Heart Failure is the inability of the heart to provide a good blood
supply to the tissues and organs of the body. It does not mean
that your heart has stopped working or that you are having a heart
attack.
Understanding Your Symptoms:
When the heart does not work normally, it may not pump enough
blood to support your other organs and may cause you to retain
fluid. This can cause leg or abdominal swelling, cough, fatigue, and
shortness of breath during activity or when lying flat.
Changes in symptoms:
Symptoms may vary from time to time; however if you closely
monitor your symptoms your specialist nurse or Doctor may be able
to adjust medications to control any changes in symptoms.
Limiting Fluids:
Monitoring fluid intake (water, coffee / tea, juice, soups, etc.) will
help avoid fluid build-up. If you have been prescribed water tablets
(diuretics), these will make you pass more urine and make you feel
thirstier. Try not to drink more than 4 pints (2 litres) of fluid per day.
Only restrict your fluids if this has been recommended by your Heart Failure Nurse.
Daily Weights:
Weighing yourself daily is your guide to keeping your fluid balance
and symptoms stable. The best time to do this is in the morning after
passing urine and before getting dressed.
Keeping a log of your weight and symptoms will help you and your
Doctor evaluate your treatment and make adjustments as needed.
A weight gain of 2 to 3 pounds in 1 day, or 5 pounds in 1 week
should be reported to your Heart Failure Nurse or your Doctor.
Physical Activity:
Maintaining an active lifestyle should be a goal for you.
Activity is important, try to continue those activities which do not
cause you any symptoms.
Mild to moderate exercise under the guidance of the medical team is
usually safe and encouraged.
You may be advised of a walking or exercise programme. Avoid
strenuous exertion such as heavy lifting or pushing.
Rest:
Try to rest if you feel tired. If your ankles are swollen put your feet
up. If you have any problems breathing when lying down use extra pillows.
What is fatigue?
Fatigue is a common symptom of heart failure. For most people,
fatigue usually subsides within a few weeks, but for some people can
persist longer. Fatigue is often felt to be both physical and mental
tiredness and is said to be overwhelming:
A feeling of having no energy, like you could spend the whole day in
bed
• Feeling breathless after only light activity.
• Difficulty sleeping.
• Feeling more emotional than normal.
• Having trouble thinking or making decisions.
Managing breathlessness
One of the most common symptoms you may experience is
breathlessness. This may occur during every day activities like
getting dressed. This is nothing to worry about and there are various
tips and techniques you can use to help manage your shortness of
breath.
Breathing techniques
• The aim is to move from fast, upper chest breathing to relaxed,
slow tummy breathing.
• Take slower breaths, in through your nose down into your
tummy, then gently breathe out through pursed lips (as if you
were going to blow out a candle) to create more room for the
next breath in. Do not force your lungs to empty.
• You may find it helpful to rest your hand on your tummy as you
do this, feel it rise and fall gently with each breath.
• Remember 3 Rs: Rise the tummy as you breathe in, Relax the
breath out, Rest and wait for the next breath to come.
• Follow the sides of the rectangle with your eyes as you breathe
in (nose) and out (pursed lips).
• Gradually slow the speed your eyes move around the edge of
the shape to slow your breathing.
Medications You May Be Prescribed:
Research has shown that certain medications, often in combination,
can help to improve your symptoms and prolong your life.
It is important that you take your medications daily as prescribed.
Consider using a medication schedule, list, blister pack, pillbox or
mobile phone to remind you to take your medications as prescribed.
Other Medical Conditions and Medications:
Conditions such as high blood pressure, heart rate irregularities,
diabetes mellitus, sleep apnoea, and infections may contribute to
worsening symptoms of heart failure.
Inform your heart team if you have any new medical problems or
new medications. For example, nonsteroidal anti-inflammatory drugs
such as ibuprofen or naproxen should be avoided.
Vaccinations for pneumonia and influenza are recommended.
It is also important that you avoid smoking or vaping, only take
alcohol in moderation and avoid recreational drugs.
Additional Heart Failure Treatments:
Your heart condition may remain stable for a long time. However,
if your heart function worsens in spite of the best possible selfcare
and medical treatment, other options may be considered, and
a specialist review may be required to discuss further treatment
options.
Help to Manage Your Symptoms Every Day
• Know the symptoms of heart failure and when to contact your
medical team.
• Weigh yourself in the morning before breakfast and write it
down. Compare is to yesterday’s weight.
• Check for swelling in your feet, ankles and tummy.
• Avoid adding salt to food and stick to your fluid restriction if you
have been given one.
• Balance activity and rest periods.
• Understand how each medication helps your heart and its
possible side effects.
• Take your medicine every day as prescribed.
• Keep a medication list in your wallet and bring your medications
to your appointments.
• Ask for medication refills 7–10 days before you run out.
• Talk to your Doctor or Heart Failure Nurse before stopping any
medication, or if you notice side-effects.
• Keep regular medical or Heart Failure Team appointments and expect regular blood tests.
Some medicines shouldn’t be taken when you have an illness that
causes you to become dehydrated. You may need to temporarily
discontinue selected medications if you develop prolonged (longer
than 48 hours) illness; such as diarrhoea and vomiting and certain
infections.
Medicines should not be stopped for longer than 48 hours unless
under direction of a GP or Heart Failure Specialist Nurse. Please
contact your heart failure nurse should you need further advice.
A Heart Failure Nurse Specialist (HFNS) with the ability to prescribe
heart medications will review you in a clinic or at home. If you are
housebound, a HFNS will visit you at home for your heart failure
assessments. For all other patients, you will be seen in a clinic
nearest to your home. However, due to capacity it is not guaranteed
that you will be seen in your preferred clinic location.
The HFNS will review your medications and provide you with
education related to your heart condition. A clinical assessment will
also be undertaken. Please bring a list of your medications with you
to the appointment. If you have any concerns whilst awaiting your
appointment, please do not hesitate to contact us.
Once you are on optimal medical therapy for your heart failure and
do not have any ongoing heart failure related issues i.e., peripheral
oedema, you will be discharged from the heart failure team.
Please let us know if you are unable to attend an appointment or if
your situation changes. If you do not attend two appointments, you will be automatically discharged.
Clinics:
Lancashire Cardiac Centre,
Blackpool Victoria Hospital,
Whinney Heys Road,
Blackpool, FY3 8NR
Moor Park Health and Leisure Centre,
Bristol Ave,
Blackpool, FY2 0JG
Lytham Primary Care Centre
Victoria Street,
Lytham St Annes,
Lancashire, FY8 5DZ
The Over Wyre Medical Centre
Wilkinson Way,
Off Pilling Lane Preesall,
Poulton Le Fylde, FY6 0FA
Fleetwood Hospital,
Pharos Street,
Fleetwood, FY7 6BE
St Annes Medical Centre
Durham Ave,
Lytham Saint Annes,
FY8 2EP
Freckleton Health Centre
Douglas Dr,
Freckleton, PR4 1RY
Kirkham Health Centre
Moor Street
Kirkham
Preston
PR4 2JN
Please monitor and report any worsening symptoms to your
Heart Failure Nurse or your Doctor.
Useful Contact Details:
Blackpool Victoria Hospital Heart Failure Team:
01253 953269
Community Heart Failure Team:
01253 957723
Heart Failure Occupational Therapist:
01253 953269
Reference:
Maria Fe White, Joan Kirschner, Michele A. Hamilton (2014) Self-
Care Guide for the Heart Failure Patient Circulation, 129:e293-e294
Available at: https://doi.org/10.1161/CIRCULATIONAHA.113.003991
Green
Symptoms are well controlled if you have:
No changes in your shortness of breath.
No extra swelling of your feet, ankles or stomach.
No chest pain.
No extra weight gain of more than 2-3 pounds (1-1.5kg).
Excellent - Keep up the good work!
- No new or worsening shortness of breath
- Physical activity level is normal for you
- No new swelling feet and legs look normal for you
- Weight check stable
Great Continue: Daily Weight check, take Meds as Directed, Low sodium eating, Follow - Up Visits
Amber
Contact your Doctor or Heart Failure Team as soon as
possible if you experience:
Rapid weight gain of more than 6 pounds over 3
consecutive days or a week.
You need more pillows than usual to sleep, or it is harder
to breathe than normal when lying down.
Increased shortness of breath, persistent cough and/or
able to do less activity than normal.
Increased swelling of your feet, ankles, or stomach.
Loss of appetite / nausea.
New dizziness or more frequent dizziness than is normal
for you.
You need to sleep sitting up in a chair (if this is new).
Heart Failure Team number: 01253 953269 – available
9am – 4pm Monday to Friday. Please leave a message if there is no one to take the call.
Pay Attention - use Caution!
- Dry, hacking cough
- Worsening shortness of breath with activity
- increase swelling of legs, feet, and ankles
- Sudden weight gain of more than 2-3 IBS in a 24 hour period (or 5IBS in a week)
- Discomfort or swelling in the abdomen
- Trouble sleeping
Check in your symptoms may indicate: A need to contact your doctor or provider, a need for a change in medications
Red Medical Alert Warning!
Call 999 or 111 immediately if you experience the following:
You are very breathless and unable to speak.
You have chest pain not relieved by GTN spray
(if you have one).
Unrelieved shortness of breath while sitting still.
Severe and persistent shortness of breath.
Warning! you need to be evaluated right away.
