Heart Care Handbook ABOUT THIS HANDBOOK
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Patient Education intermountainhealthcare.org/heart Heart Care Handbook ABOUT THIS HANDBOOK This handbook won’t teach you everything you need or want to know about heart disease and heart-healthy living. But it will give you a good start. To write this book, we consulted local experts as well as the latest guidelines and recommendations of national organiza- tions such as the American Heart Association (AHA), the American College of Cardiology (ACC), the Centers for Disease Control (CDC), and the National Institutes of Health (NIH). All of these resources are listed in Chapter 10, along with cardiac rehab programs, books, and other trusted websites to help you learn more. You don’t need to read this book from front to back. Use the Table of Contents in the front of the book (or on the first page of each chapter) to help you find what you need. Use the book for a long-term reference. Make notes in the margins, highlight important informa- tion, and add notes from your healthcare providers and cardiac rehabilitation staff. If you have questions, talk with your healthcare providers. And don’t be afraid to accept help from concerned loved ones and friends. With support and treatment, you can manage your disease and lead a healthier and happier life. Contents INTRODUCTION Looking Ahead . 5 Your cardiac care team • The role of cardiac rehab • Your emotional needs: what you may feel CHAPTER Going Home . 9 1 Heart attack: what happened • Open heart surgery: what happened • Beyond the ICU • Recovering at home • Recordkeeping during home recovery • When to seek medical care Understanding Heart Disease . 35 2 Your heart and how it works • What happens with heart disease? • Related conditions Cardiac Risk Factors . 49. 3 What are cardiac risk factors? • Risk factors you CANNOT change • Risk factors you CAN change • Other factors that may play a role • How lifestyle management can help Diagnostic Tests . 61 4 Medical history and physical examination • Blood tests • Peripheral vascular studies • Lung and oxygen tests • Sleep studies • Chest x-rays • Cardiac CT scans • Electrocardiograms (EKGs) • Stress testing • Echocardiography • Cardiac MRI (magnetic resonance imaging) • Nuclear imaging • Cardiac catheterization Treatment Procedures . 79 5 Cardiac cath lab procedures • Heart surgeries Medication . 95 6 How medication can help • Tips for managing your medication • Table of common cardiac medications CONTENTS 3 Contents (continued) CHAPTER Activity for a Healthy Heart . 105. 7 Why exercise? • Getting started • How much is enough? — the F.I.T. factors • Three types of activity — an overview • Monitoring your intensity • The shape of a session • Exercising safely • Your personal F.I.T. plan Nutrition for a Healthy Heart . .119 8 The importance of healthy eating • Building blocks • Shopping, cooking, and dining out • Go, slow, and whoa: traffic control for your plate • A heart-healthy sample menu More Healthy Habits . .145 9 Quitting smoking • Maintaining a healthy weight • Managing stress Glossary and Resources . .153 10 Intermountain Resources • Websites and phone numbers • Books • Glossary A–Z Heart Zones Action Plan . 169. If Chest Pain Strikes . .170 4 CONTENTS Looking Ahead Heart disease affects more than your physical health, it can affect your whole life. In the coming months, your emotions, relationships, and routines may all undergo changes and challenges. You’ll probably need support to change negative patterns and stick to a healthier way of living. The good news? Most heart patients learn new ways to manage their health and face the future with renewed confidence. With time, support, and education, so can you. The key to recovery is a good care team and effective treatment. In this section, you’ll meet the team and get some helpful tips on managing your emotions as you take this journey. LOOKING AHEAD 5 Your Cardiac Care Team YOU are the most You won’t face heart disease alone. Both in the hospital and out, important part of this many different healthcare providers may be involved in your care. This care team. You’ll need might seem overwhelming at first, but each person plays a different role. to communicate with everyone on the team and • Your primary care provider: This is your regular doctor, who be involved in your care will continue to care for your general health. You’ll need to make sure from the very beginning. your primary care doctor knows about your heart tests, treatments, Here are some tips: and medication. • Ask questions! Write • Physician specialists: questions down as you One or more physician specialists may think of them, and don’t also work with you. be afraid to ask them. – Cardiologists diagnose and treat heart-related conditions. • Give honest feedback. – Cardiothoracic surgeons focus on heart surgery and related follow-up care. Your input about your – Intensivists symptoms, side effects, care for you in the intensive care unit. or health history can – Anesthesiologists manage your anesthesia during surgery, help providers tell if your and follow up with you in recovery. treatment is on track. • Advanced practice providers (APP): • Keep your These include nurse appointments. Follow- practitioners (NPs) and physician assistants (PAs). These clinicians up is crucial. Use have advanced degrees and provide a wide range of medical services appointments to ask under the direction of a doctor. questions and clarify your care plan. Take notes (or • Nurses and nurse assistants: Nurses who work in intensive care or take someone with you other cardiac care units have special training and provide ongoing to take notes). education related to heart disease. Nursing assistants will help with • Follow your care plan. much of your daily care. Discuss what tests or • Other healthcare professionals: You may also work with other treatments you may need and why they care providers. are important. Tell all – Care managers or social workers can help with concerns like care providers about insurance and home care. all medication you are taking. Agree on steps – Dietitians monitor your nutrition status while in the hospital and you will take to help your provide nutrition education and advice on following a heart-healthy heart. Ask about your diet once you’re home. progress and when you – Exercise physiologists work together with you to monitor and need to follow up next. increase your activity, within appropriate guidelines. – Pharmacists prepare and deliver medication. – Respiratory therapists arrange or supervise breathing treatments. – Technicians operate medical equipment for various tests and procedures. 6 LOOKING AHEAD The Role of Cardiac Rehab To help you adjust to your diagnosis and get the best results from PROVEN BENEFITS cardiac your treatment, your healthcare provider may refer you to a Participating in cardiac rehabilitation program (cardiac rehab). Cardiac rehab reinforces every rehab can help you: part of your treatment plan, whether you’re in the hospital or out. • Reduce fear and anxiety Your cardiac rehab program might include the following services: • Recover faster • Improve fitness • Exercise. Supervised exercise sessions are tailored to your needs and • Decrease symptoms abilities. Exercise physiologists and exercise therapists will monitor your heart rate, EKG, blood pressure, and signs and symptoms and • Improve confidence report your progress to your doctor. • Make lifelong changes • Reduce risk of further • Education. You’ll learn more about your disease, procedures, heart problems medications, signs and symptoms, risk factors, and positive lifestyle changes. • Social and emotional support. Your care team, as well as other patients, will support you as you adjust to your condition and make lifelong changes to reduce your risk for further heart problems. Although it can be hard work, most heart patients enjoy cardiac rehab. They find it interesting, encouraging, and even fun. Talk to your healthcare providers about how to get involved in a cardiac rehab program near where you live. A list of Intermountain Healthcare programs and contact numbers is provided in Chapter 10. LOOKING AHEAD 7 Your Emotional Needs: What You May Feel After a heart disease diagnosis, many people have reactions like the following: • Shock, disbelief, denial: Immediately after your diagnosis, you may have a hard time acknowledging your condition. It’s tough to be told you have heart disease. It’s a new and unwelcome companion to your life. • Anxiety, anger, and depression: People often struggle to take on new daily routines. Some people feel newly vulnerable. Some FAMILY OR FRIEND? people have bothersome thoughts that make it hard to have a helpful What YOU can do outlook, such as “Why me?” or “What if?” A loved one’s diagnosis Fortunately, most people find that these feelings gradually go away. affects you, too. To help In fact, such feelings seem to be part of the normal healing process. As you ALL feel better and adjust more quickly, try physical health improves, so do emotions and attitudes. the following: • Listen. Let your loved What you can do one express feelings and fears. Try not to Try these tips to help you manage your emotions and keep moving forward: offer much advice at • Take care of your emotional health. first. They probably just As you work with your need to talk. healthcare providers to manage your physical health, don’t neglect • Help with practical your emotional health. Physical and emotional health can go hand- details. Although in-hand. You’ll probably gain emotional strength as you become you don’t want to physically stronger. Yet, if depression or anxiety continue, or if they overprotect your loved one, you might take interfere with daily activities, call your healthcare provider. away some of their • Reach out. You may need encouragement, advice, or just someone to stress by handling some practical talk to. Talk to your healthcare providers. They can put you in touch responsibilities until with counselors, peer volunteers, or religious guides who can help you they feel better.