heart failure - ministry of health

Lifestyles, Fitness

and Rehabilitation

Heart FailureHeart Failure

Heart Failure

• What is Heart Failure?– The heart is not pumping as well as it should

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should

– Usually, the heart has been weakened by an underlying condition• Blocked arteries

• Heart attack

• High blood pressure

• Infections

• Heart valve abnormalities

Heart Failure

• What is Heart Failure?– Heart failure can involve the left or right

side of the heart or both

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side of the heart or both

– Usually the left side is affected first

– Heart failure occurs when either side of

the heart cannot keep up with the flow

of blood

Heart Failure• What is Heart Failure?

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Heart Failure

• What is Left Heart Failure?– Involves the left ventricle (lower chamber) of the heart

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chamber) of the heart

– Systolic failure• The heart looses it’s ability to contract or pump blood into the circulation

– Diastolic failure• The heart looses it’s ability to relax because it becomes stiff

• Heart cannot fill properly between each beat

Heart Failure

• What is Left Heart Failure?– Systolic and diastolic heart failure are

treated with different types of

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treated with different types of

medications

– In both types, blood may “back up” in

the lungs causing fluid to leak into the

lungs (pulmonary edema)

– Fluid may also build up in tissues

throughout the body (edema)

Heart Failure

• What is Right Heart Failure?– Usually occurs as a result of left heart

failure

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failure

– The right ventricle pumps blood to the

lungs for oxygen

– Occasionally isolated right heart failure

can occur due to lung disease or blood

clots to the lung (pulmonary embolism)

Heart Failure

• How fast does heart failure

develop?– Usually a chronic disease

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and Rehabilitation

– Usually a chronic disease

– The heart tries to compensate for the

loss in pumping function by:

• Developing more muscle mass

• Enlarging

• Pumping faster

Heart Failure

• What Causes Heart Failure?– Health conditions that either damage

the heart or make it work too hard

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the heart or make it work too hard

• Coronary artery disease

• Heart attack

• High blood pressure

• Abnormal heart valves

• Heart muscle diseases (cardiomyopathy)

• Heart inflammation (myocarditis)

Heart Failure

• What Causes Heart Failure?• Congenital heart defects

• Severe lung disease

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• Severe lung disease

• Diabetes

• Severe anemia

• Overactive thyroid gland (hyperthyroidism)

• Abnormal heart rhythms

Heart Failure

• What Causes Heart Failure?– Coronary artery disease

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– Coronary artery disease

• Cholesterol and fatty deposits build up in

the heart’s arteries

• Less blood and oxygen reach the heart

muscle

• This causes the heart to work harder and

occasionally damages the heart muscle

Heart Failure

• What Causes Heart Failure?– Heart attack

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– Heart attack

• An artery supplying blood to the heart

becomes blocked

• Loss of oxygen and nutrients damages

heart muscle tissue causing it to die

• Remaining healthy heart muscle must pump

harder to keep up

Heart Failure

• What Causes Heart Failure?– High blood pressure

• Uncontrolled high blood pressure doubles a

persons risk of developing heart failure

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persons risk of developing heart failure

• Heart must pump harder to keep blood

circulating

• Over time, chamber first thickens, then gets

larger and weaker

Heart Failure

• What Causes Heart Failure?– Abnormal heart valves

Heart muscle disease

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– Heart muscle disease

• Damage to heart muscle due to drugs,

alcohol or infections

– Congenital heart disease

– Severe lung disease

Heart Failure

• What Causes Heart Failure?– Diabetes

• Tend to have other conditions that make the

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• Tend to have other conditions that make the

heart work harder

• Obesity

• Hypertension

• High cholesterol

Heart Failure

• What Causes Heart Failure?– Severe anemia

• Not enough red blood cells to carry oxygen

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• Heart beats faster and can become overtaxed with

the effort

– Hyperthyroidism

• Body metabolism is increased and overworks the

heart

– Abnormal Heart Rhythm

• If the heart beats too fast, too slow or irregular it may

not be able to pump enough blood to the body

Heart Failure

• Signs and Symptoms of Heart Failure

– Shortness of Breath (dyspnea)

• WHY?

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and Rehabilitation

• WHY?

– Blood “backs up” in the pulmonary veins

because the heart can’t keep up with the supply

an fluid leaks into the lungs

• SYMPTOMS

– Dyspnea on exertion or at rest

– Difficulty breathing when lying flat

– Waking up short of breath

Heart Failure


– Persistent Cough or Wheezing

WHY?

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• WHY?

– Fluid “backs up” in the lungs

• SYMPTOMS

– Coughing that produces white or pink blood-

tinged sputum

Heart Failure


– Edema

WHY?

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• WHY?

– Decreased blood flow out of the weak heart

– Blood returning to the heart from the veins

“backs up” causing fluid to build up in tissues

• SYMPTOMS

– Swelling in feet, ankles, legs or abdomen

– Weight gain

Heart Failure


– Tiredness, fatigue

• WHY?

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• WHY?

– Heart can’t pump enough blood to meet needs of

bodies tissues

– Body diverts blood away from less vital organs

(muscles in limbs) and sends it to the heart and

brain

• SYMPTOMS

– Constant tired feeling

– Difficulty with everyday activities

Heart Failure


– Lack of appetite/ Nausea

• WHY?

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• WHY?

– The digestive system receives less blood

causing problems with digestion

• SYMPTOMS

– Feeling of being full or sick to your stomach

Heart Failure


– Confusion/ Impaired thinking

• WHY?

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• WHY?

– Changing levels of substances in the blood (

sodium) can cause confusion

• SYMPTOMS

– Memory loss or feeling of disorientation

– Relative or caregiver may notice this first

Heart Failure


– Increased heart rate

• WHY?

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• WHY?

– The heart beats faster to “make up for” the loss

in pumping function

• SYMPTOMS

– Heart palpitations

– May feel like the heart is racing or throbbing

Heart Failure

• New York Heart Association (NYHA)

Functional Classification

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Class % of

patients

Symptoms

patients

I 35% No symptoms or limitations in ordinary physical

activity

II 35% Mild symptoms and slight limitation during

ordinary activity

III 25% Marked limitation in activity even during minimal

activity. Comfortable only at rest

IV 5% Severe limitation. Experiences symptoms even at

rest

Heart Failure

• Treatment Options

– The more common forms of heart failure

cannot be cured, but can be treated

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cannot be cured, but can be treated

• Lifestyle changes

• Medications

• Surgery

Heart Failure


– Stop smoking

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– Loose weight

– Avoid alcohol

– Avoid or limit caffeine

– Eat a low-fat, low-sodium diet

– Exercise

Heart Failure


– Reduce stress

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– Keep track of symptoms and weight and

report any changes or concern to the

doctor

– Limit fluid intake

– See the doctor more frequently

Heart Failure

• Medications used to treat Heart

Failure

– ACE Inhibitors

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and Rehabilitation

– ACE Inhibitors

• Cornerstone of heart failure therapy

• Proven to slow the progression of heart

failure

• Vasodilator – cause blood vessels to

expand lowering blood pressure and the

hearts work load

Heart Failure


Failure

– Diuretics (water pills)

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– Diuretics (water pills)

• Prescribed for fluid build up, swelling or

edema

• Cause kidneys to remove more sodium and

water from the bloodstream

• Decreases workload of the heart and edema

• Fine balance – removing too much fluid can

strain kidneys or cause low blood pressure

Heart Failure


Failure

– Potassium

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– Potassium

• Most diuretics remove potassium from the

body

• Potassium pills compensate for the amount

lost in the urine

• Potassium helps control heart rhythm and

is essential for the normal work of the

nervous system and muscles

Heart Failure


Failure

– Vasodilators

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– Vasodilators

• Cause blood vessel walls to relax

• Occasionally used if patient cannot tolerate

ACE

• Decrease workload of the heart

Heart Failure


Failure

– Digitalis preparations

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– Digitalis preparations

• Increases the force of the hearts

contractions

• Relieves symptoms

• Slows heart rate and certain irregular heart

beats

Heart Failure

• Medications used to treat Heart Failure

– Beta-blockers

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– Beta-blockers• Lower the heart rate and blood pressure

• Decrease the workload of the heart

– Blood-thinners (coumadin)• Used in patients at risk for developing blood clots in the blood vessels, legs, lung and heart

• Used in irregular heart rhythms due to risk of stroke

Heart Failure

• Treatment options

– Surgery and other Medical Procedures

• Not often used in heart failure unless there

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• Not often used in heart failure unless there

is a correctable problem

• Coronary artery bypass

• Angioplasty

• Valve replacement

• Defibrillator implantation

• Heart transplantation

• Left ventricular assist device (LVAD)

heart failure - ministry of health

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