Skip Ribbon Commands
Skip to main content

​​Congestive Heart Failure

Congestive heart failure (CHF) is a medical condition in which a weakened heart is not pumping as well as it should be. A few common causes of CHF are high blood pressure, heart attacks, and heart valve abnormalities. As a result of CHF, the flow of blood fails to move normally and fluid begins to collect in the tissues.  Fluid may collect in areas such as the legs, feet, and lungs. Fluid found in legs and feet results in swelling. The collection of fluid in the lungs can make you feel short of breath. This often can be seen by a chest x-ray or the nurse and doctor can hear the fluid by listening to the lungs with a stethoscope. 

What You Can Expect While in the Hospital

  • The nurse and doctor will listen to your heart and lungs.
  • You may be weighed daily.
  • Diet will be low salt.
  • Rest and modified exercise.​
  • You may be started on new medications.
  • One of the medications you will be started on may cause you to go to the bathroom frequently to get rid of the excess water. 
         ​

Things To Do and Watch For at Home

  • Weigh yourself daily at the same time every morning with the same amount of clothing. If you gain 2 to 3 pounds in a 24-hour period, you need to contact your physician.
  • Watch for swelling in legs, arms, feet, hands, and face. If your sleeping habits change due to breathing difficulties, contact your physician.
  • Diet - watch excess salt intake. Read labels for sodium (salt) content, and reduce as much as possible.
  • Medications - organize your pills and take them on time. This is very important. Do not discontinue pills without your physician's knowledge. Keep a list of your daily medications for your physician's reference.
  • Allow for more adequate rest and sleep. Follow the exercise recommendation from your physician. If you tire easily and become more short of breath during exercise, stop and call your physician.
  • Be sure to maintain follow-up appointments.

High Blood Pressure

The heart is a muscle that pumps blood through the arteries with each beat and keeps blood flowing throughout the body. Each heartbeat has two parts - contraction (systole) and relaxation (diastole).

Just as there are two parts of a heartbeat, there are also two parts of blood pressure measurement - systolic and diastolic pressures. Systolic blood pressure is the maximum pressure within the arteries and occurs when the heart contracts. Diastolic blood pressure is the lowest pressure within the vessels and occurs when the heart relaxes.

For Example:
122/78
122 = Systolic
78 = Diastolic 

Blood pressure that is uncontrolled or "high" causes damage that is usually gradual and unnoticed.  Serious health problems can occur in several organs because of high blood pressure.

  • Brain - Arteries that carry the blood to the brain can be damaged causing hemorrhage leading to stroke.
  • Heart - The heart must work harder to pump blood when pressure is elevated. This can cause the heart to enlarge, weakening the muscle so that eventually it does not pump as well (i.e. heart failure).
  • Kidney - The small arteries carrying blood to the kidneys may be damaged, reducing the flow of blood to them. With reduced flow, the kidneys are less able to do their job of filtering wastes.

You must take your medicines as prescribed by your doctor. If the side effects bother you, talk to the doctor. Never stop taking your medication without your doctor's knowledge. 


Myocardial Infarction

You have been admitted to the hospital because you are having a heart attack. The medical name for this is "myocardial infarction" or MI. A heart attack occurs when areas of your heart muscle do not receive blood for a period of time. The heart muscle receives blood through coronary arteries. These arteries can become blocked by fatty deposits, blood clots, or spasm. As a result of poor blood flow, the heart muscle does not get enough oxygen and becomes damaged. Your doctor will perform tests to see how much damage has been done. After a few weeks, scar tissue will develop and in some patient's new small blood vessels will begin to form. The small vessels are referred to as "collateral circulation". It may be several months before the collateral circulation reaches the areas around the damaged heart muscle. While regaining your strength remember to be patient! 

What to expect while in CCU:

  • Your heart will be monitored at all times. Your heart monitor may alarm or make "beeps". Do not be worried by this.
  • Your nurse will check your vital signs often; these include heart rate, blood pressure, respiratory rate, and temperature.
  • Your doctor will order lab tests, x-rays, and EKGs at various times during your stay. These are normal tests done on anyone who has had a heart attack.
  • Your doctor may decide to place special IVs or tubes in the veins leading to your heart. These tubes provide information on how your heart is working.
  • You will have an IV access line where intravenous (IV) medications will be administered. 

After having a heart attack you may be placed on new medications. These medications are used to increase the blood flow to the heart muscle, decrease the body's need for oxygen, and provide a more regular heart rhythm. If you have a blood clot in one of your coronary arteries, you may be given a special "thrombolytic medication" to try to dissolve the clot. Medicines taken in the past may be changed.


Arrhythmia

Arrhythmia is an irregular heartbeat that can occur in a healthy heart or can indicate a problem. The primary function of the heart is to supply blood to the rest of the body. Each heartbeat is controlled by electrical impulses traveling through the heart.  The regular beating of the heart moves blood throughout the body. In the normal heart, these electrical impulses occur at regular intervals.

Normally, the heart beats 60-100 times a minute.  This is called "sinus rhythm". Depending upon the needs of the body, it may beat faster (sinus tachycardia) during exercise or slower (sinus bradycardia) such as during sleep. When the heart beats irregularly, this can result in a rhythm disorder, or "cardiac arrhythmia. 

Arrhythmias are common abnormalities of the heartbeat. There are many types of arrhythmias. Generally speaking, those that originate from the top chambers of the heart (atria) are called "supraventricular arrhythmias" while those that come from the lower chambers of the heart ("ventricles") arc called ventricular arrhythmias.

Arrhythmias can sometimes be frightening when they occur, but in many uses, they are not life threatening and can be effectively treated with medications. Discussion with a physician is advised. 

How to Prepare:

The doctor will choose a monitor that is best for you. A few small electrodes will be placed on the skin of your chest by a technician. Small areas of the skin may be shaved or cleaned. The electrodes will be connected by thin wires to a battery-operated tape recorder (monitor) which you wear in a pouch over your shoulder. You then can go about your daily routine, being sure to complete the diary or to activate the monitor when you have symptoms.  The accuracy and usefulness of this test depend on how carefully you record your activities and symptoms and the times they occurred.  You will not be able to shower or bathe during the recording period so be sure to do so beforehand.  Avoid wearing jewelry or clothes with metal buttons or buckles that can interfere with the monitor.  Women should not wear an underwire bra for this reason.  If you have any concerns regarding the need for the test, its risks, or how it will be done, be sure to discuss them with your doctor.


Coronary Heart Disease

The inside walls of your arteries are normally smooth and flexible, which allows blood to flow through them easily.  Over the years, fatty deposits may build up on the inside of an artery's wall.  As these fatty deposits, called plaque, continue to build up, they narrow the artery and can reduce or even block the flow of blood.  When plaque builds up in the coronary arteries, the result is coronary heart disease. Blood flow in the coronary arteries may be reduced enough to cause angina or heart attack.
Angina is pain or discomfort in the chest, arm, or jaw that occurs when not enough blood flows to the heart muscle. It typically occurs during physical exertion or emotional stress, when the heart works harder and needs more oxygen.  A heart attack (myocardial infarction) occurs when a coronary artery becomes totally blocked, usually by a blood clot. This cuts off the blood supply to an area of the heart muscle and causes that part of the heart muscle to die.  Following a heart attack, the damaged heart may not pump as well as a normal heart. This may lead to heart failure. In heart failure, fluid tends to build up in the lungs and other parts of the body. Common symptoms of heart failure include shortness of breath, swelling of the feet and legs, and fatigue.  Heart failure can be caused by any medical condition that injures the heart or makes the heart work too hard for a long ti​​me. Common causes include a past heart attack, high blood pressure, heart muscle disease, and heart valve disease.  If your doctor suspects that you have coronary heart disease or heart failure, he or she may recommend that you have cardiac catheterization.


Heart Valve Disease

Heart valve disease occurs when a heart valve does not open or close properly.  In valvular stenosis, the heart valve is narrowed.  It may be thickened and/or stiff and does not open all the way.  The heart has to work harder to push blood through a smaller opening.  In valvular regurgitation (or insufficiency), the heart valve is leaky.  It may be loose, shortened, or torn.  As a result, the valve does not close tightly enough, and blood leaks backward.  The heart has to work harder to pump some of the same blood through the valve again.  Stenosis and regurgitation tend to get worse with time. They may cause the heart muscle to weaken, which can result in heart failure.  Catheterization may be needed to confirm heart valve disease and to accurately measure how severely the valve is narrowed or leaking.


Congenital Heart Defects

A congenital heart defect is a deformity of the heart that is present at birth.  An abnormal hole between heart chambers or a narrowed valve are examples of congenital heart defects.  When a defect is severe enough, it is harder for the heart to pump blood.  With time, the heart may weaken, and symptoms (such as shortness of breath and fainting spells) may develop.  In some cases, cardiac catheterization may be needed to confirm a heart defect and/or to assess how severe the problem is.


Heart Muscle Disease

Heart muscle disease, or cardiomyopathy, refers to diseases that primarily affect the heart muscle. In its most common form, called dilated cardiomyopathy, the heart muscle weakens and the heart chambers enlarge. Cardiomyopathy can be caused by a variety of conditions, such as infection or alcohol abuse, or it can occur for an unknown reason.