Download Understand heart failure

Information booklet for patients and families
Understand heart failure
Take control
Jewish General Hospital
3755 Côte St Catherine Road
Montreal, Québec H3T 1E2
www.jgh.ca
(514) 340-8222
Important - Please read carefully
This information should not be considered as medical advice. It is not to be used in
place of a visit with a doctor, nurse or other healthcare professional. If you have
questions about your individual medical situation, please consult with your healthcare
professional.
© October, 2014
Prepared by
Valerie Labelle, RN
Laurence Lebel, RN
Illustrated by
Laurence Lebel
Special thanks for the contribution to this project:
Isabelle Cormier, RN
Emilie Gauthier, RN
Nicole Lebel, RN
Paule Lebel, M.D.
Caroline Michel, M.D.
Richard Sheppard, M.D.
Monique Van Ockenburg, RN
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Table of contents
What is heart failure? ................................................................................. 4
Sympoms of heart failure ........................................................................... 6
Treatment for heart failure ........................................................................ 7
1) Medications ......................................................................................... 8
2) Diet ...................................................................................................... 9
a) Control how much fluid you drink ..................................................... 9
b) Control your sodium intake (salt) .................................................... 10
c) Consider the meditarranean diet ..................................................... 12
d) Do not drink any alcohol ................................................................. 13
3) Smoking cessation.............................................................................. 13
4) Weight ............................................................................................... 14
5) Exercise .............................................................................................. 15
6) Rest and relaxation ............................................................................ 16
7) Vaccination ........................................................................................ 16
8) Psychological adapatation ................................................................. 17
9) Recognition of increased heart failure symptoms ............................. 18
Resources and websites ........................................................................... 20
References ................................................................................................ 21
Crosswords ............................................................................................... 22
3
What is heart failure?
Heart failure is a medical condition in which the heart muscle has been
weakened or becomes stiff. The heart is not able to pump blood as well
as it should to supply needed oxygen and nutrients to your body.
Heart failure can be managed successfully, but it can’t be cured. Over
time, the degree of heart failure usually gets worse. Your symptoms may
appear, disappear for a while, and then reappear. This can happen very
quickly, or gradually over a long period of time.
Heart failure affects the whole family, not just one person. When
symptoms appear or reappear, healthcare professionals can help you
and your family.
4
Some of the causes of heart failure are:
 High blood pressure;
 Damage to the heart muscle from a heart attack;
 Heart valves that do not open and close well;
 Toxins such as alcohol, chemotherapy, cocaine and other
drugs;
 A virus or bacteria that attacks the heart muscle;
 Severe lung disease;
 A heart defect that has been present since birth;
 Unknown.
Heart failure means your heart has stopped beating.
True
False
False! Heart failure does not mean your heart has stopped
beating. Heart failure occurs when your heart muscle has been
weakened and so your heart is not able to pump blood around
your body as well as it should.
Heart failure is a normal consequence of getting old.
True
False
False! Although most people with heart failure are elderly, heart
failure does not have to be a part of the aging process. It is a very
serious condition that can be prevented and greatly helped with
available treatments.
5
Sympoms of heart failure
Heart failure symptoms can vary widely from person to person,
depending on the type of heart failure you have. Therefore, you may
have all of the symptoms described here or just a few of them. Both men
and women can have some or all of these symptoms.
Tip! Place me in sight.
6
Treatment for heart failure
You are the most important person in managing your heart failure.
You can help yourself feel better and enjoy a better quality of life.
You can live a longer and healthier life.
You can prevent or reduce the number of hospital visits related to heart
failure.
Tip! Place me in sight.
7
1) Medications
 Do not stop, add or reduce the dosage of your medications without your
doctor’s advice.
 Always check with your pharmacist before purchasing over the counter
medications. Some medications available without prescription may make your
heart failure worse.
 Avoid using natural products without talking with your pharmacist or your
doctor. Some of these products can react badly with your medication and
create side effects.
 Always keep your list of your medications on you.
 Prepare your medication using pill boxes or ask your pharmacist to do it.
If you have a headache, you should take Advil® or Motrin®.
True
False
False! These over the counter medications can cause a build-up
of fluid that makes your heart failure worse. Choose Tylenol®.
If you forget to take a pill, 2 pills can be taken at the next
scheduled dosage time.
True
False
False! It is important not to double dose. It is very crucial to take
medication as prescribed.
8
2) Diet
With heart failure, you should...
a) Control how much fluid you drink
Drink less than 6 cups (48 oz) or 1500 ml (1.5 litre) of fluid per day. This includes
all types of fluids that you drink, at meals and between meals.
Some examples of fluid are:
o water (including what you use to take your
medications)
o juice
o soft drink
o Jell-O ®
o milk
o ice cream
o alcohol
o coffee
o ice cubes
o soups
o tea
TIPS to help you control your thirst!
 Rinse your mouth with cold water or
mouth wash;
 Brush your teeth often;
 Suck on ice cubes;
 Eat frozen fruit (lemon slices, grapes,
strawberries, orange quarters);
 Chew sugar free gum or suck on
sugar free candies;
 Use artificial saliva (available in
pharmacies).
The pitcher method
Step 1
Step 2
Step 3
 Take an empty pitcher of 1.5 liters or more
 When you drink a liquid, add the same amount of
liquid to the pitcher
 When the pitcher is full, you have reached the
amount of liquid allowed for the day
9
b) Control your sodium intake (salt)
 Limit your sodium (salt) intake to 2,000 mg or less per day.
 Too much salt intake may cause a build-up of fluid in your body.
 Do not use the salt shaker.
 Avoid salt substitutes that contain potassium.
 Improve the taste of food by using these alternatives:
o Fine herbs
o Ginger
o Garlic
o Aromatic vinegars
o Onion
o Tomato juice with reduce salt content
o Lemon juice
o Spices (paprika, celery powder, curry,
o Pepper
oregano, chives, bay leaf, parsley, etc.)
10
o
o
o
o
o
ATTENTION! The following terms mean "salt":
Sodium
o Sulfite or sodium
o Monosodium
Sea salt
sulphite
glutamate or sodium
Natural salt
o Sodium benzoate
monoglutamate
Garlic or onion salt
Sodium or soda
(GMS)
Vegetable salt
bicarbonate or
o Monosodium
baking soda
phosphate
Make a habit of reading the food labels
Sodium Mg per serving
High
Medium
Low
400+
200-400
0-200
Sea salt is a low sodium alternative to table salt.
True
False
False! Chemically, sea salt is the same as table salt.
11
c) Consider the meditarranean diet
If you're looking for a heart-healthy eating plan, the mediterranean diet might be
right for you. Here are some specific steps to get you started:
12
d) Do not drink any alcohol
 Alcohol may change how your medication works.
 Alcohol makes your heart pump more weakly.
 Alcohol may cause or worsen irregular heart rhythm.
 Alcohol weakens the heart muscle, which means the heart can't pump blood
as well.
3) Smoking cessation
Smoking or breathing second hand smoke harms the heart
widely. The best action you can take to manage heart failure is to
stop smoking.
13
4) Weight
Weigh yourself every day when you first get up in the morning, after going
to the bathroom, but before you get dressed or have breakfast.
MONTH: __________________
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
26
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Important
Contact your doctor if you gained more than 5 lbs (3 kg) in a week.
Tip! Photocopy me and keep me with you at your next appointment.
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5) Exercise
Regular physical activity:
 Is part of the treatment for heart failure;
 Improves quality of life;
 Helps to slow the progression of heart failure;
 Improves physical and psychological health.
Walking is an ideal activity. It can be done outdoors or indoors at your own pace.
These symptoms mean that you should stop the activity and talk to your doctor:
 Pain
 Dizziness
 Palpitations
 More short of breath than usual
 Tightness in your chest
 Nausea
People with heart failure should avoid exercise.
True
False
False! Exercise makes muscles, including your heart, stronger
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6) Rest and relaxation
 After any period of activity, it is
important to allow the heart to
rest and catch up with the body’s
demands on it.
 Rest is
meals.
also
important
after
 Resting does not have to be
sleeping. It can be a quiet time of
listening to music, relaxing or
reading.
7) Vaccination
You should get a flu shot every year and a one-time
pneumonia shot.
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8) Psychological adapatation
Heart failure puts new limits on you and the people around you.
You will need to adapt to many changes. This will require time, courage,
determination and support.
Your healthcare professionals can help you and your family:
 If you have a hard time accepting your
diagnosis of heart failure, your new
limits;
 If you have a hard time following the
advice of your health care team;
 If you feel depressed or anxious.
Tips to maintain balance!

Continue your activities (social, professional, physical, sexual) as
much as possible;

Prioritize;

Accept the help you can get;

Express your emotions and your needs;

Share your feelings with someone you trust.
Never forget to take care of yourself at all times:
You are the priority!
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9) Recognition of increased heart failure
symptoms
You should seek help if you have these symptoms:
 More shortness of breath than usual;
 More swelling of ankles or abdomen than usual;
 Gained more then 5 lbs (3 kg) in a week;
 Need to sleep with more pillows;
 Waking up at night short of breath;
 More fatigue than usual;
 Cough that won't go away.
Once a person needs to go to the hospital for treatment of
heart failure, little can be done to improve his or her
condition.
True
False
False! For people who need to go to the hospital because of
worsening heart failure, there are several options. In the hospital,
the health care professionals work together to relieve your
symptoms. Once you are stable, the team will help you manage
heart failure at home.
People with heart failure should weigh themselves once a
week.
True
False
False! Weighing yourself every day at the same time is a key
step in keeping an eye on heart failure. Weight gain may be a
sign that your heart failure is getting worse. Weight gain can also
mean that you are holding onto fluids, which may cause swelling,
especially in the feet and ankles.
18
If you have some symptoms and your health worries you, please
contact:
CLSC
Telephone: (
HEALTH
INFORMATION
)
.
8-1-1
FAMILY DOCTOR
Name:
Telephone: (
CARDIOLOGIST
Name:
Telephone: (
PHARMACY
Name:
Telephone: (
OTHER
Name:
Telephone: (
.
)
)
9-1-1
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.
-
.
.
)
-
.
.
)
 You have extreme difficulty breathing;
 You feel heart palpitations, or rapid thumping inside your chest;
 Chest discomfort that does not go away after using Nitro®.
Go to:
.
If you cannot wait or have the following symptoms:
EMERGENCY
-
-
.
Resources and websites
For more information on heart failure, visit:
 JGH Patient & Family Resource Centre
www.jgh.ca/pfrc
 Heart & Stroke Foundation
www.heartandstroke.qc.ca
 Canadian Heart Failure Network
www.chfn.ca/patients-caregivers
 Montreal Heart Institute
www.icm-mhi.org/en/patients-and-visitors
 Public Health Agency of Canada
www.phac-aspc.gc.ca/cd-mc/cvd-mcv/index-eng.php
 MedlinePlus
www.nlm.nih.gov/medlineplus/heartdiseases.html
 American Heart Association
www.heart.org/
 Centers for Disease Control and Prevention (CDC)
www.cdc.gov/heartdisease/
 Health Canada
www.hc-sc.gc.ca/hc-ps/dc-ma/heart-coeur-eng.php
 Canada's Food Guide
www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php
For more information on smoking cessation, visit:
 Quebec Council on Tobacco and Health
www.iquitnow.qc.ca/
 Canadian Cancer Society
www.smokershelpline.ca
20
References
Arnold, J.M., Liu, P., Demers, C., Dorian, P., Giannetti, N., Haddad, H., … White, M.
(2006). The Canadian Cardiovascular Society consensus conference
recommendation on heart failure 2006: Diagnosis and management. Canadian
Journal of Cardiology, 22, 23-45.
Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J., Ponikowski, P., PooleWilson, P., & ... Swedberg, K. (2008). ESC guidelines for the diagnosis and
treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis
and treatment of acute and chronic heart failure 2008 of the European Society of
Cardiology. Developed in collaboration with the Heart Failure Association of the
ESC (HFA) and endorsed by the European Society of Intensive Care Medicine
(ESICM). European Journal Of Heart Failure, 10(10), 933-989.
Lindenfeld, J., Albert, N., Boehmer, J., Collins, S., Ezekowitz, J., Givertz, M., & ...
Walsh, M. (2010). HFSA 2010 Comprehensive Heart Failure Practice Guideline.
Journal Of Cardiac Failure, 16(6), e1-e194.
Hunt, S., Abraham, W., Chin, M., Feldman, A., Francis, G., Ganiats, T., & ... Riegel, B.
(2005). ACC/AHA 2005 Guideline Update for the Diagnosis and Management of
Chronic Heart Failure in the Adult: a report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing Committee to Update the 2001 Guidelines for the Evaluation and
Management of Heart Failure): developed in collaboration with the American
College of Chest Physicians and the International Society for Heart and Lung
Transplantation: endorsed by the Heart Rhythm Society. Circulation, 112(12),
e154-e235.
Canadian Heart Failure Network (CHFN) (n.d.). Patients & caregivers. Retrieved from
http://www.chfn.ca/patients-caregivers.
Heart & Stroke Foundation. Managing heart failure. Retrieved from
http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3751087/k.919B/Heart_dise
ase__Managing_Heart_Failure.htm.
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Crosswords
2
1
9
4
3
6
5
7
L
12
I
V
I
N
G
B
E
T
T
E
R
11
8
10
1 Action to take after a period of activity
2 Habit that can harm your heart widely
3 Healthy alternative to meat
4 Should be replaced by lemon juice, spices, herbs
5 To record every day and to bring to your next appointment
6 Minimal number of pounds gained in a week for which you should consult a
doctor
7 Limited to 1.5 liter (48 oz) per day
8 Replaces butter in the Mediterranean diet
9 Even if I experience no symptoms, I should take them as prescribed
10 A good source of fiber, protein and healthy fats
11 Common salt synonym
12 Improves physical and psychological health
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