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The words "heart failure" sound ominous and frightening. It is often confused with heart attack which is only one of the causes of this condition. Congestive heart failure refers to the inability of the heart to provide adequate pumping function to meet the needs of the body. There are many causes including very large heart attacks, heart valve disease and generalized heart muscle dysfunction. It is often complicated by heart rhythm abnormalities and kidney problems. Symptoms include shortness of breath, undue fatigue with exertion and swelling of the feet and legs.
Advanced Heart Failure represents significant congestive failure with symptoms occurring during usual activities or at rest. These are the patients requiring specialized services such as ours. |
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Heart Failure is a National Issue |
Approximately 3 million patients in the United States have congestive heart failure and 400,000 new cases are reported each year. Hospital admissions total 900,000 yearly for treatment of the problem.1 Heart failure contributes to significant disability for our seniors. Unfortunately heart failure is a common cause of death with up to 50% of those with severe heart failure living only one year.[2~3]
Many patients are repeatedly hospitalized and the cost of treatment is enormous. It is estimated that this cost now exceeds 12 billion dollars annually. [1] |
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The Problem: Patient Education, Compliance and Supervision |
Studies clearly show that worsening heart failure resulting in hospital admission is due to simple precipitating factors in 98% of cases.[4] These factors are excessive sodium intake, excessive fluid intake, and medication noncompliance. In addition, only 40% of patients weigh themselves regularly.[4] Failure to comply with all aspects of the treatment plan results in continued deterioration of cardiac function, more symptoms, hospitalization and ultimately death. Clearly, close supervision and support are required for successful management of this serious cardiac condition.
The best treatment of significant heart failure requires meticulous daily attention to weight, blood pressure, diet, salt intake, symptoms and medications. Avoiding setbacks, emergency room visits and hospitalization requires contingency planning, use of added medications when appropriate and frequent telephone contact. Periodic blood work must be done by your primary physician. Cardiac tests must be done on schedule. Records must be kept faithfully. With this approach, further deterioration of heart function and its complications can be prevented. |
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Our Center and the Heart Failure Management Program |
A disease management strategy begins with accurate diagnosis and treatment plans developed by a cardiologist in conjunction with your primary physician. Such treatment plans are best carried out when supervised by skilled nurses with advanced training in cardiology and heart failure management. Such nurses with other support staff can maintain the frequent telephone contact, weight control, dietary control and personal support needed for success. Studies have demonstrated that such programs have higher success rates.[5,6]
Our Heart Failure Management Program is supervised by a cardiac nurse practitioner. Her role is to know each patient well and facilitate all aspects of heart failure care. With attention to detail, record keeping by computer, coordination with your primary physician, office visits and telephone contract, heart failure can be controlled.
We emphasize the importance of a very narrow window of variability regarding diet, salt intake, body weight, exercise and medications. Keeping within certain limits greatly improves cardiac function, heart failure symptoms and reduces complications.
Your own education about your problem and what you can do about it yourself are the most important tools we have to help you. Our facility provides not only the cardiac testing you may need but educational material, specific dietary advice, exercise prescription and other support. With your own efforts and ours, heart failure can be controlled and quality of daily life maintained. |
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Preventive Cardiology and Your Doctor |
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Your Doctor should be aware of all aspects of your specialty care. Therefore, our Center will communicate with your doctor frequently to coordinate this part of your healthcare program. We will forward copies of all tests we do and obtain copies of blood work and other data from your physician.
Our Preventive Cardiology Center is meant to be an asset to both you and your personal physician. |
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References - Prevention of Congestive Heart Failure |
1. Massie, B.M. 4th World Congress on Heart Failure, 1998.
2. O'Connor, CM. A Twenty-five Year Experience in Patient's with Coronary Artery Disease and Chronic Heart Failure: Outcomes with Medical Therapy and Bypass Surgery. J Am Coll Cardiol 1996; 27(2a):142a.
3. Jaagosild, Prit et al. Outcomes of Acute Exacerbation of Severe Congestive Heart Failure. Arch Intern Med, 1998; 158:1081-1089.
4. Michalson, A. 4th World Congress of Heart Failure, 1998.
5. Block, et al. The Design and Implementation of a Disease Management Program for Congestive Heart Failure at a Community Hospital. CHF. 1997 (JULIAUG) 26-37.
6. Stuart, S, et al. Effects of a Home Based Intervention Among Patients with Congestive Heart Failure Discharged From Acute Hospital Care. Arc Intern Med; 158:1067-1072. |
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