Lifestyles, Fitness

and Rehabilitation

Heart Failure
 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
 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
 Heart Failure
Lifestyles, Fitness
and Rehabilitation
 What is Heart Failure?
 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 it’s ability to contract or
pump blood into the circulation
 Diastolic failure
 The heart looses it’s ability to relax because
it becomes stiff
 Heart cannot fill properly between each beat
 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)
 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)
 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
 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)
 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
 Heart Failure
Lifestyles, Fitness
and Rehabilitation

 What Causes Heart Failure?

 Coronary artery disease
 Cholesterol and fatty deposits build up in the
heart’s arteries
 Less blood and oxygen reach the heart
muscle
 This causes the heart to work harder and
occasionally damages the heart muscle
 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
 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
 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
 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
 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
 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 can’t 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
 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
 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
 Heart Failure
Lifestyles, Fitness
and Rehabilitation

 Signs and Symptoms of Heart Failure

 Tiredness, fatigue
 WHY?
 Heart can’t 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
 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
 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
 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
 Heart Failure
Lifestyles, Fitness
and Rehabilitation
 New York Heart Association (NYHA)
Functional Classification
Class % of Symptoms
patients
I 35% No symptoms or limitations in ordinary physical
activity
II 35% Mild symptoms and slight limitation during
ordinary activity
III 25% Marked limitation in activity even during minimal
activity. Comfortable only at rest
IV 5% Severe limitation. Experiences symptoms even at
rest
 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
 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
 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
 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
 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
 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
 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
 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
 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
 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)