House Calls runs every other Saturday. Today’s column is written by Trish Walker, a registered nurse with Sutter Coast Home Care. It is the first in a series addressing heat failure, also known as congestive heart failure (CHF).
Heart failure (HF) is the fastest-growing diagnosis in the world today. It affects nearly 6 million adults. There are approximately 450,000 new cases diagnosed annually, and 20 percent of those diagnosed will die within the first year, 50 percent within five years.
HF is also the most frequent cause of hospitalization in adults over 65. The numbers are staggering. There are approximately 900,000 people hospitalized with HF annually, and of those, 250,000 die. The costs amount to roughly $40 billion annually, with emergency room costs at around $15 billion.
So, what exactly is heart failure and how does it occur? HF occurs because of the heart’s inability to pump enough blood throughout the body. If affects more men than women. It occurs more frequently in patients who have other disease processes such as COPD, diabetes, coronary artery disease, heart rhythm problems or high blood pressure.
It can also occur in patients who have enlarged hearts, have heart valve problems, or have had heart attacks. High blood pressure is the leading cause of HF, and it plays a huge role in the onset of the disease and the treatment.
There are two types of HF; left-sided and right-sided. In simple terms, left-sided failure causes blood and fluid to back up into the lungs, which causes the patient to have difficulty breathing and sleeping. Right-sided failure causes fluid to back up into the body and that causes swelling.
Whichever type you have, it is extremely important for you to take the medication your physician has prescribed. If you don’t, you will most likely become hospitalized for an exacerbation of HF.
An exacerbation is when your HF symptoms become so severe that you have to go to the hospital to get treatment, or you may die. You will also need to have follow-up appointments with your physician to make sure that the medication plan is right for you and your symptoms. The doctor may add medications, or get rid of some, but whatever the plan regarding medication is, you must take it as prescribed.
When most patients are told of their diagnosis they often don’t know why they “all of a sudden got it.” They may even be in denial; however, there are those patients who focus on making sure it doesn’t progress and they want to learn everything about it. Our goal, as health care professionals, is to arm you with that information so that you can participate in “self care.” Education is the foundation of HF management.
HF management begins with changes in lifestyle. Smoking cessation is of utmost importance, as is yearly immunizations, following diet and fluid restrictions, exercise, and adhering to a medication plan. HF is a complex, chronic disease and you have to commit to a lifetime of behavioral changes, as well as educating yourself on symptom management, treatments, and preventative measures.
The next article in the series will focus on symptom management. It will educate patients on the recognition of an exacerbation and how to prevent hospitalization.