Michael E. DeBakey VA Medical Center - Houston, Texas
Heart Failure: Knowledge Makes a Difference in Quality of Life
November 13, 2002
Heart Failure: Knowledge Makes a Difference in Quality of Life
Many people with heart failure are not aware they have it . . .
by Donna Espadas and Mary York, Houston VA Medical Center's HCOCUS
Photo: For the VA health care system, heart failure is a particularly high volume condition. In 1999, heart failure accounted for 17,000 VA hospital stays. There is an increasing amount of research that suggests comprehensive care programs can reduce hospitalizations and improve overall health of congestive heart failure patients. Above, Barbara Guillory, RN, reviews educational materials on heart failure with Houston VA Medical Center veteran, Malcom Johnson. In most cases, heart failure cannot be cured, but it can be brought under control with careful work on the patient's part.
Photo provided by Houston VA Medical Center's HCOCUS
HOUSTON, TX - Heart failure affects nearly five million Americans of all ages and is responsible for more hospitalizations than all forms of cancer combined. Over 400,000 new cases of heart failure will be diagnosed next year.
Yet many people with heart failure are not aware they have it. This is because some of the most common symptoms of heart failure, such as feeling tired and short of breath, are often mistaken for normal signs of getting older. Also, people may try to avoid symptoms by making lifestyle changes such as taking the elevator instead of the stairs, sleeping with extra pillows, or cutting back on their favorite sports.
For the VA health care system, heart failure is a particularly high volume condition. In 1999, heart failure accounted for 17,000 VA hospital stays.
There is an increasing amount of research that suggests that many of these hospitalizations are preventable by improving the overall coordination of in-patient and outpatient care. This research suggests that comprehensive care pro-grams can reduce hospitalizations, lower medical costs, and improve overall health of congestive heart failure (CHF) patients.
In light of these facts, the CHF QUERI (Quality Enhancement Research Initiative) Coordinating Center at the VA's Houston Center for Quality of Care & Utilization Studies, led by Dr. Nelda Wray, developed the CHF Coordinated Care Program. The program was conducted at from October 2001 through October 2002 and was designed to improve the coordination of care of patients with CHF.The program has three main objectives:
1. To ensure that patients admitted to the hospital for worsening heart failure meet standards for discharge from the hospital before they are discharged.
2. To provide CHF patients and families with information concerning the importance of taking medications correctly, restricting salt intake, and weighing daily.
3. To provide intensive follow up of CHF patients including clinic visits, telephone calls and on-going education and reinforcement.
Preliminary findings for this project indicate that there was a reduction in readmissions for the patients enrolled in the project and that the patients were very satisfied with the care they received while participating in the project.
As a part of the second objective, the patients and their family members received an educational program entitled "Living with Heart Failure." The patients learned about their bodies, the disease, and the way heart failure is treated. They learned that they could help control their heart failure by carefully following their care plan and taking good care of themselves, and in doing so, they were better able to lead a normal active life.
What is heart failure?
Many think that heart failure means that the heart has stopped, but heart failure actually means that the heart fails to pump as well as it should. When the pump (the heart) becomes weak, fluid that should be pumped out of the heart backs up into the lungs. Fluid backing up into the lungs causes congestion, which is why it is often called "Congestive Heart Failure."
Heart failure is a serious illness. But with proper medications in the right doses and careful management, patients can feel better and live longer.
In most cases, heart failure cannot be cured, but it can be brought under control with careful work on the patient's part.
What causes heart failure?
Heart failure often occurs when another problem makes the heart weak. Coronary artery disease (blockage in the heart arteries) is the most common cause of heart failure.
With this disease, blockages in the coronary arteries decrease or cut off the blood supply to portions of the heart muscle. Sometimes it is possible to open the blockages and restore the blood supply to the heart. This may improve heart function and reduce symptoms.
Knowing whether heart failure is related to blocked coronary arteries can help the physician determine the best treatment.
High blood pressure is also a major cause of heart failure. It can also make heart failure worse. When someone has heart failure, it is wise to reduce the amount of strain on the heart in any way possible. Reducing blood pressure to normal levels is one important way to reduce strain on the heart.
Other causes include heart attack, infection of the heart muscle, and lung disease. Sometimes the exact cause of heart failure is not known.
How can I learn to live with heart failure?
There are many things that you can do to help yourself. These activities include:
- Stop smoking.
- Drink alcohol sparingly, if at all.
- Limit your intake of salt. Learn what prepared foods have large amounts of salt. Give yourself time to get use to eating a low salt diet. As you adjust, you may find that foods are more flavorful in a different way. Learning to read the nutritional information provided on food labels can help with awareness of how much salt is in foods.
- Weigh yourself every day. A sudden weight gain is one sign that you may be retaining fluid. Contact your health care provider if your weight changes significantly.
- Exercise at levels recommended by your physician. We used to believe that people with heart failure should rest often. In fact, regular exercise could improve your ability to function, decrease your symptoms, and strengthen your heart. Walking, cycling, and swimming are types of aerobic exercise recommended for patients with heart failure. Slowly increase the time, distance, and pace that you exercise. Your doctor can help you plan your exercise program.
- Take your medications. Take medications as directed by your physician. Never change or stop a medicine without checking with your doctor. Keep an updated medication list and carry it with you to all of your doctor visits. Check with your doctor or pharmacist before taking over-the-counter medications and supplements.
- Maintain frequent visits to your physician and notifying him or her if there are any changes in your symptoms.
- nderstand what heart failure is, what the symptoms are, what you should do if your symptoms change, and how your doctor treats this disease.
Many people with heart failure lead normal, active lives. They do so because they have learned to take good care of themselves. You can take control of heart failure by understanding and carefully following your treatment plan.
To learn more about the CHF QUERI Program, please contact Donna Espadas, CHF QUERI Center Manager, at (713) 794-8673.
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Point of Contact: VHAHOU Public Affairs04/21/04 08:25