Heart Failure

© Excerpted by permission of SmithKline Beecham Pharmaceuticals and Roche Pharmaceuticals.

All About Your Heart - Heart Failure

What does it mean when your doctor diagnoses your condition as heart failure (HF)?

First, let’s talk about what it doesn’t mean. Having heart failure:

• Doesn’t mean your heart has stopped working
• Doesn’t mean it’s about to stop working
• Doesn’t necessarily mean you’ve had a heart attack, or that you’ll ever have one

Having HF simply means that your heart’s pumping power is weaker than it should be. Your heart is working harder than ever to keep blood flowing through your body.

More importantly, HF can be managed. Millions of people are living with HF right now. Together with your healthcare team, you can make your heart’s job easier and help yourself feel better, too. In this booklet, we’ll discuss some of the many things you can do to make living with heart failure easier.

How the Healthy Heart Works

Beating about 60 to 80 times every minute, the healthy heart works full time to pump blood throughout the body. The blood travels through a network of blood vessels called arteries (which carry blood from the heart to the body) and veins (which carry blood back to the heart).

Blood picks up oxygen in the lungs and delivers it to all the body’s organs - along with nutrients absorbed from the food we eat. Blood is kept moving with every pump of the heart - a process called circulation.

When HF Develops

HF develops when something has damaged the heart muscle, resulting in sluggish circulation. Blood flow throughout the body is reduced, and important organs such as the kidneys don’t get all the blood they need to function well.

One of the kidney’s most important jobs is to remove salt and water from the body (by making urine) - but without a good blood supply, the kidneys can’t get rid of all the fluids. So, fluid builds up in the body, a process called “water retention”. This fluid buildup shows itself as swelling, or edema - usually in the ankles, legs and around the belly.

Fluid can also back up in the lungs, causing shortness of breath and, sometimes, coughing. Because the body can become congested with all this extra fluid, this type of heart failure is often called congestive heart failure, or CHF.

What It Feels Like and Why

Some people with HF may not have any symptoms, but usually the body gives signals likes the ones listed below to let you know when something is wrong. You may have some or all of these symptoms once in a while:

• Feeling extra tired
  Since your muscles and organs aren’t getting all the blood they need, you may feel very tired - even after a good night’s sleep.
• Shortness of breath
  If fluid has built up in your lungs, it makes breathing harder - especially during exercise. The problem can get worse at night, when lying down makes the fluid pool around the lungs, sometimes causing a hacking cough. You may find that you’ve started sleeping with extra pillows.
• Swollen ankles, legs, belly, and/or lower back
  These are the places where extra fluid is most likely to build up, as it seeps out of blood vessels into your tissues. Swelling is usually worse at the end of the day.
• Weight gain
  Extra fluid buildup from HF shows up on the scale as extra weight - about 2 pounds for each quart of extra fluid. That’s why keeping track of your weight is an important way to determine how your HF is doing. If your weight stays constant, that’s a good sign that your HF is stable.
• Urinating more at night
  While you lie down at night, the water that has built up in your body can seep back into your blood vessels - where it travels to the kidneys and gets made into urine.

What Started It?

There are many ways the heart can become damaged. Here are just a few:

• Coronary Artery Disease: Fatty deposits, called plaque, can build up in the arteries around the heart, narrowing the channel through which blood flows (think of how squeezing a garden hose blocks off the flow of water). This reduces the oxygen your heart muscle receives and results in damage.
• Heart Attack (Myocardial Infarction): When an artery to the heart becomes completely blocked with plaque, the part of the heart muscle that receives blood from that artery dies. Scar tissue forms over the area, making the heart less able to pump effectively.
• High Blood Pressure (Hypertension): If you have high blood pressure, your heart must work harder to pump blood throughout your body. Over time, this extra work can lead to heart failure.
• Damage to the Heart Valves: Valves in the heart help control the flow of blood through the heart; if they leak or are unable to open completely, the heart can’t circulate blood as well. The valves can be damaged congenitally or by other factors such as the aging process, Rheumatic fever, blood streams infections or other conditions.
• Diseases of the Heart Muscle (Cardiomyopathies): Viral infection, certain drugs used to treat cancer, chemicals such as alcohol or cocaine, or other illnesses can damage the heart muscle.

Your New Life

What You Can Do

No matter how your HF started, or how severe it is, there’s a lot you can do to manage it. By making some changes in your habits of daily living and taking medications your doctor prescribes, you can make a major difference in your health. Even simple actions can produce dramatic results in how you feel. You’ll also need to be aware of your symptoms and keep in regular touch with your doctor, to make sure your treatment is the best it can possibly be.

The key is to realize that by helping to take care of yourself, you can make a difference in your health.

Get on the Scale

Every morning when you wake up, you can take one of the most important steps toward controlling your HF: stepping on the scale. By weighing yourself daily and keeping a record, you can determine if your HF is under control.

Try to weigh yourself at about the same time each morning, after you’ve urinated but before eating or drinking.

If you notice a weight gain for more than 2 days straight, or if you’ve gained 2 or more pounds, you’re probably retaining too much water. This is an important signal for you to call your doctor unless your doctor has given you other weight guidelines by which to call.

Your doctor will probably recommend that you eat a low-salt or low-sodium diet to keep your HF under control. Eating too much salt causes the body to retain too much water. With extra fluid to deal with, the heart has to work even harder.

Get Moving With Exercise

Your heart and circulation can benefit from regular exercise. That’s why your doctor will probably recommend that you make exercise a part of your life. Be sure to talk with your doctor before you start an exercise program.

Extra Help: Medication

Most people with HF need to take medication, sometimes several different types. Taking medication is one of the simplest and most effective ways to manage your HF. You can help to manage your HF by:

• Knowing what medication you’re taking and why
• Taking your medications at about the same time each day
• Following your doctor’s instructions exactly (when to take the medications, whether you can take them with food, what to do if you miss a dose)
• Asking questions if anything is unclear
• Keeping your doctor informed of any problems or side effects you may have
• Keeping a record of all the medications you take and taking it with you whenever you get a prescription filled or visit any healthcare professional

Your Healthcare Team and You

Patient care results are much better if everyone works as a team. Your healthcare team may include doctors, nurses, dieticians, and pharmacists, but the most important member is you.

It’s up to you to stay on top of your health by weighing yourself daily and listening to your body, taking your medications regularly, keeping your appointments with your doctors, and letting them know how you are doing. Don’t be afraid to ask questions. As a healthcare consumer, you have a right to know about your condition and treatment. You deserve to have the best care possible, and you can help make it happen!

 

© Excerpted by permission of SmithKline Beecham Pharmaceuticals and Roche Pharmaceuticals.