Congestive Heart Failure Management in Loxahatchee, West Palm Beach & Belle Glade, FL

What it involves

In a primary care setting, heart failure management is the ongoing care between specialist visits: reviewing symptoms, weight, blood pressure, and medicines, and coordinating with a cardiologist when one is involved. Your provider explains what is being tracked and which changes should prompt a call.

Who this is for

• Patients diagnosed with heart failure who want a primary care provider following their day-to-day health
• Patients with a cardiologist who want their medicines, labs, and blood pressure reviewed closer to home in between
• Patients with long-standing high blood pressure or heart disease who are noticing breathlessness or swelling
• Family members who help manage a loved one's medicines and appointments

What to expect

• A review of your symptoms, your weight trend, and your blood pressure at each visit
• A check of your medicines and supplements, since some can make heart failure worse
• Coordination with your cardiologist, with records shared when you ask
• Clear instructions on which changes mean calling the office and which mean calling 911

What heart failure means in plain terms

MedlinePlus defines heart failure as a condition in which the heart can no longer pump oxygen-rich blood to the rest of the body efficiently. It is most often long-term. In one form the heart muscle cannot contract well, and in another the muscle is stiff and does not fill easily even though its pumping power is normal. When blood backs up, fluid can collect in the lungs, liver, and legs, which is where the word congestive comes from. The two most common causes MedlinePlus names are coronary artery disease and high blood pressure that is not well controlled. Tiredness is one of the symptoms people notice first, but it has many other possible causes, which the fatigue and tiredness evaluation guide walks through.

Symptoms worth knowing

MedlinePlus says symptoms often begin slowly and may only appear when you are very active at first. Over time they can show up at rest: Breathlessness also has many causes in the lungs, airways, and blood, and the shortness of breath guide lists them along with the symptoms that mean calling 911.

• Shortness of breath when active or after lying down, or waking up a couple of hours after falling asleep short of breath
• Swollen feet and ankles, or a swollen abdomen
• Fatigue, weakness, or faintness
• Weight gain and a need to urinate at night
• A pulse that feels fast or irregular, and a cough

Weight, swelling, and what to track at home

MedlinePlus advises people with heart failure to watch their heart rate, pulse, blood pressure, and weight, and says weight gain and leg swelling over a few days can be a sign the body is holding extra fluid. It also says to ask your provider what to do if your weight goes up, how much salt to eat, and whether to limit fluids. Those answers differ from person to person, which is why a written plan from your own provider matters more than a general rule. Many patients also track blood pressure at home, and the blood pressure readings guide explains how to seat yourself, size the cuff, and bring your monitor to be checked. Swelling in the ankles and legs has other causes too, and the leg swelling evaluation guide lists what MedlinePlus says a provider considers.

How heart failure is diagnosed and where the tests happen

NHLBI says a diagnosis rests on your medical history, a physical exam, and test results, and that you may be referred to a cardiologist for the tests and treatment. Blood tests can check a marker called BNP and show how the liver and kidneys are working. An echocardiogram measures the ejection fraction, the share of blood pumped out of the left ventricle with each beat, and that number helps classify the type of heart failure. A primary care visit is usually where the questions start. An EKG is part of the picture and EKG and heart screening is described on its own page, while imaging such as an echocardiogram is typically arranged through a cardiologist or an imaging facility. New chest pain is a different question from managing heart failure, and the chest pain guide on when to call 911 lists the warning signs that should never wait for an appointment. A cough that gets worse when you lie down may also be a sign of heart failure, as the persistent cough evaluation guide explains among the reasons to call your provider right away.

Medicines to ask about before you take them

MedlinePlus says it is very important to take heart failure medicines exactly as directed, and not to add other medicines or herbs without asking your provider first. It specifically lists the pain relievers ibuprofen and naproxen as medicines that may make heart failure worse. That is a practical reason to bring every bottle, including over-the-counter products and supplements, to each visit, and to ask before reaching for something new.

Blood pressure, diabetes, and labs go along with it

Heart failure is rarely managed on its own. Because uncontrolled blood pressure is a leading cause, blood pressure management is often the first thing reviewed, and patients who also have diabetes are followed for both. Lab work to check kidney function and medicine effects can be drawn at the West Palm Beach office through its in-house lab services, and your provider tells you which results matter for your plan. Patients who want to understand what raises the chance of heart problems in the first place can read the heart disease risk review guide, which covers the risk factors the CDC lists.

Sources

• MedlinePlus — Heart failure
• NHLBI — Heart Failure Diagnosis