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Lifestyles, Fitness
and Rehabilitation
Heart Failure
Heart Failure
Heart Failure
• What is Heart Failure?
– The heart is not pumping as well as it
should
Lifestyles, Fitness
and Rehabilitation
should
– Usually, the heart has been weakened
by an underlying condition
• Blocked arteries
• Heart attack
• High blood pressure
• Infections
• Heart valve abnormalities
Heart Failure
• What is Heart Failure?
– Heart failure can involve the left or right
side of the heart or both
Lifestyles, Fitness
and Rehabilitation
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
• What is Heart Failure?
Lifestyles, Fitness
and Rehabilitation
Heart Failure
• What is Left Heart Failure?
– Involves the left ventricle (lower
chamber) of the heart
Lifestyles, Fitness
and Rehabilitation
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
• What is Left Heart Failure?
– Systolic and diastolic heart failure are
treated with different types of
Lifestyles, Fitness
and Rehabilitation
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
• What is Right Heart Failure?
– Usually occurs as a result of left heart
failure
Lifestyles, Fitness
and Rehabilitation
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
• How fast does heart failure
develop?
– Usually a chronic disease
Lifestyles, Fitness
and Rehabilitation
– 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
• What Causes Heart Failure?
– Health conditions that either damage
the heart or make it work too hard
Lifestyles, Fitness
and Rehabilitation
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
• What Causes Heart Failure?
• Congenital heart defects
• Severe lung disease
Lifestyles, Fitness
and Rehabilitation
• Severe lung disease
• Diabetes
• Severe anemia
• Overactive thyroid gland (hyperthyroidism)
• Abnormal heart rhythms
Heart Failure
• What Causes Heart Failure?
– Coronary artery disease
Lifestyles, Fitness
and Rehabilitation
– 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
• What Causes Heart Failure?
– Heart attack
Lifestyles, Fitness
and Rehabilitation
– 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
• What Causes Heart Failure?
– High blood pressure
• Uncontrolled high blood pressure doubles a
persons risk of developing heart failure
Lifestyles, Fitness
and Rehabilitation
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
• What Causes Heart Failure?
– Abnormal heart valves
Heart muscle disease
Lifestyles, Fitness
and Rehabilitation
– Heart muscle disease
• Damage to heart muscle due to drugs,
alcohol or infections
– Congenital heart disease
– Severe lung disease
Heart Failure
• What Causes Heart Failure?
– Diabetes
• Tend to have other conditions that make the
Lifestyles, Fitness
and Rehabilitation
• Tend to have other conditions that make the
heart work harder
• Obesity
• Hypertension
• High cholesterol
Heart Failure
• What Causes Heart Failure?
– Severe anemia
• Not enough red blood cells to carry oxygen
Lifestyles, Fitness
and Rehabilitation
• 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
• Signs and Symptoms of Heart Failure
– Shortness of Breath (dyspnea)
• WHY?
Lifestyles, Fitness
and Rehabilitation
• 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
• Signs and Symptoms of Heart Failure
– Persistent Cough or Wheezing
WHY?
Lifestyles, Fitness
and Rehabilitation
• WHY?
– Fluid “backs up” in the lungs
• SYMPTOMS
– Coughing that produces white or pink blood-
tinged sputum
Heart Failure
• Signs and Symptoms of Heart Failure
– Edema
WHY?
Lifestyles, Fitness
and Rehabilitation
• 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
• Signs and Symptoms of Heart Failure
– Tiredness, fatigue
• WHY?
Lifestyles, Fitness
and Rehabilitation
• 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
• Signs and Symptoms of Heart Failure
– Lack of appetite/ Nausea
• WHY?
Lifestyles, Fitness
and Rehabilitation
• WHY?
– The digestive system receives less blood
causing problems with digestion
• SYMPTOMS
– Feeling of being full or sick to your stomach
Heart Failure
• Signs and Symptoms of Heart Failure
– Confusion/ Impaired thinking
• WHY?
Lifestyles, Fitness
and Rehabilitation
• 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
• Signs and Symptoms of Heart Failure
– Increased heart rate
• WHY?
Lifestyles, Fitness
and Rehabilitation
• 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
• New York Heart Association (NYHA)
Functional Classification
Lifestyles, Fitness
and Rehabilitation
Class % of
patients
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
• Treatment Options
– The more common forms of heart failure
cannot be cured, but can be treated
Lifestyles, Fitness
and Rehabilitation
cannot be cured, but can be treated
• Lifestyle changes
• Medications
• Surgery
Heart Failure
• Lifestyle changes
– Stop smoking
Lifestyles, Fitness
and Rehabilitation
– Loose weight
– Avoid alcohol
– Avoid or limit caffeine
– Eat a low-fat, low-sodium diet
– Exercise
Heart Failure
• Lifestyle changes
– Reduce stress
Lifestyles, Fitness
and Rehabilitation
– 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
• Medications used to treat Heart
Failure
– ACE Inhibitors
Lifestyles, Fitness
and Rehabilitation
– 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
• Medications used to treat Heart
Failure
– Diuretics (water pills)
Lifestyles, Fitness
and Rehabilitation
– 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
• Medications used to treat Heart
Failure
– Potassium
Lifestyles, Fitness
and Rehabilitation
– 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
• Medications used to treat Heart
Failure
– Vasodilators
Lifestyles, Fitness
and Rehabilitation
– Vasodilators
• Cause blood vessel walls to relax
• Occasionally used if patient cannot tolerate
ACE
• Decrease workload of the heart
Heart Failure
• Medications used to treat Heart
Failure
– Digitalis preparations
Lifestyles, Fitness
and Rehabilitation
– Digitalis preparations
• Increases the force of the hearts
contractions
• Relieves symptoms
• Slows heart rate and certain irregular heart
beats
Heart Failure
• Medications used to treat Heart
Failure
– Beta-blockers
Lifestyles, Fitness
and Rehabilitation
– 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
• Treatment options
– Surgery and other Medical Procedures
• Not often used in heart failure unless there
Lifestyles, Fitness
and Rehabilitation
• 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)

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Heart_Failure.pdf

  • 2. Heart Failure • What is Heart Failure? – The heart is not pumping as well as it should Lifestyles, Fitness and Rehabilitation should – Usually, the heart has been weakened by an underlying condition • Blocked arteries • Heart attack • High blood pressure • Infections • Heart valve abnormalities
  • 3. Heart Failure • What is Heart Failure? – Heart failure can involve the left or right side of the heart or both Lifestyles, Fitness and Rehabilitation 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
  • 4. Heart Failure • What is Heart Failure? Lifestyles, Fitness and Rehabilitation
  • 5. Heart Failure • What is Left Heart Failure? – Involves the left ventricle (lower chamber) of the heart Lifestyles, Fitness and Rehabilitation 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
  • 6. Heart Failure • What is Left Heart Failure? – Systolic and diastolic heart failure are treated with different types of Lifestyles, Fitness and Rehabilitation 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)
  • 7. Heart Failure • What is Right Heart Failure? – Usually occurs as a result of left heart failure Lifestyles, Fitness and Rehabilitation 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)
  • 8. Heart Failure • How fast does heart failure develop? – Usually a chronic disease Lifestyles, Fitness and Rehabilitation – Usually a chronic disease – The heart tries to compensate for the loss in pumping function by: • Developing more muscle mass • Enlarging • Pumping faster
  • 9. Heart Failure • What Causes Heart Failure? – Health conditions that either damage the heart or make it work too hard Lifestyles, Fitness and Rehabilitation 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)
  • 10. Heart Failure • What Causes Heart Failure? • Congenital heart defects • Severe lung disease Lifestyles, Fitness and Rehabilitation • Severe lung disease • Diabetes • Severe anemia • Overactive thyroid gland (hyperthyroidism) • Abnormal heart rhythms
  • 11. Heart Failure • What Causes Heart Failure? – Coronary artery disease Lifestyles, Fitness and Rehabilitation – 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
  • 12. Heart Failure • What Causes Heart Failure? – Heart attack Lifestyles, Fitness and Rehabilitation – 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
  • 13. Heart Failure • What Causes Heart Failure? – High blood pressure • Uncontrolled high blood pressure doubles a persons risk of developing heart failure Lifestyles, Fitness and Rehabilitation persons risk of developing heart failure • Heart must pump harder to keep blood circulating • Over time, chamber first thickens, then gets larger and weaker
  • 14. Heart Failure • What Causes Heart Failure? – Abnormal heart valves Heart muscle disease Lifestyles, Fitness and Rehabilitation – Heart muscle disease • Damage to heart muscle due to drugs, alcohol or infections – Congenital heart disease – Severe lung disease
  • 15. Heart Failure • What Causes Heart Failure? – Diabetes • Tend to have other conditions that make the Lifestyles, Fitness and Rehabilitation • Tend to have other conditions that make the heart work harder • Obesity • Hypertension • High cholesterol
  • 16. Heart Failure • What Causes Heart Failure? – Severe anemia • Not enough red blood cells to carry oxygen Lifestyles, Fitness and Rehabilitation • 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
  • 17. Heart Failure • Signs and Symptoms of Heart Failure – Shortness of Breath (dyspnea) • WHY? Lifestyles, Fitness and Rehabilitation • 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
  • 18. Heart Failure • Signs and Symptoms of Heart Failure – Persistent Cough or Wheezing WHY? Lifestyles, Fitness and Rehabilitation • WHY? – Fluid “backs up” in the lungs • SYMPTOMS – Coughing that produces white or pink blood- tinged sputum
  • 19. Heart Failure • Signs and Symptoms of Heart Failure – Edema WHY? Lifestyles, Fitness and Rehabilitation • 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
  • 20. Heart Failure • Signs and Symptoms of Heart Failure – Tiredness, fatigue • WHY? Lifestyles, Fitness and Rehabilitation • 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
  • 21. Heart Failure • Signs and Symptoms of Heart Failure – Lack of appetite/ Nausea • WHY? Lifestyles, Fitness and Rehabilitation • WHY? – The digestive system receives less blood causing problems with digestion • SYMPTOMS – Feeling of being full or sick to your stomach
  • 22. Heart Failure • Signs and Symptoms of Heart Failure – Confusion/ Impaired thinking • WHY? Lifestyles, Fitness and Rehabilitation • 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
  • 23. Heart Failure • Signs and Symptoms of Heart Failure – Increased heart rate • WHY? Lifestyles, Fitness and Rehabilitation • 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
  • 24. Heart Failure • New York Heart Association (NYHA) Functional Classification Lifestyles, Fitness and Rehabilitation Class % of patients 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
  • 25. Heart Failure • Treatment Options – The more common forms of heart failure cannot be cured, but can be treated Lifestyles, Fitness and Rehabilitation cannot be cured, but can be treated • Lifestyle changes • Medications • Surgery
  • 26. Heart Failure • Lifestyle changes – Stop smoking Lifestyles, Fitness and Rehabilitation – Loose weight – Avoid alcohol – Avoid or limit caffeine – Eat a low-fat, low-sodium diet – Exercise
  • 27. Heart Failure • Lifestyle changes – Reduce stress Lifestyles, Fitness and Rehabilitation – Keep track of symptoms and weight and report any changes or concern to the doctor – Limit fluid intake – See the doctor more frequently
  • 28. Heart Failure • Medications used to treat Heart Failure – ACE Inhibitors Lifestyles, Fitness and Rehabilitation – 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
  • 29. Heart Failure • Medications used to treat Heart Failure – Diuretics (water pills) Lifestyles, Fitness and Rehabilitation – 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
  • 30. Heart Failure • Medications used to treat Heart Failure – Potassium Lifestyles, Fitness and Rehabilitation – 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
  • 31. Heart Failure • Medications used to treat Heart Failure – Vasodilators Lifestyles, Fitness and Rehabilitation – Vasodilators • Cause blood vessel walls to relax • Occasionally used if patient cannot tolerate ACE • Decrease workload of the heart
  • 32. Heart Failure • Medications used to treat Heart Failure – Digitalis preparations Lifestyles, Fitness and Rehabilitation – Digitalis preparations • Increases the force of the hearts contractions • Relieves symptoms • Slows heart rate and certain irregular heart beats
  • 33. Heart Failure • Medications used to treat Heart Failure – Beta-blockers Lifestyles, Fitness and Rehabilitation – 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
  • 34. Heart Failure • Treatment options – Surgery and other Medical Procedures • Not often used in heart failure unless there Lifestyles, Fitness and Rehabilitation • 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)