Detailed Nursing Diagnosis for Heart Failure- Student Guide

Introduction

Heart failure is a condition in which the heart muscle is too weak to pump enough blood through the body. It can lead to shortness of breath or fluid buildup in and around the lungs, making it difficult for patients to breathe.

Nurses use diagnostic criteria known as nursing diagnoses to identify problems that may be contributing to this condition. We will discuss how nurses should assess their patient’s diagnosis of heart failure using three steps: listing risk factors, identifying symptoms and signs, and determining any environmental factors present.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students, for learning purposes only, and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

What is the Heart?

The heart is located in the center of the chest, between the lungs. It is an organ that pumps blood throughout the body by receiving oxygen-rich blood from the right atrium and pumping it out to the left atrium. Upon reaching the lungs, this oxygen-depleted blood receives fresh oxygen supplies and returns to be pumped to the rest of the body.

The heart is made up of four chambers:

Left and right atria (responsible for receiving blood from lungs and deoxygenated blood from rest of body, respectively) Left ventricle and right ventricle (responsible for pumping oxygen-depleted blood to lungs and fresh, oxygen-rich blood throughout the body)

Did you know?

Your heart beats about 100,000 times a day; every day of your life!

It pumps 5 to 6 quarts of blood with each beat, enough to fill a small barrel.  Over an average lifetime (70 years), the heart will have pumped 3. 5 million gallons of blood through veins and arteries throughout the body- that’s more than 3400 tons!

What is Heart Failure?

Heart failure (HF) is a complex and often chronic condition that occurs when the heart cannot adequately pump enough oxygen-rich blood to meet the body’s demands. According to the American Heart Association, HF is the leading or contributing cause of death in nearly half of all people who have a heart attack.

The Centers for Disease Control and Prevention (CDC) reports that between 112,000 and 228,000 people die each year from HF alone. HF directly contributes to 60,000 deaths per year, plus an additional 20% to 30%, or about 12,800 to 27,200 deaths, are caused by complications of the disease.

What Are the Causes of Heart Failure?

Heart failure can be caused by a wide variety of conditions, including:

• Coronary artery disease
• Congenital heart defects
• Acquired heart disease (such as rheumatic fever and viral cardiomyopathy)
• Heart muscle damage from high blood pressure or diabetes Structural problems such as aneurysm of the ascending aorta or aortic valve stenosis
• Cardiomyopathy
• Diabetes mellitus
• Hypertension (high blood pressure)
• Hyperthyroidism
• Cardiac transplantation
• Coronary artery bypass graft surgery

What Are the Symptoms of Heart Failure?

Patients with heart failure may experience some of these symptoms during a period known as decompensation.

• Unexplained or Sudden weight gain or weight loss
• Chest pain
• Palpitations (awareness of the heartbeat)
• Dizziness or lightheadedness
• Edema/swelling of the legs and/or feet
• Fatigue or feeling tired, even after rest or sleep
• Jaundice (yellowing of the skin)
• Presence of fluid in the lungs ( pulmonary edema )
• Rapid and weak pulse
• Difficulty breathing
• Shortness of breath that worsens with activity
• Decreased urine output
• Extreme weakness

What May Lead Heart Failure in Patients?

According to a National Heart, Lung, and Blood Institute (NHLBI) study, approximately half of all patients diagnosed with heart failure have coronary artery disease. This condition is an obstruction of the heart’s main blood vessels that supply oxygen-rich blood.

How is Heart Failure Diagnosed?

Heart failure can be diagnosed by reviewing symptoms, conducting a physical exam, taking an electrocardiograph (EKG), performing blood tests, or imaging studies. A doctor may advise their patient to avoid certain medications as well.

How A Physical Exam to Diagnose Heart Failure Is conducted

Step 1: Ask a patient about their symptoms.

Step 2: Check the heart, lungs, and abdomen for signs of swelling (edema). A doctor can check this by examining fingers or toes with a blood pressure cuff and checking if they blanch.

Step 3:  Check the patient’s legs, feet, and abdomen for signs of swelling.

Step 4:  Checking the patient’s heart for abnormal sounds (heart murmur) and checking for irregular heartbeats (arrhythmia).

How to Conduct Electrocardiogram (EKG) to Diagnose Heart Failure

Step 1: The patient will lie down or sit down if they’re too weak to stand.

Step 2: The doctor will place electrodes on the patient’s chest to check for electrical activity in the heart. These electrodes are placed over each of the heart’s four chambers, and one electrode is also placed on their back (back electrode).

Step 3: The doctor will apply a small amount of gel to each electrode and also put the back electrode in place.

Step 4: The doctor will turn on the EKG machine and read its printout for irregularities that may indicate heart failure. Depending on what is found, they may refer you to a specialist who can do further tests.

How to Perform Blood Test to Diagnose Heart Failure

Step 1: A particular machine will inject a small amount of radioactive dye into the patient’s arm.

Step 2: The doctor or nurse will check the patient’s heart for signs of good blood flow to different parts of the body. This is done by taking pictures during this test, called an echocardiogram.

Step 3: The patient will need to wait several hours after their injection before going home. The doctor or nurse will check the patient’s heart and blood flow again using an echocardiogram.

Step 4: The doctor will wait several hours to allow the dye to circulate throughout the patient’s body.

Step 5: A special camera, called a gamma camera, is used to take pictures of your heart while lying down. These pictures show how well blood flows through your heart and how much oxygen it carries.

How is Imaging Test Conducted to Diagnose Heart Failure?

These tests are done in a hospital or clinic by an experienced technician. The test can be done with either radioactive material (thallium) or without radioactive material. Tests that use radioactive material are more sensitive than non-radioactive tests but may carry some risk of exposing you to radiation.

What is the Nursing Diagnosis for Congestive Heart Failure?

The following is a list of nursing diagnoses to help nurses identify and treat the symptoms associated with this condition.

1. Acute Pain related to increased volume overload on the left ventricle, decreased left ventricular end-diastolic volume, and sudden changes in cardiac output

2. Activity Intolerance related to decreased oxygen delivery (cardiac output) resulting from prolonged sitting or lying down due to congestion; inadequate gas exchange because of pulmonary edema; shortness of breath with exertion due to limited oxygen supply for tissue needs; fatigue as an additional symptom from poor cardiovascular function

3. Anxiety related to feeling anxious about physical health or death, loss of a loved one, or social issues

4. Powerlessness related to age, gender; or the inability of others to help in recovery from chronic conditions resulting from an acute heart failure episode or condition

5. Constipation related to decreased mobility secondary to shortness of breath when moving about in bed or sitting; lack of caregiver assistance for performing bowel movement

6. Decreased Cardiac Output related to decreased cardiac function due to left ventricular dilation, myocardial infarction, reduced contractility, or increased resistance within the heart chambers (underfilling)

7. Urinary Retention related to bladder distension resulting from increased fluid volume and decreased blood flow to the kidneys resulting in a delay in renal function

8. Diarrhea related to significant electrolyte imbalances, wasting of the gastrointestinal system, or severe GI dysfunction

9. Decreased Cardiac Output related to decreased cardiac output secondary to pulmonary hypertension; systemic vasodilation; reduced contractility of the heart muscle (decreased myocardial function); or increased peripheral vascular resistance

10. Alteration in Comfort related to shortness of breath, fatigue, nausea and vomiting (if fluid from pulmonary edema is aspirated), diaphoresis, insomnia, or altered mood states secondary to the presence of acute (or chronic) heart failure

11. Ineffective Therapeutic Regimen Management related to unawareness of current condition or lack of comprehension due to mental status changes secondary to acute/chronic systolic heart failure, anxiety, or depression

12. Impaired Social Interaction related to the cardiac condition, risk of side effects from medications used for therapy, or feelings of fatigue

13. Impaired Spontaneous Ventilation related to shortness of breath secondary to pulmonary edema; increased work of breathing due to dyspnea on exertion; or abdominal distension

14. Potential Ineffective Breathing Pattern related to shortness of breath; dyspnea with exertion; dry cough secondary to pulmonary edema

15. Potential Altered Nutrition: Less Than Body Requirements related to loss of appetite, decreased oral intake, nausea and vomiting (if fluid from pulmonary edema is aspirated), left ventricular failure, inability to receive enteral nutrition, or gastrointestinal dysfunction

16. Potential Altered Fluid Volume related to pulmonary edema, congestive heart failure, or anxiety resulting in excessive water intake; or sialorrhea (excessive production of saliva) as a common finding from the use of dopamine agonists, which are used for therapy  (1)

17. Potential Ineffective Therapeutic Regimen Management related to unawareness of current condition or lack of comprehension due to mental status changes secondary to acute/chronic systolic heart failure, anxiety, or depression

18. Potential Impaired Skin Integrity related to increased peripheral blood flow, loss of pain sensation in lower extremities, and decreased movement

19. Potential Altered Urinary Elimination related to increased urinary output secondary to the use of dopamine agonists, which are used for therapy; alterations in bladder storage/contractility function (changes in the ability of the bladder to store urine or empty); possible development of a urinary tract infection if fluids from pulmonary edema are aspirated (resulting in an increased risk for renal failure); and changes in standard voiding patterns secondary to the presence of heart failure

20. Potential Ineffective Therapeutic Regimen Management related to unawareness of current condition or lack of comprehension due to mental status changes secondary to acute/chronic systolic heart failure, anxiety, or depression

21. Potential Altered Bowel Elimination related to decreased motility resulting from the use of dopamine agonists, which are used for therapy; changes in normal voiding patterns secondary to the presence of heart failure; abdominal distension; diarrhea that may occur as a result of electrolyte imbalances or other medications used for therapy; and/or increased water intake

22. Potential Ineffective Therapeutic Regimen Management related to unawareness of current condition or lack of comprehension due to mental status changes secondary to acute/chronic systolic heart failure, anxiety, and/or depression 

Nursing Care Plan for Congestive Heart Failure?

1.  Explain the disease process and treatment options to patients as well as their families.

2. Help patients/families to adapt to new lifestyle patterns associated with heart failure.

3. Help patient manage symptoms of heart failure, such as coughing, shortness of breath, depression or anxiety, fatigue or weakness, etc.

4. Encourage the patient to meet with a dietitian for information on modifying diet and lifestyle.

5. Work with patient/family on methods to increase activity that does not further strain the heart, such as pacing of activities, limiting movement in hot weather, or feeling dizzy or short of breath. Essential that the patient/family is aware of these circumstances and methods to avoid further strain on the heart.

6. Provide emotional support for patient/family.

7. Work with a physician since many medications used in treatment will have side effects that need to be addressed (may include: nausea, constipation, decreased levels of consciousness, itching, etc.).

8. Continue teaching patient/family regarding home care and comply with discharge instructions.

9. Encourage the use of support groups for patients and families dealing with CHF.

10. Encourage the use of health-promoting behaviors, such as maintaining adequate fluid intake, eating a healthy diet, and maintaining an appropriate weight; discontinue smoking (if applicable); proper rest periods to help prevent further damage to the heart during bedrest; exercise, if tolerated;

11. Place patient on cardiac alert bracelet or necklace.  Make sure you have given them the phone number of your facility’s 24-hour nurse call line.

12. Complete assessments on heart failure-related parameters such as weight (BMI), blood pressure, level of shortness of breath, fluid status (also by urine output).

The ICU team will regularly assess for signs or symptoms of fluid overloads, such as jugular vein distention, peripheral vascular resistance changes, or tachycardia.

13. Assess for signs of infection, a common cause of new-onset heart failure in the ICU setting.   Common sources are pneumonia and urinary tract infections (bladder or kidneys).

14. Ensure patients have an adequate pain assessment and maintain a pain management plan.   Common sources of pain are related to deconditioning, immobility, or the effects of certain medications (inotropes).

15. Ensure that patient has access to emotional support / social services as may be needed.

16. Increase frequency of vital sign monitoring (as ordered), watch for signs of worsening fluid overload or other complications.

17. If the patient is on inotropic therapy, be vigilant regarding the potential side effects of these medications listed above. Also, be aware that they may require increased doses over time to maintain adequate cardiac output and blood pressure.

18. Maintain a low threshold for contacting the physician (cardiology/internist) if you have any concerns regarding possible complications or side effects of medications.

19. Continue to increase adherence to a daily walk schedule, which will help to minimize further strain on the heart and associated symptoms

20. Engage the patient as an active participant in his care, encourage them to ask questions and make suggestions regarding their care

21. Participate in multidisciplinary rounds to discuss patient status, medications used (diuretics, vasodilators, etc.), and side effects of medications/treatments.

22. Assist the physician with wound management as needed for CHF patients – particularly those on continuous ambulatory peritoneal dialysis for end-stage renal disease

23. Ensure that patient/family has been counselled regarding their cardiac status and are aware of the associated risks, limitations, and complications (e.g., worsening heart failure, hospitalization).  Ensure they know what to do if there is a change in symptoms or a significant change in their overall status.

24. Ensure that a patient on continuous ambulatory peritoneal dialysis receives adequate fluid volume to support their kidney function, which usually requires 130-160 cc/kg (ideally over 3 hours).  Some of these patients will also require vasopressor therapy to maintain adequate BP and CO levels.

25. Be aware that many of these patients will be at an increased risk for pulmonary and other infections – due to reduced immunity, lowered conditioning status, or the treatments themselves (steroids, diuretics, etc.).

26. Look for signs of volume overload such as increased weight gain, dyspnea on exertion, or peripheral edema.  Some patients may also require diuretics or other ways to reduce fluid overload, such as using a paracentesis.

27. Ensure that the patient has been adequately assessed and treated for depression if needed.   This should be done early on after ICU admission to avoid complications related to depression or anxiety and worsening symptoms of heart failure.  It can also lead to a lack of compliance/follow-through with the physician’s orders, ultimately impacting the patient’s clinical status and recovery.

28. Promote a positive attitude in all patients. This can help reduce overall stress and depression and improve their adherence to the physicians’ orders (e.g., diet, activity).   Patients with depression are at an increased risk of complications and hospital readmissions, hurting their overall outcome.

29. Emphasize the importance of family/friend support and encourage them to participate in as much care and activities as possible – this will help overall recovery by avoiding significant caregiver-related stress.  Encourage the family to seek assistance for home care if needed (e.g., house cleaning, and meals while the patient is hospitalized).

30. Please note that patients with CHF are at an increased risk for developing delirium or dementia when hospitalized due to their underlying disease process and medications used to treat it. This can often become a significant clinical challenge even after the patient’s condition has improved.  It is essential to treat these patients aggressively and optimize their medical condition to minimize confusion, memory loss, and other cognitive deficits.

31. Advise patients not to stop taking any medications that have been prescribed for them without consulting with their physician (e.g., beta-blockers, ACE inhibitors/ARBs, diuretics).  For patients on daily aspirin for primary prevention of stroke or heart attack, it is crucial to continue this medication and inform the patient to avoid missing doses.

32. Encourage all CHF patients to eat a healthy diet with as little salt (sodium) as possible while eating fresh fruits and vegetables. This will help reduce swelling (edema). It is also essential to prevent a decline in overall condition during hospitalization.

33. For patients with CHF who are at the end stage of their disease process, be sure they understand that aggressive efforts to improve their symptoms may not be an option because worsening heart failure can lead to premature death.

You may also check Nursing Interventions for Heart Failure

What Are the Nanda I Nursing Diagnoses Involving Cardiac Function?

Cardiogenic shock:

Definition: The inability to pump oxygen-rich blood around the body at a rate that meets metabolic demands.  Symptoms include chest pain, shortness of breath, and noticeable swelling in the extremities (hands and feet). One potential complication of cardiogenic shock is acute kidney injury.

Nursing Diagnosis: Acute Cardiac Failure, Cardiogenic Shock

Nanda-I Diagnosis Code(s): Nursing diagnosis code: 10213: NANDA-I code: K33.208

Signs & Symptoms: CHF is a condition where the heart fails to pump blood sufficiently throughout the body leading to vascular congestion (edema) and fluid accumulation in the lungs (pulmonary edema). This can lead to difficulty breathing, shortness of breath, fatigue, and ultimately death if not aggressively treated. Common signs of CHF include shortness of breath (due to fluid accumulation in the lungs), fatigue, swelling, and weight gain in the abdominal region due to fluid retention. Cardiogenic shock signs and symptoms are similar to CHF, but they tend to be more severe, leading to a significantly increased risk for death within days or weeks if left untreated.

What Are the Nanda II Nursing Diagnoses Involving Cardiac Function?

Acute cardiac failure:  Cardiogenic shock.  Circulatory overload:  Due to fluid accumulation in the lungs (pulmonary edema), this can lead to shortness of breath, fatigue, and ultimately death if not aggressively treated. Cardiomyopathy:  Defined as a disease/condition involving the muscular wall of the heart causing dysfunctions in pumping and circulating blood. CHF is one type of cardiomyopathy.

Nursing Diagnosis: Acute Cardiac Failure, Cardiogenic Shock, Circulatory Overload

Nanda-II Diagnosis Code(s): Cardiovascular system: K33.10, K33.8 Musculoskeletal/integumentary/genitourinary system: R64

Signs & Symptoms: CHF is a condition where the heart fails to pump blood sufficiently throughout the body leading to vascular congestion (edema) and fluid accumulation in the lungs (pulmonary edema). This can lead to difficulty breathing, shortness of breath, fatigue, and ultimately death if not aggressively treated. Common signs of CHF include shortness of breath (due to fluid accumulation in the lungs), fatigue, swelling, and weight gain in the abdominal region due to fluid retention. Signs and symptoms of cardiogenic shock are similar to CHF, but they tend to be more severe, leading to a significantly increased risk for death within days or weeks if left untreated.

Nursing Diagnosis for Complete Heart Block

Cardiovascular system: K14.2,K40.7

Nursing Diagnosis Code(s): Nursing diagnosis code: 10338: NANDA-I code: K14.2, K40.7

Pain:  CHF is usually diagnosed based on observed signs and symptoms of the disease/condition and diagnostic tests such as blood tests, EKGs to evaluate the electrical activity in the heart, and cardiac catheterization to assess blockages affecting blood flow from the heart. Patients with CHF often experience pain throughout their bodies due to poor circulation. However, this is not always a defining characteristic of CHF.

Signs & Symptoms: This may include the potential for long-term changes in mental status, anxiety, and depression.

Trauma: CHF is usually diagnosed based on observed signs and symptoms of the disease/condition and diagnostic tests such as blood tests, EKGs to evaluate the electrical activity in the heart, and cardiac catheterization to assess blockages affecting blood flow from the heart. Patients with CHF often experience pain throughout their bodies due to poor circulation. However, this is not always a defining characteristic of CHF.

What is the Nursing Diagnosis for Ischemic Heart Disease?

Palliative care:  NANDA-I nursing diagnosis code(s): Nursing diagnosis code: 12296:: NANDA-I code: K44.0 Difficulty with Physical Mobility, Specific (self-care deficit):

Pain:   Patients will often complain of different degrees of chest pain and discomfort, typically worsened by any activity or other exertion such as lying down.  Additional symptoms of angina pectoris may include shortness of breath, feeling like the heart has stopped beating (palpitations), nausea/vomiting, and sweating. Angina will occur more frequently in people with a history of coronary artery disease or CAD.

Signs & Symptoms: Signs and symptoms may include the potential for long-term changes in mental status, anxiety, and depression.

Pain:  Angina is generally diagnosed based on observed signs, symptoms, and diagnostic testing such as EKGs to evaluate the heart’s electrical activity. Chest pain, particularly in the chest, arm, and jaw area, is common with angina. But other signs and symptoms such as fatigue, lightheadedness, and nausea may also occur, leading to an increased risk for death in patients who have severe or worsening symptoms.

Signs & Symptoms:  Angina pectoris occurs more often in people between 35-60 years of age. Pre-existing risk factors for CAD are known to increase a person’s chance of developing angina, such as smoking, high levels of cholesterol, and high blood pressure in addition to diabetes, family history, or having a sedentary lifestyle.

Pain: The condition is generally diagnosed based on observed signs and symptoms of the disease/condition and diagnostic tests such as blood tests and EKGs to evaluate the electrical activity of the heart.  Coronary artery bypass surgery or CABG is performed when a patient has single or multiple blockages in their coronary artery that restrict blood flow to the cardiac muscle causing chest pain (angina).  The objective of coronary artery bypass surgery is to create alternative blood flow and route it around the blocked area of a coronary artery. Surgery also relieves chest pain caused by angina, improves cardiac function, decreases symptoms (e.g., shortness of breath), and increases life expectancy.

Signs & Symptoms: This may include the potential for long-term changes in mental status, anxiety, and depression.

What Are the Reducing Risk Factors for Coronary Artery Disease?

Coronary artery disease (CAD) is the buildup of fatty deposits, also known as plaque, on the walls of your heart’s arteries. The accumulation of plaque narrows or blocks blood vessels that supply blood to the heart muscle and reduces blood flow.

One of the reasons for this behavior is that CAD involves a type of cholesterol called low-density lipoprotein (LDL). LDL, also known as ‘bad cholesterol, is often referred to by doctors as the “silent killer” because it can build up in the walls of arteries and slowly narrow or block the arteries.

What Are the Major Risk Factors for Coronary Artery Disease?

• Smoking, both active and passive (e.g., secondhand smoke)
• High blood pressure
• High cholesterol levels (above 200 mg/dL) in addition to low “good” cholesterol (HDL) levels
• Familial hypercholesterolemia (high LDL level in the genetic family member who has a high risk for coronary artery disease)
• High levels of triglycerides (150 mg/dL or higher)
• Diabetes, either type I or type II
• Sedentary lifestyle

How to Improve Symptoms of CAD

Although CAD has no cure, proper treatment can cause the disease to remain stable (not get worse) or even improve over time.

Treatment may include medicines, lifestyle changes, and surgery to repair a damaged heart valve or replace an artery narrowed or blocked by atheromatous plaque.

Treatment begins with diagnostic tests that determine which arteries and veins are affected by CAD and its severity.

These tests help your doctor identify which medicines may be right for you and allow your doctor to choose the best treatment option.

Examples of tests include Blood tests to check the amounts of fats (cholesterol) and blood sugar in your bloodstream;

Angiogram, a procedure that uses X-rays and dye injected into an artery in the groin or arm to produce an image of the arteries;

Echocardiogram, an ultrasound that uses sound waves to create images of the heart and blood vessels.

Once these diagnostic tests have been done, your doctor will be able to determine the best treatment for you.

Treatment for Coronary Artery Disease (CAD)

If you are suffering from symptoms of CAD, taking action now is the best way to improve your health and quality of life.  The first step in treatment for CAD is to stop smoking because smoking can make existing angina or heart attacks worse by increasing the risk of heart attack itself and hastening death among patients who have already suffered from a heart attack.

If you have had a heart attack, treatment will be based on the results of your coronary angiography and the extent of damage to your heart muscle from an MI.

Treatment may include medicines, lifestyle changes, and surgery to repair damaged blood vessels or replace them with healthy ones so that blood can flow more easily to the heart.

The treatment for acute MI may include medicines to dissolve blood clots, slow or stop a fast heart rate (antiarrhythmic drugs) and control pain and inflammation.

Examples of Medicines That Are Used in Treating CAD

ACE inhibitors help relax blood vessels, so more blood flows to your heart. There are several types of ACE inhibitors.

Some examples are:

• Benazepril (Lotensin)
• Captopril (Capoten)
• Enalapril (Vasotec)
•  Fosinopril (Monopril)
• Lisinopril (Prinivil or Zestoretic)
• Moexipril (Univasc or Uniretic)
• Perindopril (Aceon)

ARB’s help lower blood pressure and reduce the risk of heart attacks.  Examples of ARB’s include:

• Losartan (Cozaar or Hyzaar); Valsartan (Diovan)
• Candesartan (Atacand or Atacand HCT)
• Eprosartan (Teveten)
• Irbesartan (Avapro or Avapro HCT)

Beta-blockers help slow down your heart rate and lower blood pressure by blocking the action of certain natural chemicals in your body called catecholamines. Examples include:

• Metoprolol (Lopressor or Lopresor)
• Atenolol (Tenormin)
• Nadolol (Corgard or Syprine)
• Pindolol (Visken, Corgard SR, Inderal LA, InnoPran XL)
• Carvedilol (Coreg)
• Propranolol (Inderal, Inderal LA, Innopran XL, Lopresor)

Calcium channel blockers help control blood pressure by relaxing blood vessels and lowering heart rate.  Examples include:

• Verapamil (Calan or Isoptin)
  • Amlodipine (Norvasc)
  • Nitrendipine (Nitrendipine ER, Adalat CC or Diltia XR)
  • Diltiazem HCL (Cardizem)
  • Felodipine (Plendil)

Diuretics remove excess water, salt, and minerals from your body, helping it to lower blood pressure and giving you more energy. Examples include:

• Furosemide (Lasix)
  • Hydrochlorothiazide (Microzide or Hyzaar); Chlorothiazide (Diuril)
  • Spironolactone (Aldactone); Amiloride HCl (Midamor)

Beta-blocker + Diuretic medicines effectively treat high blood pressure and help prevent a second heart attack. This combination is also effective in treating chest pain and improving exercise tolerance.

Angiotensin-converting enzyme (ACE) inhibitors + Beta-blockers are very effective treatments for CAD patients who have had a heart attack or have congestive heart failure and high blood pressure.

Coronary artery bypass graft (CABG) surgery is used to treat severe coronary heart disease.  This procedure involves moving a healthy vein from your leg or chest wall and using it to bypass the narrowed section of an artery in the heart muscle, restoring blood flow around the blockage.

How Can You Prevent Coronary Artery Disease?

Visit your doctor regularly and get screened as early as possible for cardiovascular disease. This is the best way to protect yourself against heart attacks, strokes, and other forms of cardiovascular disease.

A healthy diet with proper nutrition and regular exercise. This will help you lower your risk of developing heart disease or having another attack in the future.  Medications may be necessary, depending on how severe your symptoms are.

If you have unstable angina, you will need to take medicine(s) to prevent further attacks. ACE inhibitors and beta-blockers are the most common medicines used for this purpose.

If you have heart valve damage, medicines that protect your heart may be recommended. For example, beta-blockers or calcium channel blockers can help improve blood flow to the heart.

If medicines do not control your symptoms, you may need more invasive treatment such as surgery to repair or replace damaged blood vessels in your heart;  or angioplasty with a stenting procedure to open narrowed arteries and improve blood flow.

The most recent guidelines on preventing heart disease emphasize the importance of healthy living and maintaining a healthy lifestyle.

Even if you have already had one heart attack or experienced symptoms of CAD – quitting smoking is an effective way to protect your health by reducing your risk of dying from a second heart attack or stroke.

*This information is not intended as a substitute for professional medical care. It is provided for educational purposes only. If you are concerned about your family’s health, you should always consult with a physician or other healthcare professional.

How to Prevent Complications of Coronary Artery Disease

If you have confirmed that you have CAD, your doctor may recommend medicines to help treat or prevent the disease from getting worse.

The blood-thinning medicine aspirin prevents clotting in your arteries. It helps reduce the chance of a heart attack or stroke because it keeps atheromatous plaque from sticking to the lining of your arteries.

If you have diabetes and CAD, the possibility of a heart attack or death is much greater.  Fortunately, with careful control of blood glucose, it may be possible to reduce these risks.

People who have cardiovascular disease should avoid certain medicines that can cause bleeding in the blood vessels of the brain or gastrointestinal tract.  These medicines include aspirin, ibuprofen, and naproxen unless your doctor says it’s OK to take them.

Smokers should stop smoking because it can lead to heart disease.   If you have CAD and smoke, quitting will reduce your risk of death by 50% or more in the first 20 years after giving up cigarettes.

A healthy lifestyle can also help you prevent the complications of CAD.  These include:

-Eating fruits, vegetables, and a low-fat diet;

-Exercising for 30 minutes daily;

-Not drinking excessive amounts of alcohol;

-Controlling your weight

How Do You Manage the Side Effects of CAD?

Some medicines that are used to treat CAD can have side effects.  It would help if you discussed the possible side effects of any medication with your doctor before starting a course of treatment.

There are many ways to manage the side effects of these medications, including:

• Changing dosages
• Alternating different medications
• Taking medicines to relieve the symptoms of side effects (like an antihistamine for itching)
• Take time off from work or school to deal with the side effects.

If you have CAD or suspect that you may have it, make an appointment with your doctor. Early detection of the disease is essential to preventing complications in the future.

Mary Gitonga

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