Transcript Document
Lifestyles, Fitness and Rehabilitation Heart Failure Lifestyles, Fitness and Rehabilitation Heart Failure • What is Heart Failure? – The heart is not pumping as well as it should – Usually, the heart has been weakened by an underlying condition • • • • • Blocked arteries Heart attack High blood pressure Infections Heart valve abnormalities Lifestyles, Fitness and Rehabilitation Heart Failure • What is Heart Failure? – Heart failure can involve the left or right 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 Lifestyles, Fitness and Rehabilitation Heart Failure • What is Heart Failure? Lifestyles, Fitness and Rehabilitation Heart Failure • What is Left Heart Failure? – Involves the left ventricle (lower 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 Lifestyles, Fitness and Rehabilitation Heart Failure • What is Left Heart Failure? – Systolic and diastolic heart failure are 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) Lifestyles, Fitness and Rehabilitation Heart Failure • What is Right Heart Failure? – Usually occurs as a result of left heart 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) Lifestyles, Fitness and Rehabilitation Heart Failure • How fast does heart failure develop? – Usually a chronic disease – The heart tries to compensate for the loss in pumping function by: • Developing more muscle mass • Enlarging • Pumping faster Lifestyles, Fitness and Rehabilitation Heart Failure • What Causes Heart Failure? – Health conditions that either damage 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) Lifestyles, Fitness and Rehabilitation Heart Failure • What Causes Heart Failure? • • • • • • Congenital heart defects Severe lung disease Diabetes Severe anemia Overactive thyroid gland (hyperthyroidism) Abnormal heart rhythms Lifestyles, Fitness and Rehabilitation Heart Failure • What Causes Heart Failure? – 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 Lifestyles, Fitness and Rehabilitation • What Causes Heart Failure? – 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 Lifestyles, Fitness and Rehabilitation • What Causes Heart Failure? – High blood pressure • Uncontrolled high blood pressure doubles a 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 Lifestyles, Fitness and Rehabilitation • What Causes Heart Failure? – Abnormal heart valves – Heart muscle disease • Damage to heart muscle due to drugs, alcohol or infections – Congenital heart disease – Severe lung disease Heart Failure Lifestyles, Fitness and Rehabilitation • What Causes Heart Failure? – Diabetes • Tend to have other conditions that make the heart work harder • Obesity • Hypertension • High cholesterol Heart Failure Lifestyles, Fitness and Rehabilitation • What Causes Heart Failure? – Severe anemia • Not enough red blood cells to carry oxygen • 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 Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Shortness of Breath (dyspnea) • 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 Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Persistent Cough or Wheezing • WHY? – Fluid “backs up” in the lungs • SYMPTOMS – Coughing that produces white or pink bloodtinged sputum Heart Failure Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Edema • 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 Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Tiredness, fatigue • 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 Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Lack of appetite/ Nausea • WHY? – The digestive system receives less blood causing problems with digestion • SYMPTOMS – Feeling of being full or sick to your stomach Heart Failure Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Confusion/ Impaired thinking • 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 Lifestyles, Fitness and Rehabilitation • Signs and Symptoms of Heart Failure – Increased heart rate • 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 Lifestyles, Fitness and Rehabilitation • New York Heart Association (NYHA) Functional Classification Class % of 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 Lifestyles, Fitness and Rehabilitation • Treatment Options – The more common forms of heart failure cannot be cured, but can be treated • Lifestyle changes • Medications • Surgery Heart Failure Lifestyles, Fitness and Rehabilitation • Lifestyle changes – Stop smoking – Loose weight – Avoid alcohol – Avoid or limit caffeine – Eat a low-fat, low-sodium diet – Exercise Heart Failure Lifestyles, Fitness and Rehabilitation • Lifestyle changes – Reduce stress – 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 Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – 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 Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – 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 Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – 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 Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – Vasodilators • Cause blood vessel walls to relax • Occasionally used if patient cannot tolerate ACE • Decrease workload of the heart Heart Failure Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – Digitalis preparations • Increases the force of the hearts contractions • Relieves symptoms • Slows heart rate and certain irregular heart beats Heart Failure Lifestyles, Fitness and Rehabilitation • Medications used to treat Heart Failure – 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 Lifestyles, Fitness and Rehabilitation • Treatment options – Surgery and other Medical Procedures • 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)