Thursday, April 18, 2024

Last Stage Congestive Heart Failure

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A: Patient Understanding Of Disease And Prognosis

Stages of Congestive Heart Failure – Stage D (End-Stage)

A1: Dealing with advanced heart failure and ageing

Patient statements revealed different levels of perspectives related to heart failure, ranging from descriptions of their illness adaption to changing conditions , appraisal of their own quality of life , and their handling of information regarding their illness .

A1.a: Perception of heart failure

The patients described various experiences with symptoms of heart failure, in particular, limitations such as shortness of breath, dizziness, and restrictions in activities of daily living. Frequently, they did not perceive heart failure as a life-limiting, chronic disease with a long-term course, but rather as a disease with acute life-threatening events. The patients often believed their condition was a result of their old age and not a genuine illness. Medical definitions and personal experiences may diverge: Despite their specific diagnosis and treatment, the patients reported feeling well. Consequently, they may play down their symptoms and not take their medications. However, changes in the patients perceptions were sometimes observed when their condition worsened:

Patient P1, T3 : But my heart, thats not really the problem. That is high blood pressure. Yes, I have that! Oh, yeah! You know, now now I have it under control. You know, I have never taken any pills. Yeah, and I watch out for my blood pressure. But if I say I take my tablets, that I do not do that anymore.

A.1b: Adaption to changing conditions

Treatments For Heart Failure

Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.

How you’re treated will depend on what is causing your heart failure.

Common treatments include:

  • lifestyle changes including eating a healthy diet, exercising regularly and stopping smoking
  • medicine a range of medicines can help many people need to take 2 or 3 different types
  • devices implanted in your chest these can help control your heart rhythm
  • surgery such as a or a heart transplant

Treatment will usually be needed for life.

A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.

Caring For Someone At The End Of Their Life

When someone you love is facing the end of life, its an extremely worrying and upsetting time. Given the current situation with coronavirus, you might have lots of questions about what youre allowed to do, especially if your loved one is in a hospice or care home. Many care homes are limiting visitors but government guidance has specified that visiting loved ones who are at the end of their life is important and should continue. Check with your loved ones hospice or care home about what restrictions they have in place. Unfortunately, if you have coronavirus symptoms, you wont be able to visit a loved one. Government guidance states that carers are still able to perform their caring duties if the carer doesnt have coronavirus symptoms. If you live with the person you care for and you have coronavirus symptoms, the government are advising you to ask friends and family for help with providing care or contact your local authority or healthcare provider. If someone you care for has a heart condition, they are at higher risk of severe complications of coronavirus. Be mindful of this when visiting and always follow NHS guidance around hand washing and hygiene.

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How To Use The Congestive Heart Failure Life Expectancy Calculator

To find a person’s survival odds with our heart failure life expectancy calculator, you’ll need the exact values of:

  • The age of the patient
  • The patient’s weight/height, or BMI
  • Their creatinine levels – creatinine is a product of the muscles’ metabolism. It is found at increased levels when the kidneys do not work properly
  • Ejection Fraction – the amount of blood that is pushed out of the heart during systole, out of the total amount of blood in the heart and
  • Systolic blood pressure – the larger value of the blood pressure measurement made during a routine blood pressure check-up, given in mmHg.

In addition, you need to answer the following questions:

  • What’s your patient’s sex?
  • Does your patient take angiotensin-converting-enzyme inhibitors , for example, captopril, or angiotensin II receptor blockers ?
  • Does your patient take beta-blockers, for example, propranolol, metoprolol, bisoprolol?
  • Was your patients heart failure diagnosed 18 months ago?
  • What’s your patient’s NYHA class?
  • Does your patient suffer from chronic obstructive pulmonary disease ?
  • Does your patient still smoke? Or have they managed to quit?
  • Does your patient suffer from diabetes?
  • How Do You Get Fluid Out Of A Dogs Stomach

    congestive heart failure symptoms

    To provide more immediate relief from the pressure of the fluid, the fluid may be drained by your veterinarian during a procedure called abdominocentesis. This may need to be done on a fairly regular basis if the underlying reason for the ascites is not able to be corrected with surgery, medications, and diet changes.

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    Signs It Might Be Time For Hospice

    Patients are considered to be in the terminal end stage of heart disease when they have a life expectancy of six months or less. Only a doctor can make a clinical determination of congestive heart failure life expectancy. However, look for these common signs that the disease has progressed to a point where all involved would likely benefit from hospice services:

    • The patient has advanced congestive heart failure or advanced coronary disease with frequent episodes of angina .
    • The patient has an abnormal heart and suffers significant symptoms of fatigue, shortness of breath or functional decline.
    • Optimal treatment for the patients condition has already been provided and he or she is not a candidate for further surgical or medical intervention.
    • The patient has tried optimal treatment and made the personal choice not to pursue any further specialized treatment.

    People often say, I wish I had asked about hospice sooner.1 Reports show early referral to hospice results in greater satisfaction for the patient and their caregivers. In 2015, seriously ill patients received hospice services for an average of 69.5 days, but given more time, hospice resources can supplement care provided by doctors and loved ones through a patients last six months of life.

    What Should I Expect In The Last Few Days

    As the end of life approaches, you might experience a number of physical and emotional changes. These are different for everyone. You might notice changes over weeks, days or even hours. Some of the changes might be the same as signs of a flare-up, so discuss them with your doctor or nurse.

    Signs to look out for include:

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    Hospice For Heart Disease & End

    If you are reading this, it is likely you or someone you love has been waging a difficult physical and emotional battle against heart failure or some form of heart disease. Your search for comfort, support and answers does not stop when you accept that you must learn to live with heart disease. Thats when VITAS can help.

    Hospice helps patients and their families deal with the significant impact of heart disease after curative treatment has stopped. On this page, we’ve provided answers to these questions:

    • When is the right time to ask about hospice?
    • What can hospice do for a person with heart disease?
    • What can hospice do for the family of a person with heart disease?
    • What are the overall benefits of hospice care?
    • How can I approach my hospice discussion with family members and loved ones?

    Stage A Treatment Options

    Heart failure and breathlessness in end stage care | Dr Kulasagaram Ranjadayalan

    Treatment options in stage A mainly focus on promoting your overall health and disease prevention. If you meet the stage A criteria, your doctor will recommend lifestyle changes to slow or stop disease progression.

    Heart Failure Doctor Discussion Guide

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    What Is Heart Failure

    Heart failure is a term used to describe a set of signs that suggest the heart isnt pumping blood around the body as efficiently as it should.

    Its most commonly caused by:

    • damage to the heart muscle, for example as the result of a heart attack
    • cardiomyopathy
    • high blood pressure.

    It can also be caused by:

    • heart valve problems
    • a viral infection affecting the heart muscle
    • an abnormal heart rhythm
    • excess alcohol or recreational drugs.

    Heart failure can be chronic or acute:

    Acute heart failure is when the symptoms of heart failure come on suddenly, when heart failure is diagnosed for the first time, or if symptoms suddenly become worse during long-term heart failure.

    Chronic heart failure is when someone has heart failure as a long-term condition.

    When To Seek Help

    Patients with a life expectancy shorter than six months are eligible for hospice care. A hospice provides additional aid and resources to assist the person in living comfortably and with the highest possible quality of life. Hospice caregivers can also help patients and their families plan for future needs and circumstances. They have a unique insight into how to assist those with these difficulties.

    Patients with end-stage heart failure need medical continuity throughout outpatient programs. These are just some of the symptoms that hospice care might help with. Positive inotropic drug infusions, anxiolytics, and sleeping medicines are all viable treatments. Its challenging for patients, families, and doctors caring for patients with end-stage heart failure to identify when treatment goals shift from survival to quality of life, allowing for a peaceful and dignified death.

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    Outlook For Heart Failure

    Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.

    It can severely limit the activities you’re able to do and is often eventually fatal.

    But it’s very difficult to tell how the condition will progress on an individual basis.

    It’s very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.

    Caring For Someone With Heart Failure Towards The End Of Life

    Stages of Congestive Heart Failure in 2020

    Please be aware – this information is for healthcare professionals. We also have information for the public.

    You can use our My Learning form to reflect on how this page has helped with your continuing professional development.

    Someone with heart failure may experience symptoms such as fatigue, breathlessness, oedema and pain. Towards the end of life, health and social care professionals can support the person by helping to manage their symptoms and talking to them about how they want to be cared for, now and in the future.

    On this page:

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    Signs Of A Dog Dying Of Heart Failure

    If your dog has just been diagnosed with congestive heart failure, you likely have many questions about what this means for their future.

    CHF is a serious condition that cannot be cured, but can be managed over time with proper care. So how do you know if your dog is beginning to suffer in their condition?

    In this article we will discuss the details of CHF in dogs, and help you understand the signs of a dog dying of heart failure.

    What Causes Congestive Heart Failure

    There are several conditions that can impair the pumping efficiency of the heart. Below are a few common and rare conditions that can cause congestive heart failure:

    • Coronary artery disease : This is the most common cause of congestive heart failure, as the arteries become blocked or severely narrowed, which decreases blood flow to the heart.
    • Alcohol abuse
    • Disorders of heart valves
    • Thyroid abnormalities, viral infection, and heart rhythm abnormalities are a few rare cases that can cause congestive heart failure.

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    What To Leave Behind

    When you start to plan ahead for the end of your life it can be quite normal to start thinking about the life that youve lived and the experiences that youve had and shared with others. You may also think about unresolved issues or try to make amends. Some people want to leave things behind to their family or friends as a way of expressing their feelings. You could:

    • Create a memory box or a photo album that brings back good memories. You can do this on your own or with your partner, family, friends, children or grandchildren.

    • Write letters.

    • Record voice messages on your phone or computer.

    • Make a video on your phone or computer.

    When Should We Consider Hospice Care For Chf

    Congestive Heart Failure – End of Life

    Hospice can be appropriate for many types of end-stage heart disease, including heart failure, valvular heart disease and coronary artery disease. Regardless of the type of heart disease, hospice is a fitting choice when an individual begins to experience persistent, severe symptoms that interfere with their daily life. Hospice care should also be considered if an individual begins to have recurrent hospitalizations or complicated hospitalizations, such as an ICU stay.

    One of the earliest symptoms of a declining heart is exercise intolerance. This begins with symptoms present with significant exertion and can progress to symptoms present with doing our activities of daily living, such as bathing and dressing. At its worst, symptoms are present at rest. Heart disease, depending on the etiology, can present with other more specific symptoms, including fluid overload, chest pain, lightheadedness, shortness of breath and arrythmias. Patients may experience unintentional weight loss despite a normal appetite. As the disease progresses, cardiac output can decline, resulting in low blood pressure and poor prefusion of our vital organs. This can lead to dysfunction of further organ symptoms, such as worsening kidney function.

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    Signs That You May Have Chf

    There are lots of small symptoms that people experience that can be indicative of developing congestive heart failure. A rapid or irregular heartbeat is a possible sign, as is an enlarged heart.

    However, there are also many other signs that manifest across the body. Some people suffer from weakness, fatigue, and shortness of breath. These issues can lead to an inability to exercise, which in turn may lead to weight gain and obesity issues. Weight gain may also come in the form of fluid retention. People with signs of congestive heart failure also find themselves with persistent coughs, an increased need to urinate at night, swelling of the legs and problems concentrating.

    As you can see, there are lots of potential problems here that we all need to take notice of. Isolated signs, such as fatigue and dizziness, may be part of another illness. If doctors rule out other causes, and symptoms persist, then it may be time to reassess a relative for congestive heart failure. On that note, it is important to understand the four stages of CHF.

    What Are The Complications Of Heart Failure

    Some of the complications from heart failure include:

    • Irregular heartbeat.
    • History of taking drugs that can damage your heart muscle, such as some cancer drugs.

    Stage B

    Stage B is considered pre-heart failure. It means your healthcare provider has given you a diagnosis of systolic left ventricular dysfunction but youve never had symptoms of heart failure. Most people with Stage B heart failure have an echocardiogram that shows an ejection fraction of 40% or less. This category includes people who have heart failure and reduced EF due to any cause.

    Stage C

    People with Stage C heart failure have a heart failure diagnosis and currently have or previously had signs and symptoms of the condition.

    There are many possible symptoms of heart failure. The most common are:

    • Shortness of breath.
    • Need to urinate while resting at night.
    • Rapid or irregular heartbeats .
    • A dry, hacking cough.
    • A full or hard stomach, loss of appetite or upset stomach .

    There may be times that your symptoms are mild or you may not have any symptoms at all. This doesn’t mean you no longer have heart failure. Symptoms of heart failure can range from mild to severe and may come and go.

    Unfortunately, heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.Its important to let your doctor know if you have new symptoms or if your symptoms get worse.

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    What Are The Symptoms Of End

    Heart Failure: Quick Facts

    1. More than 6 million U.S. adults have heart failure.

    2. About half of people who develop heart failure die within 5 years of diagnosis.

    3. Most people with end-stage heart failure have a life expectancy of less than 1 year.

    4. The leading causes of heart failure are diseases that damage the heart, such as heart disease, high blood pressure, and diabetes.

    Heart failure worsens over time, so symptoms are most severe during the final stages. It causes fluid to build up in the body, which produces many of these symptoms:

    • Shortness of breath . In the final stages of heart failure, people feel breathless both during activity and at rest.
    • Persistent coughing or wheezing. This may produce white or pink mucus. The cough may be worse at night or when lying down.
    • Weight gain or swelling of the feet, ankles, legs, abdomen, or neck veins.
    • Tiredness, weakness.

    In addition, people in the final stages of heart failure may suffer from:

    • depression, fear, insomnia, and isolation
    • anxiety about their future
    • trouble navigating the health care system

    Stage 2 Of Congestive Heart Failure

    Congestive heart failure

    Stage two of congestive heart failure will produce symptoms such as fatigue, shortness of breath, or heart palpitations after you participate in physical activity. As with stage one, lifestyle changes and certain medication can help improve your quality of life. Your doctor will discuss treatment with you and help you on your healthcare journey while living with CHF.

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