Understanding Heart Failure

Document created by kbass Employee on Dec 30, 2016Last modified by Mary Aycock on Jan 4, 2017
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Information for Patients and Families Living with End-Stage Heart Disease

 

The heart is a pump. It pumps blood carrying oxygen and nutrients to all parts of the body. It also helps to remove waste products. If the heart doesn't pump as well as it should it causes fluid to back up into the lungs. This is known as Congestive Heart Failure or CHF. CHF affects all body systems. Each person experiences different symptoms. This guide will help patients and families cope with heart failure.

 

Symptom

Shortness of breath, difficulty breathing


What is happening

When the heart is not pumping as it should, breathing may become faster and more labored as the body struggles to get the oxygen it needs. Having difficulty breathing increases anxiety. Being anxious can increase shortness of breath.

 

What to do

  • Find the most comfortable position for breathing. Sitting straight or leaning on an over-bed table may be helpful. Try raising the head of the bed. Loosen any tight clothing.
  • Use oxygen as ordered, if helpful. Remove extra oxygen tubing to increase airflow during severe episodes.
  • Use a fan to increase air movement; keeping the room cool may be helpful.
  • Discuss with the hospice nurse medications to reduce pain, anxiety and restlessness. Nebulizer treatments or inhalers may be helpful.
  • Practice relaxation techniques such as slow deep breathing. Stay with the patient to help relieve anxiety.
  • If shortness of breath continues, call the hospice nurse.

 

Symptom

Edema, swelling of the feet and legs


What is happening

The kidneys balance the fluid in the body. When the heart doesn't pump enough blood, the kidneys react by trying to hold onto as much fluid as possible. This fluid usually collects in the feet and legs but can also be found in other parts of the body.

 

What to do

  • Elevate feet and legs when sitting or lying down.
  • Walking for short periods may decrease swelling.
  • Avoid standing for long periods of time.
  • Avoid tight fitting shoes, socks or clothing.
  • Be careful when moving to decrease injury to fragile skin.
  • Take medications as ordered.
  • Ask the hospice nurse if changes in diet such as limiting salt would be helpful.
  • Notify the nurse of any new swelling or increase in symptoms.

 

Symptom

Feeling weak and tired


What is happening

The heart's ability to pump is decreasing. The muscles are not getting the blood they need. Blood pressure may be low.

 

What to do

  • Choose the activities that are most important.
  • Try to do things at the time of day when energy is highest.
  • Balance rest and activity. Stop and rest if feeling weak, tired or short of breath.
  • Discuss with the hospice nurse any difficulties sleeping.
  • Discuss with the hospice nurse medications that may affect energy.

 

Symptom

Cough


What is happening

When the heart is not pumping normally, blood may back up and fluid may leak into the lungs causing a cough. This cough is usually dry, but may produce frothy, pink secretions.

 

What to do

  • Raise the head of the bed or prop with pillows.
  • Change position frequently.
  • Discuss diet and medications with the hospice nurse.

 

Symptom

Feeling dizzy or lightheaded.

Confusion or forgetfulness.


What is happening

Blood carries oxygen to the brain. When the heart is not pumping as it should, the brain does not get the oxygen it needs.

 

What to do

  • Use oxygen as ordered, if helpful.
  • Change positions slowly. Sit on the side of the bed until dizziness passes before standing.
  • To decrease the risk of falling, ask for help. A cane or walker may be helpful.
  • Notify the hospice nurse of any falls or if dizziness continues.

 

Symptom

Pressure, squeezing or weight on chest.

Pain in left arm or jaw, neck or shoulder.

Feeling of indigestion or anxiety.


What is happening

The heart is not pumping as it should. Oxygen and blood flow to the heart muscle are reduced. Blockages in the arteries may prevent blood and oxygen flow to the heart.

 

What to do

Use oxygen as ordered. Do not change oxygen settings without talking to the hospice nurse.

If symptoms continue, call the hospice nurse.

 

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