Caring for a Loved One with Heart Failure

Supporting a loved one with heart failure (HF) can be challenging and anxiety-inducing, often raising many questions. Understanding the condition and how it progresses will better equip you to assist your loved one in managing their symptoms.

Understanding Heart Failure

Heart failure occurs when the heart is too weak to pump enough blood to meet the body’s oxygen needs. Sometimes the heart cannot pump with sufficient force, while in other cases, it cannot fill with enough blood. This condition can seriously disrupt the circulatory system. While heart failure can affect either side of the heart, most cases eventually involve both sides.

Congestive heart failure (CHF) is a specific and serious type of HF where the circulatory system becomes so compromised that blood and other fluids accumulate in certain areas of the body, congesting tissues. This can lead to swelling (edema) in the lower extremities, abdomen, and even around the lungs. Fluid around the heart, lungs, and other organs must be closely monitored due to its potential to cause severe symptoms.

Doctors Who Treat Heart Failure

Initially, a general practitioner (GP) or family medicine physician (FMP) may treat your loved one. As symptoms progress, they may refer the patient to specialists with more experience in managing heart failure.

• Internists: Specialize in internal medicine for adults and often collaborate with cardiologists.

• Cardiologists: Experts in diseases affecting the heart and blood vessels. Some specialize further in treating heart failure.

• Cardiac Surgeons: Perform heart and blood vessel surgeries.

• Cardiac Electrophysiologists: Focus on heart rhythm problems.

Stages of Heart Failure

Heart failure is categorized into four stages or classes, with patients progressing forward but not backward through these stages.

Class A

Risk factors include smoking, alcohol abuse, a high-fat diet, or a family history of heart problems, diabetes, or high blood pressure. Patients in this stage show no symptoms and have no limitations in daily activities. They need to manage blood pressure and cholesterol through medication and lifestyle changes, along with regular tests such as cholesterol and C-reactive protein (CRP) blood tests, chest x-rays, and electrocardiograms.

Class B

Patients show mild symptoms and slight limitations during ordinary activities but are comfortable at rest. Continued monitoring of blood pressure is essential, with possible additional tests like stress tests, MRIs, or CT scans. Treatment may include ACE inhibitors, beta-blockers, and possibly surgery for coronary artery repair or heart valve replacement.

Class C

Moderate to severe cardiovascular disease is evident. Patients experience significant limitations, with symptoms like fatigue, palpitations, or labored breathing during daily activities. Diagnostic tests include coronary angiograms and myocardial biopsies. Treatment may involve pacemakers, implantable defibrillators, and additional medications.

Class D

Severe cardiovascular disease symptoms are present, significantly limiting activities. Symptoms persist even at rest. Advanced treatments include implantable defibrillators, mechanical heart pumps, and possibly open-heart surgery, although these come with substantial risks. Continuous medication through IV drips and palliative or hospice care may be necessary.

Common Medications for Heart Failure

• ACE Inhibitors: Can interact with NSAIDs and antacids, causing kidney injury, and may lead to hyperkalemia (elevated potassium levels).

• Beta-Blockers: Common side effects include cold hands and feet, fatigue, dizziness, and dry mouth. They can also affect mental state and mood.

• Diuretics: Help eliminate excess water through urination but can deplete important minerals, causing dizziness and dehydration. Monitoring blood-potassium levels is crucial.

These medications aim to reduce stress on the heart, but certain combinations can cause bradycardia (slow heart rate), hypotension (low blood pressure), and arrhythmias (irregular heartbeats). Consult a physician immediately if these symptoms occur.

Tracking Symptoms and Treatments

Caregivers can monitor a loved one’s blood pressure and heart rate at home using a blood pressure cuff and heart rate monitor. Keep track of changes in blood pressure, weight, and physical activity levels to help doctors adjust treatment as needed.

Prognosis for Heart Failure Patients

Once HF symptoms appear (class B), the average life expectancy drops to less than five years. For those in class D, the prognosis is much worse, with a 90% one-year survival rate. However, individual prognosis depends on various factors, and it's important to balance realism with hope.

Diet and Nutrition Tips

Dietary changes can help manage symptoms and slow disease progression:

• Eat lots of fruits and vegetables.

• Choose lean proteins like skinless chicken and fish.

• Limit sodium intake to 1,500 mg daily.

• Opt for low-fat dairy products.

• Choose whole-grain and high-fiber foods.

• Reduce alcohol, sugar, and saturated fat consumption.

• Flavor foods with spices, herbs, and aromatic ingredients instead of salt and high-sodium condiments.

Monitoring Fluid Intake

Staying hydrated is crucial, but for someone with heart failure, balancing fluid intake is vital. Excess water can stress the heart, so doctors may recommend limiting fluids. Track all sources of fluids, including foods like ice cream, popsicles, and soup.

Space out fluids throughout the day with smaller, more frequent servings to avoid excessive thirst. Sugar-free gum, hard candies, and swishing water without swallowing can help manage thirst. Use a marked container to track daily fluid intake and log it to prevent overconsumption.

For information about how AmoryCare can help your a loved one at home please contact us:

Phone: 908-854-3220

Fax: 908-854-3221

Email: info@amorycare.com

Service Areas:

Union County, NJ: Berkeley Heights, Summit, Linden, Scotch Plains, Westfield, Murray Hill, Plainfield, Mountainside, Garwood, Clark, New Providence, Elizabeth, Roselle Park, Winfield, Kenilworth, Vauxhall, Cranford, Springfield, Union, Fanwood.

Morris County, NJ: Bernardsville, Boonton, Brookside, Budd Lake, Butler, Califon, Cedar Knolls, Chatham, Chester, Denville, Dover, East Hanover, Far Hills, Flanders, Florham Park, Gillette, Greenvillage, Hibernia, Ironia, Kenvil, Lake Hopatcong, Landing, Ledgewood, Lincoln Park, Long Valley, Madison, Mendham, Millington, Montville, Morris Plains, Morristown, Mt. Arlington, Mt. Freedom, Mt. Tabor, Mountain Lakes, Netcong, New Vernon, Newfoundland, Oak Ridge, Parsippany, Pequannock, Picatinny Arsenal, Pine Brook, Pompton Plains, Port Murray, Randolph, Riverdale, Rockaway, Schooley’s Mountain, Stirling, Succasunna, Towaco, Wharton, Whippany.

Essex County, NJ: Livingston, Roseland, Essex Fells, West Orange, South Orange, Short Hills, Millburn, Maplewood, Montclair, Verona, Cedar Grove, Glen Ridge, Bloomfield, Belleville, Nutley, West Caldwell, Fairfield, Irvington, Newark, East Orange.

Passaic County, NJ: Bloomingdale, Clifton, Haledon, Hawthorne, Little Falls, North Haledon, Passaic, Paterson, Pompton Lakes, Prospect Park, Ringwood, Totowa, Wanaque, Wayne, West Milford, Woodland Park.