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Congestive Heart Failure (CHF)

Advanced Heart
Failure Care

At WakeMed Heart & Vascular Physicians, our advanced heart failure specialists offer comprehensive care.

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What is Congestive Heart Failure?

Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from:

  • Narrowed arteries that supply blood to the heart muscle (coronary artery disease)
  • Past heart attack with scar tissue that interferes with the heart muscle's normal work
  • High blood pressure
  • Heart valve disease due to past rheumatic fever or other causes
  • Primary disease of the heart muscle itself, called cardiomyopathy
  • Heart defects present at birth (congenital heart defects)
  • Infection of the heart valves and/or heart muscle itself (endocarditis and/or myocarditis)

Symptoms of Heart Failure

  • Dry Hacking Cough
  • Fatigue, Loss of Energy
  • Sudden Weight Gain
  • Shortness of Breath, Especially with Activity
  • Awakening Short of Breath at Night
  • Unable to Sleep Lying Flat; Need an Extra Pillow or Need to Sit Up to Sleep
  • Swelling of Ankles, Legs and/or Stomach
  • Lack of Appetite or "Bloated" Feeling
  • Less Urination During the Day; Increased Urination at Night

How is My Heart Affected?

The "failing" heart keeps working, but not as efficiently as it should. People with heart failure cannot over-exert themselves because they become short of breath and tired.

As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Swelling (edema) often results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

Heart Failure usually develops slowly following injury to the heart. Damage to the heart muscle may be caused by coronary artery disease, heart attack, long-term high blood pressure, diabetes, heart valve disease, infection of the heart muscle, viruses or lung problems.

The heart muscle becomes weakened and must work harder to keep blood flowing through the body. The name of this condition does not mean that your heart has suddenly stopped working.

Taking Control of Your Heart

Taking Control can stabilize and perhaps reduce your symptoms, can help you live longer and keep you out of the hospital.

WakeMed Heart & Vascular features a comprehensive Congestive Heart Failure Program designed to help patients self-manage this chronic disease. Managing Congestive Heart Failure results in a better quality of life.

If you have been diagnosed with heart failure, there are many things you can do to help yourself. It is possible to feel well and lead a normal life by taking control of your heart failure by doing the following.

Click on each item to expand the information.

Weigh each morning after using the bathroom. Keep a weight diary by writing your weight down each morning. If you gain two pounds overnight or three to five pounds in a week, notify your doctor.

Heart failure causes the body to hold onto salt/sodium, which causes extra fluid to build up in your body. This fluid makes your heart work harder and causes the symptoms of heart failure. It is recommended that a person with Heart Failure have not more than 2000 mg of sodium a day. Below are tips for you to stay within the recommended amount. When reading food labels, check both the amount of salt/sodium and the serving size. Avoid foods that have more than 350 mg of sodium per serving.

Drinking too much fluid can cause fluid build-up in the body. For most people who have heart failure, fluid intake should be limited to 11⁄2 to 2 quarts a day. Your doctor will tell you how much fluid you should drink.

Your doctor may prescribe a combination of medicines to treat your heart failure. These medications may include pills to reduce fluid build-up and blood pressure reduction, and medicine to improve the way your heart works.

Staying active can help decrease your symptoms, make you feel better and improve your sense of well-being. Ask your doctor about activities appropriate for you.

Regular check-ups with your doctor will help you keep your heart failure under control.

Things to Avoid

Alcohol has a direct effect on the heart muscle. It decreases the strength of the heart’s contraction in an already weakened heart.

Cigarette smoking can damage and weaken the heart. You should avoid all forms of tobacco, including second-hand smoke.

There are some prescription and over-the counter medicines that should be avoided or taken with caution. These drugs can make heart failure symptoms worse by interacting with medicines or causing you to retain fluid. They include nonsteroidal antiinflammatory drugs (NSAIDS) including Ibuprofen (Motrin, Naproxen (Aleve) and Ketoprofen.

Herbal medicines are drugs. Always check with your doctor or a pharmacist before using these.

Taking control of your heart failure is the key to living more actively with a better quality of life. Follow the treatment plan prescribed for you. Your success depends on an active partnership between you, your doctor and nurse.

Call Your Doctor

If you have any of these symptoms:

  • Sudden weight gain of 2 pounds overnight, or 3 to 5 pounds in a week
  • Increased shortness of breath
  • Waking up breathless at night
  • Dry, hacking cough
  • More tired than usual
  • Swelling in the feet, ankles or legs

Congestive Heart Failure Program

The treatment of Congestive Heart Failure is more than providing physical relief. It's about managing a chronic disease. That includes monitoring the patient's condition and providing education about the disease, as well as giving them emotional support. WakeMed's CHF program, started in 1999, is designed to work in conjunction with the patient's primary care physician and cardiologist.

When patients enroll in the CHF Program, a cardiovascular educator provides them with educational materials, including a booklet about heart failure, a weight diary, a sodium checkbook and medication cards for recording information about their medicines.

These tools provide valuable information to health care providers on the daily condition of the CHF patient. Even after a patient has been diagnosed with CHF, hospital readmissions frequently occur because of not knowing how to manage one's lifestyle while suffering from the condition. It is the program's goal to eliminate that problem.

Follow-Up Care By Phone

A key component of the WakeMed CHF program is follow-up care after a patient goes home from the hospital called 'telemanagement.' Patients receive the first telephone call from a CHF educator 48 hours after discharge. Subsequent calls on a weekly basis continues for six weeks. The educators ask patients a number of probing questions about weight management, blood pressure, medications, and general well-being.

The CHF educators are rapid responders and listen closely for signs that a patient's condition may be declining. If they hear a 'red flag,' they try to resolve it quickly under the supervision of the physician before the patient has to be readmitted to the hospital.

After six weeks of phone calls, CHF educators taper down the calls to every other week. Eventually, the calls will come only monthly as the patient learns to manage his or her condition. The program also offers a quarterly support group meeting with a variety of short talks from other members of the health team

For more information about the WakeMed Congestive Heart Failure (CHF) Program, please contact Marian Uy, RN, CHF Program Manager, at 919-350-5732.