1. ABHM
Dr Awwad Albishri Hospital
State of art Heart failure Centre
Holy Makkah
DR Asadullah Khan Soomro
Adult Cardiology Department Dr Awwad Albishri Hospital Holy Makkah
2. Top 15 Tips for healthy
Heart Failure Living
per day
1) Understand your disease, like heart failure etiology ,ischemic/non ischemic, Dilated systolic
dysfunction, EF 40% ,non dilated perserved EF >50%.NYHA FC 1-1V. HF stages A asymptomatic to D &
E advanced HF. New onset HF, ADHF, compensated HF,Vulnerability for admission readmission.
9)Restrict fluids to 1.5 lit and salt 2 gram per day, until congested and volume over loaded. Make sure
you are on maximum tolerated dose of guide line directed / indicated device therapy. check
electrolytes, renal ( GFR) and liver function ,BNP ,uric acid periodically .
2) Understand HF risk factors ( DM,HTN ,smoking, dislipidaemias, drugs, infections ) Comorbidities
( Cancer, renal failure, COPD, thyroid ,& anemia)
Decompensating factors for readmission, drug non adherence, residual myocardial ischemia
3) Understand the reversible etiology of heart failure & LV dysfunction
( like timely revascularization, corrective surgery for valve, congenital ,pericardial, ) peripartum
cardiomyopathy & cardiotoxic drugs &etc
4) Understand about heart failure education , self care and cardiac rehabilitation. ( patient & family
education, Paramedical personnel, physician and payers/managers education) . HF Research.
5) Understand significance of multidisciplinary heart failure program ( CCPC ). HF journey and
clinical pathways for inpatient care ,out patient care, ( RAHFC, post discharge, regular & advanced
HF /device clinic) emergency HF care and community HF care . HF multidisciplinary team like HF
cardiologist,/nurse educator,clinical pharmacist,nutritionist,social worker, & exercise physiologist.
6) Understand regional heart failure model of care & network, ( Model 1 community heart failure
service with, only out patient capability, model 11 HF service with emergency and inpatient
capability, model 111 advanced HF service with LVAD & transplant capability.
7) Understand heart failure cost and prevention of ist admission and readmission syndromes
,with introduction of multidisciplinary novel out patient clinics ( RAHFC ( diagnostic to prevent ist
unplanned admission) ,RAHFC prognostic ,RAHFC therapeutic to prevent ER visits) post discharge
heart failure clinic especially for vulnerable patient & vulnerable phase to prevent HF
readmissions and reduce cost..
8) If you have HF with LV systolic dysfunction ( EF < 40% ), secondary MR and pulmonary
hypertension. Not a surgical or device candidate .Understand your guide line directed
medications effects and side effects . Start with small dose of beta blockers ,ACE /ARB and novel
ARNI and spironolactone monitor tolerability and adverse effects ( especially symptomatic
hypotension ,K and creatnin) If all good titrate to maximum dose , & adhere .do not stop on your
own even feel better.
10) We encourage physical activity, and graded exercise, sex is not contraindicated ,if new sexual
dysfunction consult physician before sex medications.
Say full stop ,and no to smoking / tobacco products, no to alcohol and recreational drugs like
captagon. Avoid NSAID ,Get seasonal vaccines.
11) If you are in permanent atrial fibrillation ,implanted device, ICD,CRTD ,PPM, and LVAD. Check and
keep your INR around 2 to 3. If unexplained fever, loss of appetite, hypotension, signs of stroke (
weakness ,head ache vomiting) ,sudden arm/leg severe pain with coldness, consult physician .
12) Know your medications especially loop diuretic ( furosemide ) play with them according to your
symptoms , if volume over load , > weight and edema can increase the dose to 100-200 mg per day
.consult your physician if unresponsive or in case of renal injury.Take care if were on chemothrapy
13) Daily weight record, every morning before break fast and after free from bath room .If weight gain
of > 2 pounds per day for 2 days or > 5 pounds a week or develop signs of fluid retention increase
dose of diuretics and discuss with your physician. All HF patients should know their dry weight ,when
decongested and stable Functional Class.
14) Understand heart failure zones, you should be ever green, yellow means be alert or contact
physician ,red is to go to emergency, if symptomatic hypotension, worsening of breathlessness and
angina at rest , syncopae ,fast heart beat, inappropriate ICD shocks ,signs of stroke, worsening of
major organ function, renal ,liver injury and last not the least rhabdomyolysis
Check
Your
HF
Zone
Daily.
Be Ever green
If no dyspnea on
routine activity.
No weight gain, no
edema
Worsening of HF
symptoms, FC
111,1V. PND Weight
gain 2-3 pounds in
24 hours.
Sudden
Breathlessness,
Angina,Palpitations
with syncope.
Hypotension
Call ambulance.
Heart Failure Zones
Email, hssbasadsoomro@ gmail.com
