Stages Or Classes Of Heart Failure
Your patient may have been told what stage or class their heart failure is at this explains how severe it is.
NYHA classification divides heart failure into four classes:
- Class 1: no limitation of physical activity. Ordinary physical activity does not cause undue fatigue, breathlessness, or palpitations.
- Class 2: slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in undue breathlessness, fatigue, or palpitations.
- Class 3: marked limitation of physical activity. Comfortable at rest but less than ordinary physical activity results in undue breathlessness, fatigue, or palpitations.
- Class 4: unable to carry out any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken discomfort is increased.
Patients with advanced heart failure will usually fit into class 3 and 4, despite the best specialist treatment. Read more about the definition of heart failure from NICE .
What Causes Congestive Heart Failure In Dogs
Heart disease, which can develop into heart failure, is commonly seen in older dogs. According to veterinary cardiologist Dr. Bonnie Lefbom, Dipl. ACVIM, incidence of heart disease varies from between 15% to 30% of older, small dogs and 5% to 15% of giant breed dogs.
Congestive heart failure, which can occur as heart disease progresses, is less common thanks to the veterinary treatments available today, but some dogs with heart disease will go on to develop heart failure. Dr. Lefbom says small breed dogs with a long-standing heart murmur are the most common patients with CHF. Large and giant breed dogs more commonly develop a weakened heart muscle.
One of the most common causes of heart failure in dogs is chronic degenerative valve disease . Just like in older people, the heart valves can start to break down and leak, causing backflow in the heart and a heart murmur, says Dr. Lefbom, who practices at the Regional Veterinary Referral Center in Springfield, Virginia. Over time, with continued backflow through the valves, the heart enlarges. When the heart gets too big, fluid backs up in the lungs.
Some breeds at higher risk for developing CVD include Cavalier King Charles Spaniels
The Dream Bundle Is A Simple Effective Tool
- Sleep disturbances are among the most commonly reported symptoms of heart failure.
- Educating patients with heart failure about sleep hygiene and individualizing care plans can limit sleep disruptions.
- Nurses can implement the evidence-based, nonpharmacologic DREAM bundle to help patients manage heart failure symptoms and improve sleep quality.
Heart failure remains the fastest growing serious cardiovascular complication in the United States, with sleep disturbances among the most commonly reported symptoms. This article provides recommendations for assessing sleep disturbances and implementing an evidence-based, nonpharmacologic sleep intervention bundle for managing heart failure symptoms and improving sleep quality.
You May Like: What Causes Heart Palpitations After Eating
Reason : Are Beta Blockers Making You Tired
The anti-adrenaline effect of beta-blockers the very quality that makes them valuable for treating heart failure can make patients feel tired.
Most patients do not experience any side effects. But if you feel fatigued after starting your medicine, its important to do two things: Keep taking your medicine, and report your symptoms to your doctor. If you stop suddenly, you may risk having rebound adverse effects.
According to Dr. Taylor, understanding why beta-blockers must be taken often makes it easier to deal with this side effect. Once patients know the drug will improve their heart function, help them stay out of the hospital and live longer, most are willing to put up with a little fatigue, he says.
You and your physician can try to figure out if the symptoms are really a side effect or due to your heart problem or even possibly due to an unrelated condition such as sleep apnea. Usually, well adjust the medication dose or switch to an alternative medication and check if the side effects go away with time.
If he is able to wean the patient down or off the drug, and fatigue remains a problem, the beta-blocker is not to blame.
Heart Failuresigns And Symptoms
Heart failure is a condition in which the heart fails to function properly. The terms “heart failure” and “congestive heart failure ” don’t mean that the heart has actually “failed” or stopped but mean one or more chambers of the heart “fail” to keep up with the volume of blood flowing through them.
Heart failure is brought on by a variety of underlying diseases and health problems.
Your condition may involve the left side, the right side or both sides of the heart. Each side has two chambers:
- An atrium or upper chamber
- A ventricle or lower chamber
Any one of these four chambers may not be able to keep up with the volume of blood flowing through it.
Two types of heart dysfunction can lead to heart failure, including:
- Systolic Heart Failure This is the most common cause of heart failure and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs.
- Diastolic Failure The muscle becomes stiff and loses some of its ability to relax. As a result, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.
Read Also: What Happens In Heart Failure
Hospice And Congestive Heart Failure
When a heart failure patient has been diagnosed with six months or less to live, the added support of hospice care helps them remain in their home until end of life.
Crossroads Hospice & Palliative Care provides a team of nurses, aides, social workers, volunteers, and chaplains to support the patient and their family through the final stages of congestive heart failure symptoms. To learn more about referring your patient to hospice, please call Crossroads at 1-888-564-3405.
Why Does Chf Get Worse When Lying Down
There are a few reasons why CHF may get worse when lying down. One reason is that when you lie down, your heart doesnt have to work as hard to pump blood to your brain. This can cause a decrease in blood flow to your heart, making it work harder. Additionally, when you lie down, your blood vessels can expand, which can lead to an increase in blood pressure. This can cause fluid to leak out of your blood vessels and into your lungs, making it difficult to breathe. Finally, lying down can also cause your body to retain fluid, which can exacerbate CHF symptoms.
Recommended Reading: How Long After Shoveling Snow Can You Have A Heart Attack
Emotional Symptoms Towards The End Of Life
People with heart failure may experience different emotions and feelings. They may feel:
- up and down, with good days and bad days
- like they lack control over their life
- like it’s hard to cope with the reactions of others.
People may not think heart failure is as serious as other illnesses, such as cancer. Patients with heart failure can look well even when they feel very ill.
If a patient has anxiety or depression, their healthcare team will assess how it affects them and whether they need treatment, such as cognitive behavioural therapy or medication.
You can support the patient by providing emotional care and helping them with activities to make them feel better, such as reading, going outside and listening to music or audio books. Find out more about providing emotional care.
More Strategies To Help You Sleep Better
To get a better night’s sleep with heart failure or any chronic condition, the main focus should be on good sleep hygiene, says Khayat. He recommends maintaining a regular sleep and wake time, avoiding alcohol and caffeine before bedtime both of which can disrupt sleep and putting your electronic devices to bed several hours before your bedtime. The light emitted from electronic devices can make it more difficult to fall asleep.
If your doctor says its okay, Khayat also suggests those with heart failure get daily brisk exercise. A cardiovascular routine that lasts 20 or 30 minutes about four to five hours before bedtime helps in improving their sleep consolidation, their ability to generate sleep and to stay asleep, he says.
Freeman is also a big fan of managing stress, whether its yoga, meditation, getting a handle on your finances or other issues that keep you up at night. Today, stress is at an all-time high, he says. The expression Ill lose sleep over it, is true. Stress really impacts how we sleep. Its important to do something mindful and stress relieving for 30 minutes every day.
Lifestyle medicine, as Freeman calls it, which includes managing stress, getting seven hours of sleep each night, exercising regularly, eating a predominantly low-fat, whole food, low-salt plant-based diet, and not smoking, can help manage heart failure symptoms and even prevent the condition from developing in the first place.
Additional reporting by Sandra Gordon.
Recommended Reading: Causes Of Heart Attack
Improve Quality Of Life
Educating patients with heart failure about sleep hygiene and individualizing plans of care can limit sleep disruptions. Consider using the DREAM bundle to help reduce morbidity and mortality, improve quality of life, and diminish symptoms for these patients.
At the time this article was written, Olivia Koontz was a 4th year nursing student at Creighton University College of Nursing in Omaha, Nebraska. Amy A. Abbott is an associate professor at Creighton University College of Nursing.
Sleeping On Your Side With Congestive Heart Failure
In congestive heart failure , your heart muscle has become less efficient in pumping blood around your body. Shortness of breath occurs when you lie down as a result of this. Shortness of breath can begin shortly after you wake up from a nap, sometimes several hours after you wake up. As a lay down, you should be on your side. This position can frequently help to alleviate sleep apnea.
You May Like: What To Do To Lower Heart Rate
What Treatments Are Available For Congestive Heart Failure
Although Congestive Heart Failure in dogs cannot be cured, it can be managed with medications. The goal is improving the dogs quality of life and extending longevity.
Veterinarians and veterinary cardiologists treat heart failure using many of the same medicines used for people with CHF, Dr. Lefbom says. A common example is the drug called Lasix, or furosemide, to help clear fluid from the lungs.
With proper treatment, most dogs with CHF can live relatively normal lives. Your veterinarian might recommend some lifestyle changes, for instance, decreasing intense activities like ball chasing. Dogs with CHF generally self-limit, seeming to know how much activity is OK and when its time to back off. However, Dr. Lefbom says the most important thing is to keep the dog doing at least some of what they love.
Compassionate Understanding Womens Health Care At Herkare
Our team at HerKare is here to help you feel great again. We put you in charge at our womens health clinic. Our goal is to help you stay healthy and help improve your quality of life. Whether you need an annual exam or are coming in to talk about any symptoms or concerns you have about your health, we believe in providing compassionate womens health care in a welcoming environment. We take time to listen and understand, and then help you feel better. Make an appointment today and lets talk about your health and wellbeing!
Recommended Reading: Toothache And Heart Attack
Iv Sleep And A Healthy Heart
There are many things you can do to keep your heart healthy. You should be sure to do the following:
- Eat a balanced diet
- Watch out for and treat high blood pressure
- Get regular medical check-ups
Another thing you can do is to make sure that you get enough sleep to keep your body well rested. You can often sleep better by simply following the practices of good sleep hygiene. Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep. See the Resources section of this site to find out how you can start down the path to better sleep.
Watch for signs that you may have a sleep disorder. Obstructive sleep apnea is a sleep disorder that can put great stress on your heart. Men who are overweight and have large necks are most likely to have OSA.
Symptoms of OSA include the following:
- Gasping for breath or choking while asleep
- Trouble staying awake during the daytime
You may not be aware of these signs because they only occur while you are sleeping. Your breathing is normal when you are awake. Ask a bed partner or someone else who has observed your sleep to find out if you snore or stop breathing during your sleep.
If your doctor thinks that you have a sleep disorder, he or she may suggest that you take a sleep study. This is called a polysomnogram. A sleep study is usually done overnight in a sleep center. It charts your brain waves, heart beat, and breathing as you sleep. It also records your eye and leg movements as well as muscle tension.
What Health Conditions Are Linked To A Lack Of Sleep
Adults who sleep less than 7 hours each night are more likely to say they have had health problems, including heart attack, asthma, and depression.3 Some of these health problems raise the risk for heart disease, heart attack, and stroke. These health problems include:
- High blood pressure. During normal sleep, your blood pressure goes down. Having sleep problems means your blood pressure stays higher for a longer period of time.4 High blood pressure is one of the leading risks for heart disease and stroke. About 75 million Americans1 in 3 adultshave high blood pressure.5
- Type 2 diabetes. Diabetes is a disease that causes sugar to build up in your blood, a condition that can damage your blood vessels. Some studies show that getting enough good sleep may help people improve blood sugar control.6
- Obesity. Lack of sleep can lead to unhealthy weight gain. This is especially true for children and adolescents, who need more sleep than adults. Not getting enough sleep may affect a part of the brain that controls hunger.6
Read Also: What Is The Highest Heart Rate Ever Recorded
Heart Failure And Sleep Stats
According to the Centers for Disease Control , about 5.7 million U.S. adults have heart failure. Those with heart failure are 10 to 15 times more likely to report sleep disturbances secondary to nocturia and orthopnea than the general population.
- Sleep disturbances and heart failure have a bidirectional relationship therefore, each condition exacerbates symptoms associated with the other.
- The prevalence of sleep-related breathing disorders increases from 5% in the general population to 47% to 83% in those with heart failure.
- Patients with heart failure are more prone to psychological issues such as anxiety and depression, which can negatively impact sleep.
Is It Best To Avoid Grain
Though no definitive conclusions have been made, veterinary researchers, nutritionists and the FDA continue to investigate the cause of diet-induced heart muscle disease . This leaves many pet owners wondering if they should avoid feeding grain-free diets, especially for dogs with heart disease or at risk for heart disease.
Feeding a grain-free diet may have less to do with the problem, and the bigger concern seems to be dog foods with high levels of peas, lentils and chickpeas , Dr. Lefbom says. With so many diets on the market, there is no easy answer to what to feed each individual dog.
Your best bet is to talk to your veterinarian about the best food to feed your dog, and what types of formulations or ingredients to avoid.
Recommended Reading: How Do You Calculate Your Max Heart Rate
Heart Failure Causes Sleep Problems
Complications of heart failure can affect your sleep. For example:
- Chest pain and discomfort make it hard to relax and fall or stay asleep.
- Lying in bed can make you feel short of breath.
- You may have to get up during the night to pee.
During the day, you’re standing and sitting, so extra fluid would normally settle in your legs and feet. But lie down, and it’s going to move up into your chest This can close in your lungs and airways, making it harder to breathe.
Your doctor might prescribe diuretics to help get rid of that extra fluid. But these medicines don’t stop working when you sleep, which can mean interrupting your slumber for a trip or two to the bathroom.
Subjective And Objective Daytime Sleepiness
There was no significant difference between the SDB and NoSDB groups for subjective ESS SDB: 7 NoSDB: 9 p=0.55), yet objectively the SDB group were significantly sleepier on the OSLER test min NoSDB: 40.0 min p=0.01).
OSLER results were further separated according to the time of day the test was taken . The current authors found no significant differences in the SL recorded by the OSLER test for each time of day .
You May Like: What Is The Medical Term Of Heart Attack
Does Congestive Heart Failure Make You Sleep A Lot
Heart failure might leave you exhausted. Things that would not have exhausted you in the past now do. With advanced heart failure, you are more likely to feel exhausted all of the time. Sleep problems are very common in people with heart failure. You may be left tired even when you get enough rest.
You should ask your doctor about any concerns you have regarding your sleep quality or quantity. In addition to being tired, you may also have other symptoms that suggest a problem with your sleep. Problems sleeping include:
– Difficulty falling asleep or staying asleep- Waking up often during the night or feeling as if you did- Feeling rested after waking up- Having periods where it is hard to get back to sleep
If you are having trouble getting some shuteye, there are several things you can do to improve your sleep quality and quantity. Making these changes may help you deal with fatigue caused by heart failure.
Try going to bed and getting up at the same time each day. This will keep your body clock regular, which will help you stay alert and calm during those times when you need to be.
Avoid alcohol and caffeine after 3 p.m., because they can affect your ability to sleep.