Cardiology. Heart Failure. Information
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1 Cardiology Heart Failure Information
2 Heart Failure Service This leaflet is for patients who have heart failure. It explains what it is, what the symptoms are and what treatment to expect. What is Heart Failure? Heart failure is the term used when the heart s pumping power is weaker than normal and it does not pump enough blood around your body to supply all its needs. Heart failure is a long-term condition which can be treated but not cured. What causes Heart Failure? Your heart failure could have been caused by several things. The most common causes are: A previous heart attack High blood pressure Heart valve disease Long term excess alcohol. 2
3 Other less common causes are Cardiomyopathy (disease of the heart muscle) A virus infection in the heart An irregular heart rate (arrhythmia) Thyroid gland disease Anaemia. What are the signs and symptoms? The most common symptoms are swelling of your feet, ankles and legs breathlessness especially when doing exercise or when lying down at night Fatigue (feeling unusually tired and weak) What is the treatment? The main treatment is with medicines and adjusting your lifestyle. The treatment aims to: Reduce your symptoms Reduce the risk of your heart failure getting worse Help you return to as normal a life as possible. You can help to control your symptoms by changing your lifestyle and self-monitoring of symptoms: 3
4 Weigh yourself daily - Before breakfast, checking for increased swelling (shoes/clothes getting tighter), more breathless than usual doing daily activities. If your weight increases by 1-2 Kg (2-3lb) over 3 days or your symptoms are getting worse, contact your doctor or heart failure nurse. Reduce the amount of salt you eat - Avoid food with high salt content and do not add salt to food. Watch the amount of fluid you drink - Unless advised otherwise by your doctor, you should drink approximately litres a day. Reduce your weight - (if you are overweight) by planned diet and exercise. Stop smoking - Not only will this improve your symptoms and reduce your risk of having a heart attack or stroke, it will improve your circulation and increase your energy levels. It is very important to try to quit smoking. Moderate your weekly intake of alcohol units per day for women, 2-3 units per day for men. If your heart failure was caused by alcohol you should stop drinking alcohol completely. 4
5 Keep active and exercise regularly - Walking is a good form of exercise. Do small amounts daily that you feel comfortable with and gradually increase the length of time. Allow adequate rest time (1½ hours) for digestion after a large meal. You may wish to discuss your needs with your doctor or nurse. General Health - Protect yourself against chest infections by having your pneumonia and annual 'flu vaccinations Sexual activity - People with heart failure may be concerned about sexual activity, but you can resume a sexual relationship once you feel ready to do so. As with other forms of activity you may become tired or breathless. If this happens stop and rest for a short time. Work -You may have some restrictions depending on your job. However as long as you feel well enough, continuing to work and to socialise are very important. Driving - Please discuss this with your doctor, as it will depend on the type of licence that you hold. You must also inform your insurance company. Sleeping -You may find it helpful to sleep with extra pillows. 5
6 Medicines There are a number of medicines that are used for treating heart failure. Taking the correct medicine properly is vital for treating the causes and symptoms of heart failure. It is very important to take your medications every day. Make sure that you have enough so that you do not run out. If you have side effects from your medicine please discuss them with your doctor or nurse before stopping. Most people will benefit from treatment with some or all of the following 4 types of medicine: 1. Diuretics (Water Tablet) - For example Furosemide or Bumetanide. Diuretics help to remove fluid and salt from the body, (making you pass more urine). In getting rid of that fluid they help to reduce ankle swelling and improve breathing. 2. Angiotensin converting enzyme (ACE) inhibitor - For example Ramipril, Perindopril. These medicines relax the blood vessels making it easier for the heart to pump the blood around the body therefore making you feel better and improving your quality of life. 6
7 You will start on a low dose and gradually increase the amount depending on your blood pressure and kidney function. 3. Beta-blocker - For example Bisoprolol, Carvedilol. These tablets work by slowing the heart beat and reducing the amount of work your heart has to do. Usually the dose is increased gradually over several weeks. Please note - If you have asthma you must tell your doctor, as you may not be able to take this medicine. 4. Mineralocorticoid Receptor Antagonists (MRA) - For example Spironolactone or Eplerenone. They have long-term benefits in controlling symptoms and improving quality of life. They also have a mild diuretic effect Other medicines may also be prescribed, such as: Aspirin (and other anti-platelet medicines) - This prevents blood from clotting by reducing the stickiness of platelets which reduces the risk of a heart attack or stroke Digoxin - This is sometimes given, depending on your symptoms. It is used to strengthen the heart beat and if the beat is irregular it can help to steady it. 7
8 Your doctor will select a combination of these and sometimes other drugs to suit your needs. Surgical treatment Very occasionally heart failure can be improved with surgery, such as having a heart valve replacement or with device therapy to help maintain an effective heart rhythm. Your doctor will discuss this with you if it is appropriate. 8
9 Contact Information For further information or answers to any questions or concerns you may have, please contact: Heart Failure Nurse Monday to Friday 8.00am 4.00pm Community Heart Failure Nurse Monday to Friday 9am -5.30pm Except Wednesdays 9am 3pm British Heart Foundation Greater London House 180 Hampstead Rd London W1H 4DH Family Heart Association P.O. Box 116, Kidlington Oxford OX5 1BT Confidential helpline:
10 NHS website Support Group (Heartwise-Corby) Heart Failure Support Programme (16 weeks) based at Lakelands Hospice, Corby Local Stop Smoking Support Line Additional Organisations Relate Northampton Peterborough Contact Quit line Asian Quit lines: Bengali Hindi Gujarati Urdu Punjabi Turkish/Kurdish
11 Citizens Advice Bureau Corby Kettering Rushden Transport Assistance Corby Car Pool Kettering Volunteer Centre Wellingborough Volunteer Centre Serve, Rushden Volunteer Action, Oundle Northampton Volunteer Car Scheme Volunteer Action, South Leicestershire
12 If you need this information in another format or language, please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI 441 January 2015 Review: October 2016
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