The staff of the Texas Heart Institute at St. Luke's Episcopal Hospital Heart Failure Program has prepared some useful information about heart failure to help educate those interested in the topic. The following information covers frequently asked questions about heart failure, when to seek help and the "4 D's" of managing heart failure at home.

Frequently Asked Questions

What is Heart Failure?

Heart Failure is not a disease, but it is a condition that occurs when the heart is unable to pump enough blood to meet the body's needs. This makes the heart work harder, which eventually leads to the symptoms of heart failure.

What are some of the common causes of Congestive Heart Failure?

• Coronary artery disease (blockage of the arteries)
• Damage after a heart attack
• High blood pressure
• Heart muscle disease (cardiomyopathy)
• Heart valve problems
• Chronic rapid or irregular heart beat

What are the common risk factors for heart disease?

• Smoking Obesity (over weight)
• Lack of regular exercise
• High cholesterol
• Hypertension (high blood pressure)
• Stress
• Diabetes
• Use of alcohol and illegal drugs

What are the early symptoms of Heart Failure?

• Shortness of breath, wheezing or coughing when active or when resting
• Weakness or tiredness
• Problems breathing when lying down
• Waking up at night coughing or short of breath Swollen ankles or feet
• Dizzy spells
• Chest discomfort "Racing" or fast heart beat
• Abdominal bloating or nausea

Heart Failure Progression

Heart Failure is a chronic and progressive disease. How long a person might be expected to live with the condition depends on the cause, stage, and treatment plan. The New York Heart Association classifies severity of the symptoms into four classes.

• NYHA I: No limitations; normal physical activity does not cause symptoms
• NYHA II: Slight limitation of physical activity; comfortable at rest, but ordinary physical activity results in symptoms.
• NYHA III: Marked limitation of physical activity; comfortable at rest, but less-than-ordinary physical activity results in symptoms
• NYHA IV: Inability to carry on any physical activity without discomfort; symptoms are present at rest.

When to go to the Emergency Department

If you have already been diagnosed with heart failure, you should go to the St. Luke's Episcopal Hospital Emergency Department, your local emergency department, or call 9-1-1 if you are experiencing:

• New chest pain or discomfort that is sharp, severe, occurs during rest, or is accompanied by other symptoms and causes you concern
• A change in your heart rate that causes symptoms such as shortness of breath, nausea, perspiration, dizziness, or extreme fatigue
• Shortness of breath that is NOT relieved when you rest or change position
• Sudden numbness or weakness in your arms or legs
• Sudden, severe headache
• Fainting spells
• Confusion, slurred speech, loss of balance, or unawareness of surroundings

When to Call Your Health Care Provider

If you have already been diagnosed with heart failure, call your cardiologist, primary care physician, or heart failure nurse if you are having problems with:

• Weight gain of two pounds in one day or five pounds in one week
• Swelling in your ankles, legs, or abdomen that has become worse
• Shortness of breath that has become worse, especially if you wake up short of breath
• Extreme fatigue or decreased ability to carry out regular activity
• A respiratory infection or a cough that has become worse or won't go away
• Frequent chest pain or discomfort when you exert yourself similar to pain you have had in the past that is relieved with rest
• Rapid, irregular or difficult breathing whether you are resting or carrying out regular activity
• Dizziness, lightheadedness or restlessness

The "4 D’s" of Managing Heart Failure

Diet

• Low sodium diet with a maximum of 2,000 mg (2 gm) of sodium per day
• Restrict fluids to 6-8, 8-ounce glasses a day
• Limit alcohol intake or cut out alcohol altogether
• Select items low in salt when dining out

Drugs

• Know your medications, dosages, and side effects
• • B = BETA BLOCKER (Coreg®, Lopressor®)
  • A = ACE INHIBITOR (Zestril®, Vasotec®, Capoten®)
  • A = ANGIOTENSION II RECEPTOR BLOCKERS (Cozaar®, Diovan®)
  • D = DIURETIC (Lasix®, Bumex®, Aldactone®, Zaroxlyn®)
  • D = DIGOXIN (Lanoxin®)
• Do not run out of your medications

Take medications only as directed.

Do's

• Do know your symptoms of increasing heart failure and call your physician and/or Heart Failure Center if any of these symptoms occur:
• Swelling
• "Racing" heart
• Fatigue or Dizziness
• Shortness of breath
• Coughing
• Inability to breathe lying flat
  
• Do weigh yourself every day at the same time in the same clothes
• A 2-5 lb. rapid weight gain can signal a problem
  
• Do exercise in moderation based on your doctor's recommendations
  
• Don'ts
• Don't SMOKE
• Don't run out of your medications
• Don't eat foods high in salt or add salt to foods
• Don't wait to call your doctor or the Heart Failure Center nurse when you notice increasing symptoms
• Don't overexert yourself; instead, take frequent rest breaks