Lifestyles, Fitness

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Lifestyles, Fitness and Rehabilitation
Heart Failure
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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• What is Heart Failure?

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• What is Left Heart Failure?
• Involves the left ventricle (lower chamber) of
  the heart
• Systolic failure
• The heart looses its ability to contract or pump
  blood into the circulation
• Diastolic failure
• The heart looses its ability to relax because it
  becomes stiff
• Heart cannot fill properly between each beat

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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)

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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)

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• 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)

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Heart Failure
Lifestyles, Fitness and Rehabilitation

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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• What Causes Heart Failure?
• Coronary artery disease
• Cholesterol and fatty deposits build up in the
  hearts arteries
• Less blood and oxygen reach the heart muscle
• This causes the heart to work harder and
  occasionally damages the heart muscle

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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

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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

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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

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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

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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

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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 cant 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

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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 blood-tinged
  sputum

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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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• Signs and Symptoms of Heart Failure
• Tiredness, fatigue
• WHY?
• Heart cant 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

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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

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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

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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

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Heart Failure
Lifestyles, Fitness and Rehabilitation

• New York Heart Association (NYHA)
  Functional Classification

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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)