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Heart Failure

Heart failure is a chronic condition that occurs when the blood flow and oxygen to your body and vital organs is reduced. This happens when the heart is weakened, stiff or damaged.
Heart failure videos

With support from experts and organizations across the province, Cardiac Services BC produced an eight-part educational video series to offer those living with heart failure, their families and caregivers quick and easy access to information on living with and managing the condition.

In this section

Introduction to heart failure

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Heart failure is a chronic condition that affects the heart’s ability to pump enough blood for your body. The most common cause of heart failure is damage to the heart muscle from a heart attack, or from blockages in the arteries around your heart. However, heart failure can be caused by other conditions, including high blood pressure, infection or inflammation in the heart muscle, or hereditary disease. Measuring the percentage of blood that pumps from your heart to your body after each contraction (your ejection fraction) helps to identify the type of heart failure you have. 

Diagnostics, tests and devices

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There is no single test for heart failure. Blood tests and imaging like chest x-rays and electrocardiograms (ECG or EKG) are often used to diagnose heart failure, while tests like exercise tolerance testing or angiograms can help identify the cause of your heart failure. Some devices used to manage heart failure include:

‎If you require travel and/or transportation support to receive care, there are resources available to you.

 

Heart failure zones

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The Heart Failure Zones are a tool you can use to guide yourself and your loved ones on when to get help. People living with heart failure tend to move between different “zones” (red, green, yellow) depending on how their health is doing and what’s going on in their lives. There are many reasons you might move from one zone to another. Some of these triggers are in your control, and others aren’t. 

  • Green Zone = You’re doing well, and your symptoms are in control
  • Yellow Zone = This is a warning, and your symptoms are starting to get worse
  • Red Zone = You need to act fast and get help immediately

Mental health and coping

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Getting a heart failure diagnosis, a major change in your treatment plan, a worsening of your condition or hospitalization can be distressing and emotional. The heart failure journey has peaks and valleys over time. There are practical strategies to cope and adapt to tough emotions, including: 

  • Managing worry
  • Reducing stress 
  • Building new habits 
  • Considering different viewpoints 

If you or someone you know is struggling with mental health and coping, the resources below are some of the many pathways to mental health and coping information and help. 


Tools for finding mental health support in your community:

Online courses:

  • Bounce Back: A free virtual health skill-building program that helps people who are experiencing mild to moderate depression or anxiety 

  • Mind Space Skills for Wellbeing: 8-week course to help with anxiety and depression


Mental health information:
  • Heretohelp: Mental health and substance use information you can trust
  • MindHealth BC: This website provides mental health resources available in your community. You will find mental health and substance use information, self-help resources, online programs, and support groups. 

Crisis lines:

If you are feeling in crisis, including thinking of ending your life or harming yourself, please contact a crisis line or go to your nearest Emergency Department.

  • BC Suicide Prevention and Intervention Line: 1-800-SUICIDE (1-800-784-2433)

  • KUU-US Crisis Line Society: Toll-free at 1-800-588-8717; Adults and Elders at 250-723-4050; Children and Youth at 250-723-2040

  • Indian Residential School Survivors Society – Lamathut Crisis Line: 1-800-721-0066 or 604-985-4464

 Healthy eating

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Eating healthy meals and monitoring your fluid and sodium intake are important when effectively managing heart failure. Choose balanced meals that you enjoy, connect you to your family, culture and traditions, and are highly nutritious.

Healthy eating information and support is available to people living in British Columbia through the programs and resources below.


 

Physical activity

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When you have heart failure, staying active is a critical part of caring for yourself and staying well. While physical activity and exercise have their benefits when living with heart failure, it’s especially important to pay attention to how you’re feeling both before and during exercise. 

When you introduce new physical activity into your life with heart failure, whether it’s aerobic activity, strength training, balance and flexibility, or sex and intimacy, it’s important to check-in with your health care provider first. You can ask your health care provider to refer you to a cardiac rehab program. 

General physical activity support and heart failure-specific sexual activity information can be accessed through HealthLinkBC.

  • Between the hours of 9:00 a.m. and 5:00 p.m., Monday to Friday, qualified exercise professionals are available to speak to (free of charge) by calling 8-1-1.
    • You can also leave a message outside of these hours or email a qualified exercise professional.
  • HealthLinkBC: Heart Failure and Sexual Activity 

Medications

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The number of medications your health care provider will recommend for heart failure depends on your ejection fraction.

For people with an ejection fraction of 40 per cent or less (a reduced ejection fraction, or HFrEF) taking four types of medications together is called quadruple therapy, or “guideline-directed medical therapy” (GDMT). When you take them together, they can add five to eight years to your life.

Once you start these four medications, you could see improvements after a month, but it may take many months before you feel their full benefits. Typically, when starting these medications, you will start with low doses and your health-care provider will gradually increase the dose, usually over three to six months.  

Assistance with the cost of prescription medication is available to eligible residents of British Columbia through the following programs:


Information about medications for heart failure is available through the following resources:


Advance care planning

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It's important for the health care team, patient and their family to work in partnership to discuss medical options and make care decisions centered around the patient's wishes and care goals. 

Advance Care Planning means reflecting on your personal values and beliefs around wellness and illness. Then sharing these beliefs with the people that are important to you and your health care team. These values and beliefs can then be followed if a medical decision needs to be made on your behalf.




Treatment

 

Treatment

There is no cure for heart failure. Instead, treatment is focused on helping you live a longer and healthier life by:

  • monitoring symptoms 
  • monitoring weight daily, and maintaining a healthy weight
  • managing diet, including limiting sodium, potassium and fluids
  • ensuring daily physical activity
  • managing blood pressure
  • avoiding unhealthy habits, such as smoking (tobacco, cannabis, vaping) and drinking alcohol
  • taking medications as prescribed

Procedures

For some people, surgery and medical devices are needed to treat the heart failture. Treatments could include:

  • an implanted device, such as a pacemaker and/or cardioverter defibrillator (CRT)
  • coronary artery bypass graft (CABG)
  • ventricular assist device (VAD), to help the heart pump while awaiting heart transplant
  • heart transplant, although not everyone is a good transplant candidate 

Care management

Effective management of heart failure requires a combination of close monitoring of your weight, healthy lifestyle and medications. Your health care providers will work with you and support you to manage your condition.

Self-management

Your daily activities can have a major impact on the progression of heart failure. It's important for patients and/or their caregivers to play an active role in their health by:

  • monitoring symptoms
  • monitoring your weight daily
  • managing diet might include limiting sodium, fluids and potassium
  • ensuring daily activity 
  • managing blood pressure
  • maintaining a healthy weight
  • avoiding unhealthy habits such as smoking (tobacco, cannibas, vaping) and drinking alcohol 
  • taking medications as prescribed




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