# Presentation: 007192

## Congestive Heart Failure(CHF)

**Kathy Green, MS, RN**
**Patient Health Education**

**Notes:**
Congestive Heart Failure(CHF)

Kathy Green, MS, RN
Patient Health Education

## Heart Failure Incidence and Prevalence

- ♥  **Prevalence**
- 	Worldwide – 22 million
- 	United States – 5 million
- ♥  **Incidence**
- 	Worldwide – 2 million new cases year
- 	United States – 500,000 new cases year
- ♥  Afflicts 10 out of every 1,000 people over age 65 in the United States
- (Stats from American Heart association - 2002)

**Notes:**
Heart Failure Incidence and Prevalence

♥  Prevalence  
	Worldwide – 22 million
	United States – 5 million		
♥  Incidence
	Worldwide – 2 million new cases year
	United States – 500,000 new cases year
♥  Afflicts 10 out of every 1,000 people over age 65 in the United States 
(Stats from American Heart association - 2002)

## Normal Healthy Heart

- ♥  Muscle
- ♥  Four Chambers
- ♥  Four Valves
- ♥  Vena Cava – O2 poor
- ♥  Pulmonary Veins – O2 rich
- ♥  Aorta

**Notes:**
Normal Healthy Heart

♥  Muscle
♥  Four Chambers
♥  Four Valves
♥  Vena Cava – O2 poor
♥  Pulmonary Veins – O2 rich
♥  Aorta

## What Is CHF ?  

- ♥  The heart does not pump efficiently
- ♥  The heart is not able to move as much blood as it should with each beat
- ♥  Organs in the body do not get enough oxygen rich blood that they need to work well

**Notes:**
What Is CHF ?

♥  The heart does not pump efficiently
♥  The heart is not able to move as much blood as it should with each beat
♥  Organs in the body do not get enough oxygen rich blood that they need to work well

## Diagnostic Evaluation

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**Notes:**
Diagnostic Evaluation

Figures

## What Causes Heart Failure?

- ♥	Coronary Artery Disease
- ♥  Untreated High Blood Pressure
- ♥  Faulty Heart Valves
- ♥  Cardiomyopathy
- ♥  Lung Disease
- ♥  Diabetes
- ♥  Infections
- ♥  Alcoholism
- ♥  Toxic Drugs

**Notes:**
What Causes Heart Failure?

♥  Coronary Artery Disease
♥  Untreated High Blood Pressure
♥  Faulty Heart Valves
♥  Cardiomyopathy
♥  Lung Disease
♥  Diabetes
♥  Infections
♥  Alcoholism			
♥  Toxic Drugs

## 	2 Types of Heart Failure

**Systolic Dysfunction**
**(Contraction)  2/3 of Patients**
- ♥  The heart becomes weak and enlarged
- ♥  The weakened heart muscle can’t contract
- ♥  Not enough blood is pumped from the chambers

**Diastolic Dysfunction**
**(Relaxation)**
- ♥ Chambers don’t fill up so less blood goes to the lungs and body
-  ♥ Stiff heart muscle can’t relax
- ♥  Not enough blood fills the chambers

**Notes:**
2 Types of Heart Failure

Systolic Dysfunction
(Contraction)  2/3 of Patients
♥  The heart becomes weak and enlarged
♥  The weakened heart muscle can’t contract
♥  Not enough blood is pumped from the chambers

Diastolic Dysfunction
(Relaxation)
♥ Chambers don’t fill up so less blood goes to the lungs and body
 ♥ Stiff heart muscle can’t relax
♥  Not enough blood fills the chambers

## What is an Ejection Fraction? (EF)

- 	**The amount of blood that pumps out of the heart with each beat**
- ♥  Normal EF = 50 – 65%
- ♥  Damaged Heart Muscle EF = 40%
- ♥  Potential Heart Transplant EF = 20%

**Notes:**
What is an Ejection Fraction? (EF)

The amount of blood that pumps out of the heart with each beat
♥  Normal EF = 50 – 65%		
♥  Damaged Heart Muscle EF = 40%
♥  Potential Heart Transplant EF = 20%

## When the EF is Abnormal What Happens in the Body?

- ♥ Less blood goes to the brain that may make you feel confused or dizzy
- ♥  Your lungs may fill up with fluid making you feel short of breath
- ♥  Your kidneys may not be able to get rid of the fluid
- ♥  Your belly, ankles and feet may swell up

**Notes:**
When the EF is Abnormal What Happens in the Body?

♥ Less blood goes to the brain that may make you feel confused or dizzy   
♥  Your lungs may fill up with fluid making you feel short of breath  
♥  Your kidneys may not be able to get rid of the fluid   
♥  Your belly, ankles and feet may swell up

## Other Signs and Symptoms of CHF

- ♥  Extreme Fatigue
-  				♥  Frequent Coughing
- ♥  Sudden Weight  Gain
- 			♥  Chest Pain or Pressure
- ♥  Nausea, Loss of Appetite or Bloating
- 			♥  Decreased Urination

**Notes:**
Other Signs and Symptoms of CHF

♥  Extreme Fatigue
♥  Frequent Coughing
♥  Sudden Weight  Gain
♥  Chest Pain or Pressure
♥  Nausea, Loss of Appetite or Bloating				
♥  Decreased Urination 

## Do You Know Your EF and Class of CHF?

- ♥  Why do I need to know my EF and Class of CHF?
- 	Heart Failure is a chronic progressive disease that is not curable but is treatable

**Notes:**
Do You Know Your EF and Class of CHF?

♥  Why do I need to know my EF and Class of CHF?
Heart Failure is a chronic progressive disease that is not curable but is treatable

## New York Heart Association Functional Classification

**Class I**
**	****No symptoms with ordinary activity**

**Class II**
**	****Slight limitation of physical activity results in fatigue, shortness of breath, chest pain or irregular heart beat**

**Notes:**
New York Heart Association Functional Classification

Class I
No symptoms with ordinary activity

Class II
Slight limitation of physical activity results in fatigue, shortness of breath, chest pain or irregular heart beat

## New York Heart Association Functional Classification

**Class III**
- 	**Marked limitation of physical activity.**
**	****Comfortable at rest, but less than ordinary physical activity results in fatigue, irregular heart beat, pain or shortness of breath**

**Class IV**
**	****Unable to carry out any physical activity without discomfort**
**	****All symptoms in class III even at rest**

**Notes:**
New York Heart Association Functional Classification

Class III	
	Marked limitation of physical activity.
	Comfortable at rest, but less than ordinary physical activity results in fatigue, irregular heart beat, pain or shortness of breath

Class IV
	Unable to carry out any physical activity without discomfort
	All symptoms in class III even at rest

## What Can I Do To Prevent Progression of the Disease?

**♥  ****Become Conscious of Lifestyle Choices!**
**♥  ****Make Better Choices...**
**	****☺  ****Quit Smoking****	****	**
**	****☺  ****Reduce Weight****	**
**	****☺  ****Avoid Excess Alcohol and Drugs**
**	****☺  ****Exercise****	**
**	****☺  ****Take Medication**

**Notes:**
What Can I Do To Prevent Progression of the Disease?

♥  Become Conscious of Lifestyle Choices!
♥  Make Better Choices...
	☺  Quit Smoking		
	☺  Reduce Weight	
	☺  Avoid Excess Alcohol and Drugs
	☺  Exercise	
	☺  Take Medication

## Self Care Strategies

- ♥  Take an active part in  your care
- ♥  Communicate with your healthcare team  (Healthwise for Life)
- ♥  Be knowledgeable about your health
- ♥  Take your medication as prescribed
-      * Never run out of medications
- ♥ Treat high cholesterol, diabetes and irregular heart beat

**Notes:**
Self Care Strategies

♥  Take an active part in  your care
♥  Communicate with your healthcare team  (Healthwise for Life)
♥  Be knowledgeable about your health
♥  Take your medication as prescribed 
     * Never run out of medications
♥ Treat high cholesterol, diabetes and irregular heart beat

## Self Care Strategies

- ♥  Keep high blood pressure under control
- ♥  Salt restrictions
- ♥  Daily weights and record
- ♥  Health Buddy
- ♥  Look for swelling
- ♥ Immunizations
- ♥  Manage stress

**Notes:**
Self Care Strategies

♥  Keep high blood pressure under control
♥  Salt restrictions	
♥  Daily weights and record
♥  Health Buddy	
♥  Look for swelling
♥ Immunizations
♥  Manage stress	

## Early Symptoms of Heart Failure		

- ♥  A weight gain or loss of 2 or more pounds in 1 day, or 4 pounds in 1 week
- ♥  Confusion, restlessness or lightheaded
- ♥  A feeling of fullness or bloating in your stomach
- ♥  Cough, shortness of breath, swelling
- ♥  Fatigue, lose of appetite, or nausea

**Notes:**
Early Symptoms of Heart Failure	

♥  A weight gain or loss of 2 or more pounds in 1 day, or 4 pounds in 1 week
♥  Confusion, restlessness or lightheaded
♥  A feeling of fullness or bloating in your stomach
♥  Cough, shortness of breath, swelling
♥  Fatigue, lose of appetite, or nausea

## Urgent Symptoms of Heart Failure	

**♥  ****Increased shortness of breath while resting  or trouble sleeping**
**♥  ****Waking up suddenly at night due to difficulty breathing**
**♥  ****A need to sleep sitting up or a need for more pillows than usual**
**♥  ****A fast irregular heart beat, a racing heart that makes you feel** **dizzy, or like you are going to pass out**
**♥  ****Coughing up pink frothy mucus**

**Notes:**
Urgent Symptoms of Heart Failure	

♥  Increased shortness of breath while resting  or trouble sleeping
♥  Waking up suddenly at night due to difficulty breathing
♥  A need to sleep sitting up or a need for more pillows than usual
♥  A fast irregular heart beat, a racing heart that makes you feel dizzy, or like you are going to pass out
♥  Coughing up pink frothy mucus

## Time Is Life

- ♥  Know the warning signs
- ♥  Heart disease is the leading cause of death in women
- ♥  Take one aspirin unless you are allergic to it
- ♥  Make a plan and share it with your family
- ♥  Don’t delay call 911

**Notes:**
Time Is Life

♥  Know the warning signs
♥  Heart disease is the leading cause of death in women
♥  Take one aspirin unless you are allergic to it
♥  Make a plan and share it with your family
♥  Don’t delay call 911

##      			Symptoms of Heart Failure

- 				**Call 911 **
- ♥  Chest discomfort or pain that lasts more than 15 minutes that is not relieved with rest or nitroglycerin
- ♥  Severe, persistent shortness of breath
- ♥  **Loss of consciousness**

**Notes:**
Symptoms of Heart Failure

Call 911 

♥  Chest discomfort or pain that lasts more than 15 minutes that is not relieved with rest or nitroglycerin
♥  Severe, persistent shortness of breath
♥  Loss of consciousness

## Question?

- Post Quiz Introduction to Heart Failure
- Evaluation Form

**Notes:**
Question?

Post Quiz Introduction to Heart Failure

Evaluation Form

## The End

**Notes:**
The End