© 2000 heart failure society of america, inc. understanding heart failure presented by susan...

© 2000 Heart Failure Society of

America, Inc.

Understanding Heart Failure

presented bySusan Roberts, ANP

Scott Ward, ANPCongestive Heart Failure Clinic

as a service ofDurham VA Medical Center

© 2000 Heart Failure Society of

America, Inc.

What is Heart Failure?

• Heart failure is a condition that develops when the heart's muscle becomes weakened after it is injured, often from a heart attack or high blood pressure, and fails to pump enough blood to meet the metabolic needs of the body.

© 2000 Heart Failure Society of

America, Inc.

Heart Failure Does NOT Mean...

• That the heart has stopped working or is about to stop working, or that the patient has had a heart attack.

PATIENTS CAN LIVE WITH HEART FAILURE!

© 2000 Heart Failure Society of

America, Inc.

How Does Heart Failure Affect the Body?

• Not enough blood circulating

• “Congestion” or fluid build up in the lungs, extremities, and other areas of the body

© 2000 Heart Failure Society of

America, Inc.

How Many People Have Heart Failure?

• Heart failure is very common

• Heart failure affects nearly 5 million Americans

• An estimated 400,000 to 700,000 new cases are diagnosed each year

© 2000 Heart Failure Society of

America, Inc.

What Causes Heart Failure?

Heart failure results after injury to the heart. Risk factors include:

• Heart attack

• High blood pressure

• High cholesterol

• Damage to the heart valves

• Diabetes

• Obesity

• Advancing age

• Cocaine and alcohol use

© 2000 Heart Failure Society of

America, Inc.

What Are The Symptoms of Heart Failure?

Think FACES...

• Fatigue

• Activities limited

• Chest congestion

• Edema or ankle swelling

• Shortness of breath

© 2000 Heart Failure Society of

America, Inc.

Diagnostic Workup for Heart Failure

The following tests are helpful in diagnosing heart failure:

• Echocardiogram, or “ECHO” Ejection Fraction

Healthy heart = 60% or more

Heart failure = 40 % or less

• Electrocardiogram

• Chest X-ray

© 2000 Heart Failure Society of

America, Inc.

New York Heart Association (NYHA) Classification

• Class I - No limitation of physical activity

• Class I - Slight limitation of physical activity

• Class III - Marked limitation of physical activity

• Class IV - Unable to carry on any physical activity without discomfort

© 2000 Heart Failure Society of

America, Inc.

Is There a Cure For Heart Failure?

• No, currently there is no medical cure

• BUT, early diagnosis and proper treatment can:

- Significantly slow the progression of disease

- Keep patients out of the hospital

- Save lives!

© 2000 Heart Failure Society of

America, Inc.

What Are The Treatments for Heart Failure?

Experts recommend:

• Diuretics - helps control symptoms

• Digoxin - helps control symptoms

• ACE Inhibitors - can slow down disease progression

• Beta Blockers - can slow down disease progression

• Spironolactone - can slow down disease progression

This combination of medications has been proven to save lives and keep people out of the hospital.

© 2000 Heart Failure Society of

America, Inc.

Medicines to Control Symptoms...

• Diuretics: decrease fluid retention and reduce swelling

• Digoxin: improves blood circulation by strengthening the contraction of the heart

© 2000 Heart Failure Society of

America, Inc.

Medicines That Save Lives…used for their neuro-hormonal effects

• ACE Inhibitors: dilate or widen blood vessels; increase blood flow and block the body’s response to substances which can damage the heart

• Beta blockers: help strengthen the heart’s pumping ability; block the body’s response to substances which can damage the heart

© 2000 Heart Failure Society of

America, Inc.

Medicines That Save Lives…

• Spironolactone- for class III-IV heart failure patients. Can block the body’s response to substances which can damage the heart.

© 2000 Heart Failure Society of

America, Inc.

AICD’s and Pacemakers

• Some patients with heart failure can benefit from an automatic internal cardiac defibrillator (AICD) or biventricular (BiV) pacemaker. In order to qualify for an AICD the patient must:

- Have an EF or 30% or less, and - Have a history of CAD, although results of a recent clinical trial (SCD-HeFT) indicate that patients without CAD may also benefit

© 2000 Heart Failure Society of

America, Inc.

BiV Pacemakers

• In order to qualify for a BiV pacer, the patient must meet the qualifications for an AICD and:

- Have NYHA Class III or IV symptoms

- Have a QRS complex >120

© 2000 Heart Failure Society of

America, Inc.

Can a Person Live with Heart Failure?

YES!!!• Patients need regular follow-up

• Educating patients regarding signs and symptoms of heart failure is crucial

© 2000 Heart Failure Society of

America, Inc.

Discharge Teaching for Heart Failure Patients

• Take medications as prescribed. Don’t run out.

• Weigh daily. Weight gain of 3 pounds overnight, or 5 pounds in 5 days indicates fluid retention.

• Stop smoking.• Eat a low sodium diet.• Take blood pressure daily. Goal for most

patients is < 130/80.

© 2000 Heart Failure Society of

America, Inc.

Discharge Teaching for Heart Failure Patients

• Proceed with activity as you can tolerate it. If it makes you short of breath, slow down or stop. If you have chest pain, slow down or stop and if unrelieved by nitroglycerin, call your doctor or 911.

• Any questions, call your provider.

© 2000 Heart Failure Society of

America, Inc.

For More Information About Heart Failure, Contact…

The Heart Failure Society of Americavia their web sites:

• Individuals - www.abouthf.org

• Professionals – www.hfsa.org