heart failure.ppt

Lifestyles, Fitnessand Rehabilitation

Heart Failure

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


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


Heart Failure• What is Heart Failure?


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


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)


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)


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


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)


Heart Failure

• What Causes Heart Failure?• Congenital heart defects• Severe lung disease• Diabetes• Severe anemia• Overactive thyroid gland (hyperthyroidism)• Abnormal heart rhythms


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

• 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

• 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

• 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

• What Causes Heart Failure?– Diabetes• Tend to have other conditions that make the

heart work harder• Obesity• Hypertension• High cholesterol


Heart Failure

• 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

• 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

• Signs and Symptoms of Heart Failure– Persistent Cough or Wheezing• WHY?

– Fluid “backs up” in the lungs

• SYMPTOMS– Coughing that produces white or pink blood-

tinged sputum


Heart Failure

• 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

• 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

• 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

• 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

• 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

• New York Heart Association (NYHA) Functional Classification


Class % of patients

Symptoms

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

• Treatment Options– The more common forms of heart failure

cannot be cured, but can be treated• Lifestyle changes• Medications• Surgery


Heart Failure

• Lifestyle changes– Stop smoking– Loose weight– Avoid alcohol– Avoid or limit caffeine– Eat a low-fat, low-sodium diet– Exercise


Heart Failure

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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)


heart failure.ppt

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