pulse rate daily.
-
Learn
how to take your own blood pressure or have a family member learn how to
take it.
-
Accept
the fact that you will need to take medicines for your heart and limit the
salt in your diet for the rest of your life. Be careful with salt substitutes,
however. Many contain high levels of potassium. Some of the medicines used
to treat heart failure raise the levels of potassium in your blood. Salt
substitutes may raise the potassium levels too high.
-
Develop
a way to make sure that you take your medicines on time.
-
Weigh
yourself at least every other day, at the same time of day if possible.
Contact your health care provider if you gain more than 3 pounds in 1 week,
or if you keep gaining weight over weeks to months. Weight gain may mean
your body is having trouble getting rid of extra fluid.
-
Know
the symptoms of potassium loss, which include muscle cramps, muscle weakness,
irritability, and sometimes irregular heartbeat.
-
Follow
your health care provider's advice on how much fluid you should drink.
-
Consult
a written diet plan and list of foods before you prepare snacks or meals.
-
Try
not to eat or drink too much.
-
Monitor
your activities to make sure that they do not cause you to become too tired
or short of breath.
-
Avoid
extremes of hot and cold (including hot tubs), which may cause your heart
to work harder.
-
Keep
regular medical appointments.
Information maintained
by the UMHS Clinical Care Guidelines Committee
University of Michigan
Health System
734-936-4000
(c) copyright 2006 Regents of the University of Michigan
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