The document discusses heart failure, including its causes, types, signs and symptoms. It defines heart failure as when the heart cannot pump enough blood to meet the body's needs. Left heart failure involves the left ventricle, and can be systolic or diastolic. Right heart failure usually occurs secondary to left heart failure. Common causes include coronary artery disease, heart attack, high blood pressure, and diabetes. Signs and symptoms include shortness of breath, cough, edema, fatigue, lack of appetite, and confusion.

1. Lifestyles, Fitness
and Rehabilitation
Heart Failure
CCF/CHF
LVF 1st + RVF 2nd = CCF/CHF
By :
Mr Murdin b Amit
Bsc in Health Science (Hons), Ba in Buissness Administration (Hrm)(Hons)
Head of Medical Science Subject
College of Assistant Medical Officer,
Seremban, Negeri Sembilan
murdin_1966@yahoo.com
HP: 012 - 6044385

2. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Heart Failure?
– The heart is not pumping as well as it
should
– Usually, the heart has been weakened
by an underlying condition
• Blocked arteries
• Heart attack
• High blood pressure
• Infections
• Heart valve abnormalities

3. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Heart Failure?
– Heart failure can involve the left or right
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. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Heart Failure?

5. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Left Heart Failure?
– Involves the left ventricle (lower
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. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Left Heart Failure?
– Systolic and diastolic heart failure are
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. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What is Right Heart Failure?
– Usually occurs as a result of left heart
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. Lifestyles, Fitness Heart Failure
and Rehabilitation
• How fast does heart failure
develop?
– Usually a chronic disease
– The heart tries to compensate for the
loss in pumping function by:
• Developing more muscle mass
• Enlarging
• Pumping faster

9. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What Causes Heart Failure?
– Health conditions that either damage
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. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What Causes Heart Failure?
• Congenital heart defects
• Severe lung disease
• Diabetes
• Severe anemia
• Overactive thyroid gland (hyperthyroidism)
• Abnormal heart rhythms

11. Lifestyles, Fitness Heart Failure
and Rehabilitation
• What Causes Heart Failure?
– 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
Lifestyles, Fitness
and Rehabilitation
• What Causes Heart Failure?
– 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
Lifestyles, Fitness
and Rehabilitation
• What Causes Heart Failure?
– High blood pressure
• Uncontrolled high blood pressure doubles a
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
Lifestyles, Fitness
and Rehabilitation
• What Causes Heart Failure?
– Abnormal heart valves
– Heart muscle disease
• Damage to heart muscle due to drugs,
alcohol or infections
– Congenital heart disease
– Severe lung disease

15. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• What Causes Heart Failure?
– Diabetes
• Tend to have other conditions that make the
heart work harder
• Obesity
• Hypertension
• High cholesterol

16. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• What Causes Heart Failure?
– Severe anemia
• Not enough red blood cells to carry oxygen
• 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
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Shortness of Breath (dyspnea)
• 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
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Persistent Cough or Wheezing
• WHY?
– Fluid “backs up” in the lungs
• SYMPTOMS
– Coughing that produces white or pink blood-
tinged sputum (Froty Sputum)

19. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Edema
• 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
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Tiredness, fatigue
• 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
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Lack of appetite/ Nausea
• WHY?
– The digestive system receives less blood
causing problems with digestion
– Physiological disturbance to Vagus nerve
• SYMPTOMS
– Feeling of being full or sick to your stomach

22. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Confusion/ Impaired thinking
• WHY?
– Changing levels of substances in the blood
( sodium) can cause confusion
– Lack of O2 reach to the brain
• SYMPTOMS
– Memory loss or feeling of disorientation
– Relative or caregiver may notice this first

23. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Signs and Symptoms of Heart Failure
– Increased heart rate
• 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
Lifestyles, Fitness
and Rehabilitation
• New York Heart Association (NYHA)
Functional Classification
Class % of patients Symptoms
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
Lifestyles, Fitness
and Rehabilitation
• Treatment Options
– The more common forms of heart failure
cannot be cured, but can be treated
• Lifestyle changes
• Medications
• Surgery

26. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Lifestyle changes
– Stop smoking
– Loose weight
– Avoid alcohol
– Avoid or limit caffeine
– Eat a low-fat, low-sodium diet
– Exercise

27. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Lifestyle changes
– Reduce stress
– 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
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart
Failure
– ACE Inhibitors (Enalapril 5-10mg bd/tds)
• 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
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart Failure
– Diuretics (water pills) – Frusemide 40-80mg
• 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
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart
Failure
– 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
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart Failure
– Vasodilators
• Hydrallazine 100mg stat or Prazosin 1-2mg bd/tds
• Cause blood vessel walls to relax
• Occasionally used if patient cannot tolerate ACE
• Decrease workload of the heart

32. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart Failure
– Digitalis preparations
• Digoxin 0.25mg-0.5mg bd
• Increases the force of the hearts contractions,
increases the blood stroke volume
• Relieves symptoms
• Slows heart rate and certain irregular heart beats

33. Heart Failure
Lifestyles, Fitness
and Rehabilitation
• Medications used to treat Heart Failure
– Beta-blockers (Tab Metoprolol 50-200mg)
• 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
Lifestyles, Fitness
and Rehabilitation
• Treatment options
– Surgery and other Medical Procedures
• 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)