Congestive Heart Failure Clinic

(To refer patients to the CHF clinic, call 515-235-5000)

Iowa Heart Center’s CHF clinic helps people with heart failure take charge of their lives. Through education, counseling and timely physical assessments, patients can frequently avoid costly hospital stays.

Heart failure

CHF is a condition caused by a malfunctioning heart that is unable to pump enough blood and oxygen to meet the body’s needs. Over time, this also causes other body organs to malfunction.

Among those organs are the kidneys. When the kidneys sense the loss of blood, they instinctively retain salt and water to preserve blood volume – even though there’s already too much salt and water in the body. Eventually this extra fluid spills over into tissue, causing edema. The legs and feet swell, and the abdomen may become distended and cause discomfort. Fluid may also enter the lungs, decreasing breathing capacity.

Patients can help themselves, stay out of the hospital

CHF patients are more likely to be hospitalized than any other group of heart patients. But they can help themselves – and avoid hospitalization – in a number of ways. The most important thing is to take the medications a physician has prescribed. Iowa Heart Center’s CHF clinic is designed to help patients by offering:

· education to prevent recurrent hospitalizations and to decrease the length of stay when in the hospital

· assessment of symptoms at an early stage

· guidance and emotional support, 24 hours a day

· dietary counseling

Clinic visits

At each appointment, a registered cardiac nurse specially trained in heart failure meets with the patient to assess their physical condition. This assessment includes:

· asking the patient how he/she feels

· obtaining weight and blood pressure measurements

· listening to the heart and lungs

· assessing fluid status

· reviewing medications

The clinic’s medical director will also be apprised of their condition. Medications may be adjusted if appropriate; the patient will also meet with the physician if it is considered necessary.

What patients can do

It is very important to take all medications that are prescribed. They help the heart pump more efficiently and, as a result, help alleviate the shortness of breath and swelling in the hands, stomach and feet.

Secondly, patients should weigh themselves each morning on the same scale, and at the same time of day (ideally, after the morning urination and before breakfast). Patients gaining three or more pounds overnight should call the clinic.

Medications have been prescribed assuming the patient’s salt intake, fluid intake, and activity levels are the same each day. In fact, these levels vary from day to day. Since the medications cannot handle these variations, clinic patients are taught to adjust their own medications.

Overweight patients will also benefit from losing excess pounds. Added weight puts an additional burden on an already stressed heart.

Physical activity

Heart failure patients have certain limitations. Rest is important. Here are some additional activity guidelines:

· space daily activities such as bathing, shaving, eating and dressing. treat them as exercises, resting after each one

· perform activities at a slow to moderate pace. stop when tired or short of breath

· knowing limitations. heart failure patients do not have the “second wind” that most people do

· resting doesn’t necessarily mean sleeping. patients can rest by sitting quietly in a chair for 20-30 minutes

Provoking problems

Heart failure patients often experience problems when they:

· fail to take medications as prescribed

· eat too many high-salt foods or add salt to food

· drink more water or other fluids than prescribed

· smoke tobacco products

· have a rapid or irregular heartbeat

· experience strong emotions such as fear, excitement or anxiety

Signs of concern

There are a number of signals to alert the patient when their condition is worsening. Patients should notify the CHF clinic staff if they:

grow extremely short of breath, or even slightly more short of breath than normal
tire more than usual from typical activities
develop a cough without any flu-like symptoms
notice swelling in the feet, ankles, hands, stomach/abdomen, lower back or hips
gain three pounds overnight, or five or more pounds over several days
feel anxious
develop a cold sweat
have trouble sleeping unless your head is elevated
have extreme muscle fatigue

Patients, you or your office staff should contact the CHF clinic immediately if patients experience any of these symptoms. For appointments or answers about heart failure, call (515) 235-5000.