Heart Failure Clinic
What is a heart failure clinic?
A heart failure clinic can work with you to improve your quality of life by helping you manage your symptoms of heart failure. Staff at the heart failure clinic will help put together your own personalized heart failure management programme that will encourage you to be an active partner in your care to improve your symptoms. These programmes usually represent a co-operation between heart failure staff and physicians and involve other specialties as required. Patients in some areas may be offered regular follow-up and monitoring.
How will attending a heart failure clinic help you?
The heart failure clinic will help educate you on your condition and improvements that you can gain through diet, exercise and medication. The clinic will also allow you to receive more convenient follow-up care (e.g., by telephone-monitoring by heart failure clinic staff, or other means) and it may encourage you to set and meet small goals in changing your lifestyle. These programmes may also provide the contact details of a person that would be available to discuss what you should do if your symptoms worsen. You may also learn about any clinical trials of new therapies, and perhaps take part in them.
This is a service provided by Apollo Gleneagles Hospitals, Kolkata, Department of Cardiology with an aim to help heart failure patients proactively manage their heart disease and improve their quality of life.
The goal of AGHL's HF clinic is to reduce hospitalizations and improve heart failure patient care. We closely monitor heart failure patients and provide personalized outpatient therapy. We use individual programs that educate patients about heart failure and help manage disease.
There are steps you can take to stop the progression of the disease and prevent the likelihood of an acute heart failure episode which will require emergency room evaluation and/or hospitalization.
In the Heart Failure Clinic at Apollo Gleneagles Hospitals, Kolkata, cardiologists trained and specialized in the diagnosis and treatment of heart failure care for people with heart failure.
Doctors in the Heart Failure Clinic have extensive experience and expertise in diagnosing and treating heart failure. AGHL doctors expertise in treating heart failure offers an opportunity for prolonged life and improved quality of life for people who have found limited options elsewhere.
AGHL cardiologists trained in heart failure work as a multidisciplinary team with staff in many areas to provide you with comprehensive care. Depending on your condition, your treatment team may include:
- Heart rhythm specialists (electrophysiologists)
- Exercise physiologists
- Sleep disorders specialists
- Mechanical support device specialists
- Cardiac surgeons
- Palliative care specialists
Other staff may be involved in your care, such as nurses, nutrition specialists (dietitians), social workers, physical therapists and other medical professionals trained in diagnosing and treating heart failure.
To determine the type and progression of your heart failure, cardiologists may conduct tests including:
- Cardiac catheterization
- Cardiac MRI and CT scan
- Cardiopulmonary exercise testing
- Electrophysiology studies
- Nuclear cardiology studies
Your treatment may include lifestyle changes, medications, surgery or medical devices. Your care is integrated, from diagnosis and treatment to follow-up. Depending on your condition, your heart failure treatment may include procedures such as:
- Implantation of implantable cardioverter-defibrillators (ICDs)
- Implantation of pacemakers, including biventricular pacemakers
- Implantation of ventricular assist devices
- Heart transplant for some people who have advanced heart failure
The professional experienced team provides outpatient care and an inpatient program if you require hospitalization. In the hospital, your care is directed and monitored by reputed cardiologists. Doctors work with your local doctors to optimize follow-up care.
HF Clinic Services at AGHL
Services that the AGHL HF Clinic offers to patients include:
- Monthly follow-up calls by Clinic staff help to avoid readmission to the hospital
- Monitoring of chronic medications (i.e., angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and diuretics) along with your primary care doctor and/or your cardiologist as and when required
- Symptom management
- Diet/sodium and fluid restriction education
- Education programs: general heart failure programs and patient/family programs to help the patient and family members understand how to avoid trips back to the hospital
For more information about heart failure treatment or to learn what you can do to prevent the disease, call the Apollo Gleneagles Hospitals helpline at 91-33-23203040
Someone is available to speak to you Monday through Saturday from 9 am - 5.30 pm.
The Heart Failure Clinic has an active clinical research program. You may have the opportunity to participate in experimental therapies or clinical trials.
You may be referred by your primary doctor, or you may make an appointment without a referral. Please confirm when you request an appointment.
When to Call the Doctor
APOLLO GLENEAGLES HOSPITALS EMERGENCY NUMBER 1066
If you have sudden, severe symptoms such as chest pain or severe shortness of breath, you may need to go to the Emergency Room.
- Sudden weight gain (2-5 pounds in 2-4 days). Keep a daily log of your weights so you can follow trends.
- Swelling of the abdomen or ankles
- Worsening shortness of breath
- You are not comfortable sleeping flat in bed at night, or you wake up because of shortness of breath
- Worsening cough
- Persistent new onset of nausea, vomiting, diarrhea
- Worsening dizziness or new onset of spells of sudden dizziness
- New onset of profound fatigue with exertion
Understanding Heart Failure
What is Heart Failure
Heart failure is a serious medical condition where the heart does not pump blood around the body as well as it should. This means that your blood can't deliver enough oxygen and nourishment to your body to allow it to work normally. This, for example, may cause you to feel tired or fatigued. It also means that you can't eliminate waste products properly - leading to a build up of fluid in your lungs and other parts of your body, such as your legs and abdomen.
Heart failure often develops because you have (or had) a medical condition, such as coronary artery disease, a heart attack or high blood pressure, which has damaged or put extra workload on your heart.
Heart failure can develop at any age but clearly becomes more common with increasing age. Around 1% of people under 65 years of age have heart failure, but 7% of 75-84 year olds have heart failure and this increases to 15% in people older than 85. It is the most common cause of hospitalisation in patients over 65 years of age.
Although it is called heart 'failure', this doesn't mean that your heart is about to stop working. It does mean that your heart is having difficulty working to meet the needs of your body (especially during activity).
How does the Normal Heart Work
Your heart is a specialised muscle that pumps blood around your body. Blood carries oxygen and nourishment to all parts of your body and carries waste products to several organs, notably your lungs and kidneys to eliminate.
Your heart is divided into two pumps which work together. Blood coming back from the organs and tissues of your body enters the right side of your heart which then pumps it to your lungs. Your lungs remove waste carbon dioxide from the blood and recharge it with oxygen.
The oxygen-rich blood returning from your lungs enters the left side of your heart, which then pumps it to all parts of your body, including your heart muscle itself.
This process ensures that there is always enough oxygen and nourishment for your body to work efficiently.
Types of Heart Failure
Heart failure is different in every patient - the parts of the heart affected and the symptoms can vary widely. For this reason, your doctor may use several different terms for describing your heart failure.
The two main types of heart failure are chronic heart failure and acute heart failure .
Chronic heart failure is more common and symptoms appear slowly over time and worsen gradually.
Acute heart failure develops suddenly and symptoms are initially severe. Acute heart failure either follows a heart attack that has caused damage to an area of your heart or, more frequently, is caused by a sudden lack of ability by the body to compensate for chronic heart failure.
If you develop acute heart failure, it may be severe initially but may only last for a brief time and improve rapidly. It usually requires therapy and administration of medication by injection (intravenously).
There is another type of heart failure: Heart failure of the right ventricle.
Heart failure usually results from damage to the main pumping chamber, the left ventricle, which supplies the body with blood. This may be due to muscle injury such as a heart attack or damage to the valves in the left side of the heart.
This causes congestion in the lungs and shortness of breath. Sometimes, heart failure mainly affects the right ventricle which pumps blood to the lungs. This may be due to muscle injury, such as a heart attack localised to the right ventricle or damage to the valves in the right side of the heart.
This may cause congestion in the liver, intestines and fluid accumulation in the lower limbs.
Heart failure on both sides of the heart may be caused or worsened by irregular heart rhythms such as atrial fibrillation, which is usually a rapid and irregular heart rate that may prevent proper filling of the ventricles.
Causes of Heart Failure
Heart failure can be caused by current or past medical conditions, which either damage or add extra workload to the heart. If you have (or had) more than one of these conditions your risk of heart failure is substantially increased. Your doctor should be able to tell you what may have caused your heart failure.
This section lists the different conditions that can cause or trigger heart failure, explaining what each condition is and how it can cause heart failure.
Some of the more common causes of heart failure include:
- Past heart attacks
- Coronary artery disease
- High blood pressure
- Heart valve disease
- Heart muscle disease or inflammation of the heart
- Congenital heart defects
- Lung conditions
- Alcohol / drug abuse
Less commonly, someone whose body is compensating well for his/her heart failure may develop symptoms if their heart is temporarily unable to keep up with their body's needs.
Conditions that can trigger this type of heart failure include:
- Kidney disease / poor kidney function
- Abnormal heart rhythm
- Overactive thyroid gland
If these triggers are treated the heart failure can often get better.
Other conditions, such as diabetes, may aggravate heart failure.
In addition people with heart failure frequently become symptomatic if they stop taking their medicines or do not follow their treatment plan properly. For some people the cause of their heart failure is unknown, and they don't have any of the conditions listed above. If you are unsure of the cause of your heart failure you should discuss it with your doctor.
How can Heart Failure change over time
Heart failure is a serious, chronic condition that tends to gradually get worse over time. Eventually it can shorten your life.
The progress of heart failure is unpredictable and different for each person. In many cases, the symptoms remain at a stable level for quite some time (months or years) before becoming worse. In some cases the severity and symptoms become gradually worse over time. Or they may progress rapidly following, for example, a new heart attack, a heart rhythm disorder or a lung infection. Such acute conditions usually respond to treatment.
Most importantly, you should understand that careful management of your condition can not only ease symptoms but can also improve prognosis and prolong life. Your doctor and other members of your healthcare team will work with you to treat your condition effectively, using a combination of medical treatments and changes to your lifestyle.
What goes wrong in Heart Failure
If you have heart failure, your heart has difficulty pumping blood around your body. This can happen for many reasons - commonly because you have (or had) a medical condition which has damaged (e.g. coronary heart disease with a heart attack) or placed extra workload (e.g. high blood pressure) on your heart.
This damage or extra workload can affect the squeezing (contraction) or filling (relaxation) of your heart, and frequently both.
If your heart does not contract as it should, it will not be able to pump sufficient blood in your ventricles out of your heart. If your heart is not able to empty and relax fully, less blood will be able to enter your heart, and therefore less blood is available to pump out of your heart.
Heart failure has two main effects. Firstly, not enough blood is getting to your body, which may cause fatigue. Secondly, blood backs up waiting to enter your heart. This build up of blood causes fluid to leak out of your blood vessels and into the surrounding tissues. This leads to fluid accumulation (usually in your legs and abdomen) and congestion in your lungs.
At first your body will adapt to try and compensate for your weakened heart's poor pumping. However, these adaptations can only compensate for a limited time, and in fact, in the long-term these adaptations can actually make your heart even weaker.
Symptoms of Heart Failure
Heart failure symptoms can vary widely from person to person, depending on the type of heart failure you have. Therefore, you may experience all of the symptoms described here or just a few of them.
In the early stage, you are unlikely to notice any symptoms, but if your heart failure progresses you are likely to experience symptoms, which become more severe.
The main symptoms of heart failure are caused by fluid accumulation or congestion and poor blood flow to the body. This section will explain these symptoms and provide tips on how to improve them.
Symptoms caused by fluid accumulation or congestion
- Shortness of breath
- Weight gain
- Swollen ankles
Symptoms related to the reduced blood flow to parts of the body.
- Rapid heart rate
Other symptoms of heart failure
- Loss of appetite
- Need to urinate at night
In addition to the physical symptoms of heart failure, some people can be affected by the seriousness and severity of heart failure and may experience emotional symptoms, such as depression and anxiety.
However many of these symptoms you experience, it is important to monitor them on a daily basis. If you notice something new, or a symptom suddenly gets worse, you should tell your doctor or nurse without delay.
Common Tests for Heart Failure
If you suspect you have symptoms of heart failure you should talk to your doctor (normally your primary care physician / GP).
Your doctor will likely perform a thorough examination of your body and will ask you about your symptoms, your medical history and your lifestyle. It is important that you answer any questions as honestly and accurately as possible so that your doctor can make an accurate diagnosis and can work with you to find the best treatment.
If your doctor suspects you have heart failure he or she will probably suggest you have certain tests. These tests will help to show whether your heart is working properly and, if not, where the problem lies.
This section explains the tests your doctor may want you to have and what the test can show. The most common tests are:
- Medical history and physical examination
- Electrocardiogram (ECG)
- Blood tests
- Chest x-ray
Additional tests may be able to find out more about your heart failure or identify the cause. These include:
- Lung function tests
- Exercise testing
- Cardiac Magnetic Resonance Imaging (MRI)
- Cardiac catheterisation and angiography
- Nuclear medicines techniques
As the symptoms presented to the doctor may vary widely between patients you may only receive a few of these tests, and it is very unlikely you will receive all of them. If you have any concerns regarding your tests, you should discuss them with your doctor.
WHAT CAN YOU DOCTOR DO
Heart Failure Medicines
Here we provide a guide to the types of heart failure medicines that are available. It is important that you speak to your doctor about any concerns or questions you have about your heart failure medicines. You are likely to require medication for your heart failure for the rest of your life.
There are lots of medicines that you may be given. All of these can help to keep your symptoms under control and improve your quality of life. Some of them have side effects - but the benefits usually greatly outweigh the problems. If you do find it hard to cope with one of your medicines because of side effects, it's important to talk to your doctor rather than stopping the medicine straight away. Your doctor may be able to work with you to find a version that suits you better.
Not all medicines are needed by every person with heart failure. Which medicines are right for you will depend on your symptoms, general health and lifestyle. Your doctor will take into account any other medical problems you have that may affect your treatment. It is very important to take your medicines exactly as your doctor tells you as this will ensure that the medicine works as well as it can. You are likely to need more than one medicine at a time. Making a note or chart could help you to keep track.
- ACE (Angiotensin converting enzyme) inhibitors
- ARBs (Angiotensin II receptor blockers)
- Sinus node inhibitors
- Beta blockers
- Aldosterone receptor antagonists
Medicines for acute heart failure
It is important to take your medicines to ensure you have the best possible results from your treatment.
Tips and tools for remembering to take them.
You may find that you have been prescribed a number of medicines for your heart failure, and that you need to take them at different times of the day. The followng tips and tools may help you to remember to take your medicines at the right time:
- Make a wall chart with the names of your medicines, the dose, and the time of day you need to take them.
- Buy a pillbox (also called a Dosette box) labelled with the days of the week and times of day. Fill the box at the beginning of the week to help you keep track. Ask a family member or nurse to check the box so that you know you get it right.
- Set an alarm to remind you if a medicine has to be taken at a particular time.
- Make family and friends aware of your medication schedule so they can remind you.
- Make a habit or routine out of taking your medicine to help you remember, e.g. just as you brush your teeth, eat breakfast or dinner.
- Remember to take your medicines with you when you leave the house, then you can ensure you take them on time.
- Pack enough medicines with you when you are away on holiday - and always put them in your hand luggage - and do not forget the prescription from your doctor.
- Reorder your prescriptions ahead of time to make sure that you never run out.
Other prescription and over the counter medicines
Some prescription medicines can interact with your tablets and cause side effects if you take them together. You need to remember that some medicines you can buy without prescription can also interact with your heart failure medicines. Be sure to check with your doctor before you start taking any other prescription or over the counter medicines.
It is strongly recommended that you talk to your doctor before taking any alternative/natural/herbal remedies.
Sometimes, it may be necessary for you to have heart surgery. While surgery generally improves heart failure, it will only be carried out if the anticipated benefits of the procedure outweigh the risks. Major surgery, such as heart surgery, carries a number of risks.
Surgery that can improve your heart failure includes coronary artery bypass, valve replacement surgery and heart transplantation. Due to recent medical advances and improvements, these surgeries are widely performed.
- Coronary artery bypass grafting (CABG)
- Valve surgery
- Heart transplantation
If you have an abnormal heart rhythm or if the electrical impulses do not travel through your heart properly, your doctor may decide your heart needs additional support. A number of advanced medical devices can help support your heart by using painless electrical signals to keep it beating regularly and/or improve function. These devices may not only improve symptoms but have been shown to improve long-term survival.
These devices are constantly getting smaller, more efficient, and with longer lasting batteries. Typically these devices are inserted with a local anaesthetic. They are positioned under your collarbone so as not to be visible on the outside of your body. Most devices will require periodic monitoring, usually annually, on an outpatient basis.
Heart devices that are currently available:
- Cardiac Resynchronisation Therapy (CRT)
- Implantable Cardioverter Defibrillators (ICDs)
- Left Ventricular Assist Devices (LVAD)
Your doctor may recommend other procedures to improve or investigate your heart failure.
- Percutaneous Coronary Intervention (PCI)
People that may be involved in your care
After you have been diagnosed with heart failure, you are likely to see several different specialists who will help you improve and manage your condition. Below is a list of the healthcare professionals you may see, what they do and why you might see them.
Your cardiologist is responsible for your overall medical management, including making sure you have the relevant tests and prescribing your treatment.
Your pharmacist will be able to give you lots of useful information about your medicines. He/she can tell you if there are any foods or other drugs which should be avoided with your heart failure prescription medicines. Your pharmacist can also help to explain any instructions that you need to understand to take your medicines properly.
Dieticians can advise you on how to improve your diet to help manage your heart failure, for example cutting down on your salt or fluid intake. They may work with you to develop an appropriate diet plan to help you maintain a healthy body weight.
Geriatrician/Care of the elderly specialist
You may be referred to a care of the elderly specialist if you are of a certain age and affected by other disorders commonly seen in older people.
Physical and occupational therapists
Physical and occupational therapists will help you to recover from hospitalisation or a procedure and live as full a life as possible through a cardiac rehabilitation programme. They can also give you practical advice on saving your energy.
A psychologist may be able to help you and your family cope with emotional stress, anxiety, depression and other psychological problems caused by your heart failure.
Self care management of Heart Failure Managing Heart Failure at home
In addition to taking all of your medications as prescribed, you can personally impact your health.
The first and perhaps most important thing is to weigh yourself every morning. You should weigh yourself after you urinate and before you have anything to eat or drink. People with HF tend to hold on to extra fluid. At first, extra fluid in the body helps to make sure there is good blood flow to the kidneys and other organs. However, over the long term, the extra fluid puts an added strain on your heart. By weighing every day you can see a mild weight gain before you start to have symptoms of fluid retention. Some symptoms are shortness of breath, fatigue and loss of appetite.
Take your blood pressure twice a day. Take it once in the morning and once in the evening. If you feel dizzy, lightheaded, nauseous or feel like you might pass out, take your blood pressure and pulse and call your doctor. It is especially important to monitor your blood pressure and pulse when changes are made in your medication.
Your doctor may ask you to follow a low cholesterol, low fat, no-added-salt diet with a fluid restriction.
The following pages have information about this eating plan. A very important part of self-care is limiting your sodium intake. People with HF tend to hold on to salt and fluid. Eating a very high-salt diet may increase fluid in the body. An increase in fluid in the body makes the load your heart has to pump larger. The human body needs only about 500 mg of sodium daily. It is important for people with Heart Failure to limit their salt intake to less than 2000 mg per day.
1 tsp table salt = 2000 mg sodium
Over time, your tastes will adjust to low-salt foods.
Below are some tips to tame your taste for salt:
- Buy fresh foods such as fruits and vegetables.
- Rinse canned foods before cooking or eating them.
- Do not cook with salt.
- Do not buy convenience foods like frozen dinners (even low-fat meals), cheeses.
- Avoid eating out. Stay away from Mexican, Chinese and fast-food restaurants. They are almost all high in salt. If you do eat out, order your food baked, broiled, steamed or poached. Ask that no salt be added to your food. Use small amounts of condiments and salad dressings, as most are high in sodium
- Use herbs and spices as alternatives to salt. Ask your doctor before using salt substitute products.
- Become a label reader: try to buy foods labeled low sodium.
Limit fluid intake to 2 liters (8 cups) a day. As mentioned above, people with HF tend to retain fluids. Taking in more than 2 liters a day can place a burden on your heart.
Taking in too much fluid also works against diuretics. You don't want to replace the fluid that the diuretics have helped your body get rid of. You will feel thirsty. To ease your thirst, try using small amounts of sugar-free hard candy.
For easy conversion, remember:
- 1 cup = 8 ounces = 240 cc
- 4 cups = 32 ounces = 1 quart = 1000 cc = 1 liter
- 8 cups = 64 oz = 2 quarts = 2000 cc = 2 liters
- 1 milliliter = 1 cc
- 1 small amount = 30 cc
REMEMBERALL foods that are liquid at room temperature count towards your total fluid intake.
Here are some examples of foods that count as part of your fluid total:
l ice cream 2. tea 3. soup 4. water 5. yogurt 6. ice cubes 7. Jello 8. coffee 9. pudding 10. juice l1. soda l2. milk
Exercise, stress management and energy conservation
What exercise is right for you?Aerobic exercise increases your heart rate and makes your circulation better. Good examples of exercise are walking, swimming or bicycling. To help you start exercising, ask your doctor about cardiac rehabilitation. Recent research has shown good benefits for people with HF.
If you are starting to exercise on your own, start easy and advance slowly. Always allow yourself a few minutes to warm up and cool down. At first, exercise for only a few minutes. Then, slowly, as you gain more strength, add on a minute or two. If you cannot talk with someone while you exercise, you are probably working too hard. SLOW DOWN. If you have chest pain, shortness of breath, nausea or dizziness, STOP RIGHT AWAY. A good exercise goal is 30 minutes, three to five times a week.
Stress ManagementWhile stress is a part of being human, learning to deal effectively with it allows you to live a healthier and happier life. Below are some activities that may help you in reducing stress:
Exercise, Consider private counseling. Join a support group, Volunteer Laugh, Do what makes you truly happy, Meditate, Be gentle with yourself
People with HF often have a great deal of fatigue and low energy, so it is a good idea to practice energy conservation. The following are good tips to live by:
- Plan ahead. Schedule heavy tasks first thing in the morning when you are freshest.
- Set priorities. Don't do unnecessary tasks.
- Rest often. Short periods of rest allow you to recover. Try to get 7-8 hours of sleep each night.
- Avoid unnecessary bending and stretching.
- Be realistic with what you can and cannot do all in one day.
- Ask for help. There may be some tasks that are too difficult for you (for example: mowing the lawn in hot weather).
- Organize areas that help you complete a task and decrease the number of unnecessary trips for supplies.
Questions to ask your doctor
It is important to make the most of appointments with your doctor to answer any questions you have about your heart failure treatment. Here we provide a list of general questions and an explanation of why you may find it useful to ask them. You can print these out and take them with you when you next visit your doctor.
How many pills should I take and when?This will help you to create your own personal medicine chart to keep a track of when and how often to take your medicines.
Can my medicine(s) cause any side effects?This will make sure you know what to expect from taking the medicine, and allow you to prepare yourself for any unwanted side effects e.g. if dizziness is a side effect of your medication you can prepare by not standing up too quickly or getting out of bed too rapidly.
Who should I contact if I think I am having a bad reaction to my medicine(s)?Your doctor will advise you who to contact if you feel unwell after taking your heart failure medicine. You can then make sure you always have the details to hand and also share it with family and friends.
How often do I need to get a new prescription?
Your doctor will prescribe your medicine for a specific amount of time, and will tell you if you need to make another appointment. With most heart failure medicines it is important that you take them every day, therefore it is important to plan ahead to make sure you don't run out remember holidays or planned travel.
How do I know if I need a device?Your doctor will evaluate your symptoms and heart function. If your heart beats too slowly, you may need a pacemaker. If you have moderate or serious symptoms of heart failure and evidence of poor, uneven contraction, you may require a CRT. If you have had episodes with serious rhythm disturbance, you may be considered for an ICD.
What are the risks associated with having the device implanted?
Your doctor will be able to tell you the risks involved in having the device implanted. For most patients, the benefits of having a device far outweigh any risks.
Will I need a general or local anaesthetic in order to have the device inserted?A general anaesthetic involves you being put to sleep but with a local anaesthetic you will be awake but the part of your body being operated on will be made numb. Your doctor will be able to tell you whether you need a local or a general anaesthetic so that you can be prepared. You may be asked not to eat or drink for up to 6 hours before either a general anaesthetic or most procedures.
Will I need to stay overnight in hospital when I have my device inserted?Your doctor will tell you if you need to stay overnight in the hospital. This often depends on whether you will be having a general anaesthetic as recovery time will be longer for a general anaesthetic than for a local anaesthetic. You may need to come in to hospital the night before if your device is being inserted early in the morning.
How often will I need to come back to have my device checked?Your doctor will be able to tell you how often your device needs to be checked. It is very important to attend these appointments so you should make sure you plan ahead and don't book a holiday when your device is due to be checked. Your device will need replacing at some point and your doctor will be able to give you an idea of when you should expect this.
Will I be able to travel by aeroplane, drive a car and perform other normal activities?Following the insertion of your device you should still be able to fly and drive a car and your doctor will be able to advise you on what you should avoid doing. There may be some restrictions on driving following implantation of your device and this should be discussed. Your doctor or physiotherapist will recommend a programme of gradual physical activity, to make sure that you do not put too much strain on your body too quickly.
Will I have to take any extra medicines following the insertion of the device?
You may need to take additional medicines, or you may need to change the medicines you were taking before you received the device. Your doctor will tell you what medicines you need to take, how often and for how long. You will then be able to add these into your daily routine and add them to a medicine chart to remind you to take them correctly.
Surgery and procedures
What are the risks associated with this surgery?Before you have any surgery, your doctor will discuss the procedure and any associated risks. For most patients, the benefits of surgery far outweigh the risks.
How long will the surgery/procedure take?Your doctor will be able to give you an idea of how long the procedure will take and how long you will be in hospital so you can plan accordingly.
Will I feel anything?Your doctor will inform you whether you will need to have a general or local anaesthetic during the procedure. If it is a general anaesthetic you will be put to sleep and you will not be aware of the surgery/procedure taking place. If you are having a local anaesthetic you will be awake during the procedure, but you should not be able to feel the operation as the area being operated on will be numb.
Will I have to take any extra medicines following the procedure?You may need to take medicines after your surgery that are different from those you were taking before the procedure. You could take along the questions on the medicines list so that you can check how much to take, how often, and if there are any associated side effects.
How long before I start to feel better?Your doctor may be able to give you an idea of how long it will take to recover from your operation. While it may not take too long to recover from the surgery, it may take a while for you to notice the benefits of the surgery on your heart failure symptoms.
Will I have to make any lifestyle changes?Following your surgery you may not be able to go back to your normal diet and physical activity, straight away. Your doctor will be able to advise you on what you can do and what you should try to avoid doing.
Caring for yourself when you have heart failure is mainly about staying well. One way to stay well is to minimise the risk of getting respiratory infections like influenza (flu) or pneumonia, as respiratory problems can worsen heart failure.
Safe vaccines that can provide immunity against flu and pneumonia are available. You should discuss having these vaccines with your nurse or doctor who will be able to advise you in more detail about them.
When travelling, your travel agent will advise you regarding the immunisations or medications, for example malaria tablets, that may be required according to your destination.
If you take anticoagulant medicines your doctor or nurse may advise a different vaccination programme, which may need to be started earlier than the usual vaccination schedule.
Adapting your lifestyleHeart failure is a chronic condition, which means it requires long-term treatment. You should be prepared to make changes to your lifestyle to help control your heart failure, and any other medical conditions you may have.
In addition to managing the heart failure therapy your doctor has recommended, you may have to adapt other aspects of your lifestyle, such as diet, exercise, smoking and alcohol consumption, to ensure that you get the most benefit from your treatment.
This section provides you with further information on how each of these lifestyle factors affect your heart failure, and what changes you should try to make to reduce their impact on your condition.
- Warning Signs
- Chest pain
- Shortness of breath
- Awakening short of breath/needing more pillows
- Fainting and/or dizziness
- Rapid weight gain
- Swelling or pain in the abdomen
- Increased swelling of the legs or ankles
- Loss of appetite/nausea
- Increasing fatigue