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Your Guide to Living with Heart Failure

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Your Guide to Living with Heart Failure MAY 2019 OX465 Your guide to living with heart failure Adult community services in Bexley and Greenwich oxleas.nhs.uk This guide is intended to provide you with information about living with heart failure and help you to manage your condition at home. It contains charts for you to record information about your weight and medication and a section for your heart failure nurse to record notes from your appointments. Please bring it with you to appointments with your heart failure nurse. What is heart failure? Heart failure can lead to symptoms of: Heart failure is a condition in which the heart is unable to • tiredness pump blood around the body effectively. It does not mean • breathlessness the heart is about to stop, but feet and ankle swelling rather, if left untreated, the • heart muscle would continue • ‘bloated’ feeling to weaken. It is one of the most reduced appetite. common heart problems in the • UK. There are various cases of If you have heart failure, you heart failure, including: may experience shortness of • a history of heart attacks breath, weakness, tiredness and swelling of the ankles. However • coronary artery disease some people experience very heart valve disease few symptoms and their • heart failure may have only • viral illness been discovered by a special heart scan known as an • excessive alcohol intake echocardiogram. • high blood pressure. 2 Sometimes a specific cause We run five heart failure clinics of the heart failure cannot be a week and visit patients in their found. own homes who are unable to attend a clinic. Although rarely completely curable, there are effective In the heart failure clinic and treatments for heart failure. A when you are visited at home range of medications can assist you will be seen by a nurse the heart, help to control and who specialises in the care and improve symptoms and increase treatment of people with heart life expectancy. Many of these failure. Each time you will be drugs need to be started at low examined and your weight, doses and increased slowly. pulse and blood pressure Once started most treatments recorded. From time to time need to be continued you may also need an ECG indefinitely. (electrocardiogram) and blood tests. Your Heart Failure Nursing Team Your nurse will make sure that Your Heart Failure Nursing Team you are prescribed the right is run by Oxleas NHS Foundation medication to work most Trust. Our goal is to support effectively for you. Everyone people to better manage reacts differently to medicine, their condition in their own so to ensure you are on the best home and avoid unnecessary dose for you, your nurse may hospital admissions and A&E adjust drug doses quite often at attendances. first. They may also talk to your GP about how the medication The team consists of: is working and discuss • a consultant cardiologist alternatives. • heart failure specialist nurses Your nurse will also explain (4 each in Bexley and the things you can do to keep Greenwich) yourself as well as possible and answer any questions you may • healthcare assistant to take have about your condition. bloods and perform ECGs • an administrator • input from a psychologist. 3 Monitoring your weight When weighing yourself, follow It is a good idea for people these guidelines. with heart failure to weigh Always use the same scales. themselves regularly, as this • gives an indication of how much • Always weigh yourself at the fluid the body is retaining. For same time of day. example, if your weight goes up by four pounds, you may be • Always weigh yourself retaining around three pints of wearing the same sort of fluid. The more fluid you retain, clothes/shoes. the more your ankles may swell • Always use the same units, and your breathing will feel ie pounds and ounces or worse (particularly when you lie kilograms. down, or try to do things). If your weight goes up by Weigh yourself every day. two to three pounds in one Most people find it easiest to day, make sure you weigh weigh themselves first thing in yourself the next day and if the morning, after going to the it is still raised, particularly if toilet, in their night-wear before you have noticed an increase breakfast. in breathlessness or ankle swelling, contact your doctor or You can record your weight on heart failure nurse for advice. the following pages if you want to. If your weight has increased very quickly it is likely to be due to fluid retention and it is likely that you will need to take an extra dose of your diuretic (water) tablets for a day or two. Your doctor or nurse will advise you about this. 4 Date Weight Date Weight Date Weight 5 Medication Important It is very important that you • Make sure you take your take your medication regularly, medications every day. as if you miss doses or muddle Always have a supply of your tablets up, your heart • medication so you never run failure may get worse and you out. may get more side effects. You need to devise a system • Bring all of your tablets (in that ensures that you take your their original containers) with medication as it is prescribed. you when you see the doctor You can use the form on page or nurse. 10 to help you organise when to • Keep taking the tablets unless take your tablets. Talk to your your doctor or nurse tells you pharmacist or nurse if you feel to stop. that you need extra help in coping with your tablets. • If you are bothered by side effects, please discuss this It is likely that you will be with your nurse or doctor. prescribed a combination of tablets (see the following pages • Do not take any ‘over the for the types of medication counter’ medicines without used) and your condition will checking with your doctor, be monitored closely as each nurse or pharmacist first. new tablet is introduced. The • For minor aches and pains, medications listed in this booklet such as a headache, you can are the most commonly used in take Paracetamol, up to eight the treatment of heart failure, tablets in 24 hours. but there are others that can be used if you are not able to take • Do not take any non-steroidal those listed. anti-inflammatory drugs (NSAIDs), including Nurofen, Brufen, Ibuprofen, Indomethacin, Diclofenac, Naproxen, Voltarol or Arthrotec. 6 Here are some of the most Diuretics (water tablets) common heart failure Name of drug: medications. Your nurse will _____________________________________________ write the name of the drugs you are taking into the relevant These help your body to get rid spaces below so you can read of excess fluid by making your about how they work and why kidneys lose extra water so you you are on them. pass urine more frequently. They help to reduce ankle ACE (Angiotensin Converting swelling and make you feel less Enzyme) inhibitors breathless. You should notice Name of drug: that you pass more urine after _____________________________________________ taking your tablets. These work by relaxing your It doesn’t matter what time blood vessels, making it easier of day you take the tablet, for your heart to pump blood although most people take it through them. The dose is first thing in the morning. always started very low and If you are worried about having increased over time. to find toilets when you are out When you are on an ACE shopping, on a car journey or inhibitor, your blood pressure will at a special occasion, it is OK need to be monitored and you to delay taking the tablet until will need regular blood tests to later in the day (but try not to monitor your kidney function. leave it out altogether). It is recommended that you do not Possible side effects include: dry take it later than 3pm as it may irritating cough; low blood continue to work into your bed pressure; and dizziness. time and lead to a disturbed Angiotensin-II receptor night’s sleep. antagonists Occasionally, diuretics may Name of drug: make you lose essential _____________________________________________ substances (called electrolytes) These have a similar effect as from your blood. You will need ACE inhibitors described above, to have blood tests to monitor but are less likely to cause a dry your electrolyte levels. cough as a side effect. 7 Digoxin Aldosterone Antagonists Current dose of Digoxin: Name of drug: _____________________________________________ _____________________________________________ This drug can help your heart These drugs reduce salt and beat more strongly and ensures water retention and may make that it doesn’t beat too fast. This the heart muscle less stiff. is especially important if you They are useful in controlling are in an irregular heart rhythm symptoms in people with such as atrial fibrillation. moderate to severe heart failure. Blood tests to Side effects include: nausea; loss measure the amount of of appetite; visual disturbances; potassium are required and diarrhoea. If this occurs occasionally. please see your doctor or nurse as soon as possible. Possible side effects include: enlargement of breast tissue Beta Blockers (men); painful or sensitive Name of drug: nipples; and impotence. _____________________________________________ Use the table to record the Beta blockers work by slowing details of your medication and down your heartbeat so your when you should take it. heart doesn’t work so hard. Some Angiotensin Receptor also relax your blood vessels, Neprilysin Inhibitor making it easier for the heart to pump blood through them. Name of drug: The dose is always started off at _____________________________________________ a low level and built up slowly These are new medications depending on how you feel, your which help improve the heart’s pulse and blood pressure.
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