LIVING Well with Heart Failure
By Joseph Rinaldi, M.D., Summa Physicians Inc., Akron LIVING WELL Magazine
An estimated 5.8 million Americans are living with heart failure (HF) right now – and about 675,000 new cases are being diagnosed each year. As the U.S. population ages, these numbers are expected to increase.
Recent studies show that patients who participate in a structured heart failure management program have fewer complications and hospitalizations than patients who don’t opt to participate in a program.
Learning how to work with your doctor to manage your heart failure can make a big difference in your health.
An effective heart failure management program can:
- Assist patients (and their families) in becoming active partners with physicians in their own care
- Improve patients’ quality of life and life expectancy by teaching patients how to monitor and manage their heart failure symptoms
- Help patients understand the importance of following their treatment plan
- Increase patients’ awareness and understanding of the symptoms of worsening heart failure – so they know when to seek medical help – before a situation turns critical
- Reduce patients’ emergency room visits and hospital admissions due to heart failure complications
What is heart failure?
Heart failure does not mean that the heart has stopped working – just that the heart muscle has become weakened or damaged in a way that leaves it unable to pump blood throughout the body efficiently.
What are the causes and symptoms of heart failure?
Heart failure can be caused by many things, including: a prior heart attack, high blood pressure, heart valve disease, an infection of the heart muscle, alcoholism or drug abuse, chemotherapy treatment or thyroid disease.
Some symptoms of heart failure can include shortness of breath, increased fatigue (tiredness), swelling (edema) of the legs, feet or abdomen, cough and/or lung congestion, palpitations (fast, irregular heartbeats) or being unable to lie flat when in bed due to difficulty breathing.
What will I learn about heart failure during a heart failure management program?
Individualized, easy-to-understand patient education is an important part of learning how to control and manage heart failure. Some of the things you should learn while participating in a heart failure management program include:
- An overview of heart failure, what causes it and its associated symptoms
- What medications are used to treat it
- Why it is important to limit sodium (salt) in the diet
- What foods to avoid/include in a healthy diet
- Why patients must weigh themselves daily and record their weight in a log
- How fluid retention (edema) causes worsening symptoms
- Information about other factors that can impact your heart health (depression and sleep apnea)
- How to recognize worsening symptoms and know when to seek appropriate medical care
- How seeking medical care early – before your condition worsens – can help avoid an emergency room visit or even a hospitalization
Typically, what happens during the first and follow-up visits to a heart failure management program?
During the first visit, an advanced practice nurse and/or cardiologist will record your height, weight and vital signs; take a complete medical history; review all of the medications you are taking; conduct a test to assess exercise capacity and a screening for sleep apnea; perform a quality of life assessment; provide educational materials about heart failure; and conduct a physical exam. The nurse or cardiologist may also order labs or diagnostic testing, if needed.
During follow-up appointments, the nurse or cardiologist will take a cardiac history, conduct a physical exam, record weight, vital signs and review the patient’s weight log; review medication dosages and adjust as needed; review lab and test results; conduct a depression screening (at three months); provide ongoing individualized heart failure education to patients and their families; and provide referrals to other specialists as needed.
When selecting a heart failure management program, what are some of the questions I should ask?
Some of the questions you should ask your doctor include:
- What are the goals of this program?
- Who will be conducting each part of the program? What are their credentials?
- Where can I access this program? Is it close to my home?
- Can my family members accompany me on my visits? Can they attend the patient educational sessions?
- Will I be seen by a cardiologist, an advance practice nurse, or both?
- What other support services are available through this program?
- Does a registered dietitian offer tips on how to stick to a low-sodium diet?
- Does a pharmacist offer advice on medication management, minimizing side effects, etc.?
- Is there a patient support group available I can join?
- What happens if I experience a problem or my condition worsens suddenly on a weekend, holiday or late at night?
- Will I be able to reach a cardiologist by phone after-hours?
- Can I get an urgent evaluation by a cardiologist either same- or next-day? Or will I have to visit the emergency room for care?
- Does this program screen for other conditions that can impact heart health, such as sleep apnea or depression?
- How and when/how often will information about my care be shared with my primary care physician?
If you (or someone you love) is struggling to effectively manage their heart failure condition, please call 1-888-720-5318 for more information about Summa’s heart failure management program. Then talk to your doctor about getting a referral to the Heart Failure Program at Summa Health System.
Joseph Rinaldi, M.D., is the medical director of Summa Health System’s Heart Failure Program at Summa Akron City Hospital. Dr. Rinaldi is a board-certified cardiologist with Summa Physicians Inc.
 Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart Disease and Stroke Statistics—2010 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.* Circulation. 2010;121:e1-e170.