Heart Failure

The Heart Failure Program, or as we like to call it – the Heart Healing Program – is specifically designed to give patients with progressive heart disease the tools needed to manage their condition on a daily basis in order to improve their long-term health.

Heart Success

From Heart Failure to Heart Success

At the Tallahassee Memorial Heart & Vascular Center, we have a dedicated program, known as the Healing Heart Program, designed to give our patients with progressive heart disease the tools you need to manage your condition on a daily basis in order to improve your long-term health. The Healing Heart Program includes strategies for improving diet, getting more exercise, taking prescribed medications, knowing the signs/symptoms to watch for and when to call your physician.

Our program includes:

  • Dedicated Healing Heart Navigator to assist patients with education and obtaining follow-up appointments in an outpatient setting
  • Tools designed to help patients know signs/symptoms of worsening condition and when to call the doctor
  • Follow-up phone calls
  • Follow-up in Tallahassee Memorial Heart Failure Clinic with a cardiologist to ensure the latest guideline directed medical therapy is used
  • Nutrition counseling
  • Access to the Tallahassee Memorial Cardiac Rehabilitation Program

Heart Failure Clinic

Tallahassee Memorial HealthCare is home to one of the region’s only Heart Failure Clinics. The Heart Failure Clinic is designed to help provide a smooth transition for the heart failure patient from the hospital to home. Heart Failure Clinic follow-up appointments are usually scheduled within seven days of discharge from the hospital, so that the team can ensure the heart failure patient is continuing to progress upwards on the path of heart healing success. During the clinic visit, patients can expect the following:

  • Nutrition counseling
  • Medication evaluation
  • Education, medical history and physical
  • Lab work to check on kidneys and electrolytes
  • Written instructions to continue proper heart failure management
  • Referrals for Heart Failure Lifestyle Management Program, Cardiac Rehab or Home Health Care Services

Some of the services that are provided by the clinic may not be needed by every patient. Some of these special services are:

  • Intravenous medications to reduce extra fluid accumulating in the body and around their heart
  • Intravenous inotropic medication (i.e., Milrinone) support
  • Evaluation for advanced heart failure therapy

Gian Giove, MD is our Heart Failure specialist and has been directing the Heart Failure Clinic since 2016.  Dr. Giove came to TMH from the University of Alabama following completion of Advanced Heart Failure and Cardiovascular Disease fellowships and an internal medicine residency at the Mount Sinai School of Medicine.  Dr. Giove also held a research fellowship position in Heart Failure and Transplantation at the Texas Heart Institute, Dallas Texas and has numerous presentations and publications to his credit.  

What is Heart Failure?

What is Heart Failure?

Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems.

The term “heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.*

For most people HF is a chronic condition that will not go away. But by taking an active role in your care and working closely with your healthcare team you can live longer and more comfortably.**

Causes of Heart Failure

  • High blood pressure
  • Abnormal heart valves
  • Excessive use of alcohol
  • Abnormal heart rhythm
  • Coronary Artery Disease Cardiomyopathy
  • Low red blood cell count
  • Severe lung disease
  • Overactive thyroid
  • Congenital heart disease

Signs & Symptoms of Congestive Heart Failure

As Heart Failure develops or worsens, you may experience some or all of the following. Call your doctor if you have new onset or increase in any of these symptoms:

  • Shortness of breath, especially when lying down
  • Tired, run-down feeling
  • Coughing or wheezing, especially when you exercise or lie down
  • Swelling in feet, ankles, legs and/or abdomen
  • Weight gain (2-3 lbs. In 2 - 3 days)
  • Confusion or can’t think clearly

Treatment

Early diagnosis and treatment can improve quality and length of life for people who have heart failure. Treatment usually involves taking medications, reducing sodium in the diet, and getting daily physical activity. People with heart failure should also track their symptoms each day so that they can discuss these symptoms with their health care team. ***

 

References: *National Heart, Lung, and Blood Institute **Krames ***Centers for Disease Control and Prevention

Medications

Medications

It is very important for you to obtain and take the medications your physician has prescribed for you. Not taking your medications as prescribed can cause serious problems. Never stop taking a medication or begin taking a new medication unless it is ordered by your doctor. If you have any side effects, tell your physician right away.

The following is a list of the medications commonly given to someone with heart failure. You may or may not be given these medications based on your type of heart failure.

  • ARNI (Angiotensin-Receptor Neprilysin Inhibitor) - Blocks harmful stress hormones that narrow blood vessels, causing the body to hold on to salt and water and prevents the breakdown of helpful hormones, allowing the body to get rid of extra salt and water 
  • ACE Inhibitor (angiotensin-converting enzyme) - lowers blood pressure and decreases the hearts workload.
  • Angiotensin Receptor Blocker - lowers blood pressure. Please note this medication may be prescribed instead of an ACE Inhibitor.
  • Beta-Blocker - lowers blood pressure and slows the heart rate.
  • Diuretic - helps your body get rid of extra water and sodium.
  • Aldosterone Antagonist - decreases the strain on the heart, reduces salt retention and improves blood flow.
  • Hydralazine and Nitrate - In some people, decreases how hard the heart has to work and lowers blood pressure. Two separate medications used together.
  • Digoxin - Helps your heart pump better
  • Additional medications might be ordered depending on other heart problems you may have, such as:
    • Statin - Lowers cholesterol levels
    • Anticoagulant - Prevents blood clots

Other Treatments

If your physician has determined that your heart failure has been caused by certain conditions other treatments might be offered to you:

  • Coronary artery disease
    Angioplasty, stents or bypass surgery may be needed
  • Heart valve problems
    Surgery to repair or replace heart valve
  • Heart beat issues
    Placement of biventricular pacemaker or automatic internal cardiac defibrillator
  • Severe cases of heart failure
    Left ventricular assist device (LVAD) or heart transplant may be discussed

Nutrition Therapy

Heart Failure Nutrition Therapy

What do I need to know about my diet to help me manage my heart failure?

  • Limit my sodium intake to 1200mg per day - (no more than 300mg/meal) Sodium, or salt, causes my body to hold onto fluid and makes my heart work harder.
  • Eat fresh fruits, vegetables and meats.
  • Processed foods, canned vegetables, fast food and restaurant meals have very high sodium contents. I CANNOT HAVE THESE ITEMS.
  • Do not cook with salt and remove the saltshaker from the table. One teaspoon of salt has twice the amount of sodium I am allowed in one day.
  • Drink no more than 2 quarts, or 8 cups, of liquid in one day.
  • Manage my weight. Ask my doctor or dietician what my healthy weight should be.
  • Add flavor to foods without sodium by:
    • Adding lemon juice, lime juice, fruit juice or vinegar
    • Dry or fresh herbs add flavor - try basil, bay leaf, dill, rosemary, parsley, sage, dry mustard, nutmeg, thyme and paprika
    • Pepper, red pepper flakes and cayenne pepper can add spice to your meals without adding sodium
    • Buy a sodium free seasoning blend or make your own at home
  • Weigh myself every day. Keep a record of my weight everyday. If I gain 2-3 pounds in 2-3 days, I need to call my doctor. The doctor may need to adjust my medications.

Reading the Food Label

  • DO select Foods with 140 mg or less of sodium per serving
  • DO NOT EAT more than 300 mg sodium per meal
  • Reduced sodium does not mean that a food is low in sodium

foodLabel

Use the following chart as a guide:

  • Reduced sodium - 25% less than the original product
  • Low sodium - 140 mg or less per serving
  • Very Low sodium - 35 mg or less per serving
  • Sodium Free - 5 mg or less per serving
  • No Salt added or unsalted - No sodium was added during processing but check the label to make sure

Daily Steps

Daily Steps for Heart Healing Success

  • Weigh yourself in the morning before your first meal. Write your weight on the daily
    tracking chart you have been given.
  • Take your medication as prescribed.
  • Check for swelling in your feet, ankles, legs and stomach.
  • Avoid drinking more than 2 quarts, or 8 cups, of fluids per day.
  • Look at the zones below. Which zone are you today?

zones