Heart Failure
Heart failure is when the heart doesn't pump or work as well as it used to. Heart failure may be caused from several factors: tissue around the heart may have become infected causing heart failure; the heart may have suffered damage, such as caused after a heart attack; the valves in the heart may have become insufficient causing a back-flow of blood, the heart then has to pump harder and becomes weaker. Or rarely, the stress of pregnancy can cause heart failure.
With heart failure (congestive heart failure or cardiomyopathy) the heart is unable to pump enough blood to meet the demands of the body. Oxygen can not be delivered to the body adequately. Extra fluid may spill offer into the tissue causing edema in the legs, feet and hands, the abdomen may swell, and the fluid may eventually go to the lungs worsening the ability to breathe. Most patients have shortness of breath when walking distances or they may have to sit up to breath. If these symptoms worsen, or change, then the patient needs to be seen by their primary care physician or cardiologist. Patients need to keep track of their weights daily, notifying their physician with any increase of weight over 3-5 pounds. You will also need to keep track of your sodium intake (salt intake) and activity levels. Limiting the amount of sodium you have/use on a daily basis will help limit the amount of fluid you retain.
What can you do? As an individual you can do a lot to help control the frequency of increase heart failure symptoms. One is weigh yourself on the same scale, at the same time, every day. We recommend that you do this right after you urinate and before you eat breakfast every morning. If you have gained over 3-5 pounds overnight, call your practitioner. Second, take your medications as prescribed. They are given to you on an individualized basis depending on your degree of heart failure, your salt intake, fluid intake and activity levels. Thirdly, if you are overweight, shed those extra few pounds, after discussing a weight management program with your physician. Losing the extra pounds will be of benefit as the excess weight puts an extra burden on your already stressed heart. Fourth, remain physically active, according to your physicians recommendations. Limit your activities according to your body. If you feel tired - rest, if you are short of breath - rest. Know your limitations, you may need to do your activities at a slower pace than you would have before. Space your activities apart. For example, don't try to bath, shave, eat and dress in the same hour. Divide them up and rest in between, remember resting, does not mean sleeping. Sleeping in excess during the day will, of course, disturb your natural sleep cycle.
What can make it worse? Some things may cause your heart failure to worsen. Things like eating high-salt foods, drinking excess fluids, smoking, activities or situations that would increase your heart rate, failure to take your medications, or increasing your anxiety or stress level.
What should I report? Please call or come in for an evaluation if you are becoming increasingly short of breath, grow increasingly tired, develop a cough, notice increased swelling in your feet or ankles. Or if you find that you have swelling in your hands, fingers, low back or hips. If you gain 3-5 pound overnight, feel anxious, experience chest pain or if you can't sleep laying flat.
A team approach. With congestive heart failure, you and your doctor need to work closely together to find the right mix of medications for you, the right activity levels, the correct diet, and plan of treatment. Your cardiologist will work closely with your primary care doctor. Treatment may include valve replacement, bypass surgery, heart transplant, medical therapy. It all depends on the cause of the heart failure. You may need to be enrolled in a cardiac rehab program to help increase your exercise tolerance, you may talk with a dietician to discuss your limitations, and you may be working with a social worker if you are unable to return to work.
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