Living with Heart Failure

Receiving a diagnosis of heart failure can be really frightening but knowing what this diagnosis means and what to expect can help patients deal better with the challenges ahead. 

Heart failure is a common condition that can occur in both children and adults and it is caused by coronary heart disease, high blood pressure and diabetes, amongst other things. 

Heart failure is a condition where the heart is failing to function properly in terms of pumping blood around the body. 

Many people are diagnosed with heart failure after being admitted to hospital with chest pain suggestive of a heart attack or angina. 

If a heart attack has occurred then there may be some significant damage to the heart tissue that requires a lengthy period of recovery and a range of interventions to aid rehabilitation. 

There is no cure for heart failure but there are many things that can help mitigate symptoms and delay the disease progression even in older adults.

In some cases of heart failure the heart does not fill with blood as normal and there may be damage to the heart’s valves stopping blood from passing from one chamber to another as it should. 

In other cases the muscle of the heart is not strong enough to actually pump the blood to the rest of the body. Some patients have heart failure involving both issues.

Heart failure usually develops over time as one or both sides of the heart become weaker. 

In right-sided heart failure not enough blood is pumped to the lungs to be saturated with oxygen. 

In left-sided heart failure, the heart cannot pump enough oxygenated blood around the body. 

Right-sided heart failure can cause a build-up of fluid in the lower limbs, liver, abdomen and veins in the neck while failure of the heart as a whole results in fatigue and shortness of breath.

Elderly patients with heart failure are encouraged to regain or retain their independence by carrying out routine daily tasks such as washing and dressing, taking exercise. 

Heart failure patients will also normally be referred to a cardiac rehabilitation specialist for education, exercise and counselling, and referral to a dietitian may also be included in care after a heart attack or diagnosis of heart failure. 

These interventions are designed to reduce the risk of further heart problems and to encourage recovery from any earlier tissue damage. 

Exercise also improves the strength of muscles and reduces body fat and, therefore, the production of pro-inflammatory substances that may trigger heart damage. 

Exercise and diet both play a role in stress reduction, blood sugar management, and mood regulation and can help those with heart failure to contend more easily with the emotional challenges of their illness. 

While many elderly people with heart failure may feel disinclined to exercise it is important to note that even minimal activity, can make a significant difference to their health. 

Smoking cessation is one of the best things to do for overall health as well as heart health. This remains true even later in life; it is never too late to stop smoking and begin to see the benefits. 

Many elderly people living with heart failure will often feel fatigued much more easily than in the past and can accept this as part of their condition. 

Some patients are surprised, however, to find that they are increasingly weepy and emotional as they deal with both the shock of diagnosis and hospitalisation and new physical limitations. 

It is important that patients with heart failure are allowed to rest and recuperate and that they feel able to ask for help when needed. 

Although some tiredness is to be expected it is important to seek medical attention if fatigue becomes unusual or if any other symptoms arise such as:

• Sleep disturbances due to angina (chest pain)

• Angina whilst sitting or doing light activity

• Increasing frequency or severity of chest pain

• Shortness of breath, lightheadedness, fainting, or a racing heart

• Swollen ankles, feet or legs

• Increasing need for nitrate (nitroglycerin), or less effectiveness of this medication

• Rapid increase in weight, of more than 5lbs in a week

With heart failure in more elderly patients it is sometimes all too easy to dismiss symptoms as part of old age, but it is important that such patients feel able to communicate effectively with health care workers, friends, and family and have their concerns listened to and appreciated.

Taking prescribed medication and following physicians’ advice is important in managing heart disease.

The severity and progression of the condition depends largely on these factors in addition to the reduction of risk of other conditions such as diabetes, lung and kidney disease. 

Some medications for heart failure can interact with other drugs or supplements and so patients and caregivers should familiarise themselves with the information provided with prescription medications and discuss any concerns with a qualified physician. 

Even over-the-counter painkillers, cold remedies and vitamin and mineral supplements may affect the absorption and metabolism of heart medications.

Those living with heart failure are advised to have an annual flu vaccination as well as a pneumococcal vaccination to protect against one form of pneumonia. 

Such infections can be more severe for those with heart failure as the body is less able to fight off these viruses or cope with symptoms. 

Another key component of managing heart failure is to have regular physicals and check-ups to catch problems early.