Guidelines for the care of patients with end-stage heart failure

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor II Nguyen Quoc Viet - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Heart failure is a consequence of many common cardiovascular diseases with an increasing incidence, heart failure is divided into different degrees. Patients with grade 4 heart failure always have symptoms of fatigue and shortness of breath even at rest. Caring for people with end-stage heart failure is a non-drug approach that improves the patient's life.

1. What is heart failure?

Heart failure is a complex clinical syndrome that results from physical damage to the heart or cardiac dysfunction leading to a decrease in the heart's ability to pump blood to the organs (systolic heart failure) or a decrease in the heart's ability to function properly. Blood capacity (diastolic heart failure)
Heart failure is a disease that cannot be completely cured by medical treatment, but the use of drugs and care regimens can slow the progression of the disease.

2. Heart failure grading

There are many ways to classify heart failure, however, the New York Heart Association (NYHA) Heart Failure Classification based on the patient's functional symptoms is easy to perform.
Heart failure is divided into 4 degrees
Grade I: No limitation of physical activity, normal activities do not cause fatigue, shortness of breath or palpitations. The patient has cardiovascular disease, has not shown heart failure clinically. Grade II: Slight limitation of physical activity. The patient's usual physical activity results in fatigue, palpitations, dyspnea or chest pain. With rest, the symptoms are gone. Grade III: Limited physical activity. Although he is healthy at rest, he has symptoms of fatigue and shortness of breath with just light exercise... Grade IV: No physical activity does not cause shortness of breath. Symptoms of heart failure occur even at rest, even a slight physical activity increases the symptoms.

3. Guidelines for the care of patients with heart failure grade 4

Patients with heart failure grade 4 have a severe prognosis, medical treatment only helps to slow down the progression of the disease. Caring for patients with end-stage heart failure helps patients improve their lives, reduce symptoms, and prolong their lives.

3.1. Diet

Limit water intake to only about 30ml/kg body weight and 35ml/kg if body weight is over 85kg, avoid intravenous fluids without the guidance of medical staff. Eat enough nutrients and vitamins, increase fiber, limit foods that contain a lot of fat. Maintain a healthy weight to avoid weight gain. Limit sodium intake (<2g/day). Avoid processed foods, fast food, MSG... Do not eat fermented foods such as melons, sauerkraut... Reduce or should not drink alcohol Quit smoking, do not use addictive substances

3.2. Exercise regime

Gentle and safe physical activity. Avoid heavy exercise such as jogging.... Should exercise regularly. If you take a break, you should start again with a gentler level. Avoid exercising outdoors when the weather is too hot or too cold. If you have any uncomfortable symptoms, you should stop exercising, rest until the symptoms are gone. Travel and entertainment: Depending on your health status, when you go away, you need to bring along documents related to illness, medications you are using and preventive drugs under the guidance of medical staff.

3.3. Adherence

Patients must adhere to the use of medication as prescribed by the doctor, not to quit on their own. Because heart failure patients may have cognitive impairment, it is essential for family members to remember and give the patient adequate medication. Understand drug side effects.

3.4. Other care issues

Complete influenza and pneumococcal pneumonia vaccinations according to guidelines Patients with heart failure may present with symptoms of depression and cognitive impairment, and therefore should be supported in social integration Often Regularly record weight, detect rapid weight gain early. Notify medical staff immediately when there are signs: In case of increased shortness of breath, edema or sudden unexplained weight gain of more than 2kg in 3 days. Although end-stage heart failure has a severe prognosis and uncertain survival time. But with the right care, patients can improve their lives, live more happily, slow the progression of the disease and help patients increase their life expectancy.