Physiotherapy for Heart Failure patients

What Can Happen in Heart Failure?

Your Heart does not pump enough blood. Blood backs up in your veins. Fluid increase in your body, causing swelling in your feet, ankles, and legs. This is called edema. Fluid builds up in your lungs. This is called "pulmonary edema." Your body does not get enough blood and oxygen.

What Are the Different Types of Heart Failure?

There are types of heart failure according to which segment of the Heart is not working correctly, as mentioned below:

1. Left heart failure.

2. Right heart failure.

3. Systolic phase failure.

4. Diastolic phase failure.

5. Acute Heart failure.

6. Advanced heart failure.

What Are the Primary Causes of Heart Failure?

• Diseases of arteries inside the Heart like high blood pressure.

• The disease of valves of the Heart.

• Weakness of muscles of the Heart.

• Increased physical exertion.

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• Obesity.

• Alcohol.

• Chronic smoking habits.

What Are the Symptoms of Heart Failure?

• Difficulty in breathing (dyspnea) at rest and on minimal efforts.

• Nighttime wake-up dyspnea (awakened from sleep because of shortness of breath).

• Weakness.

• Fatigue.

• Collection of water or fluid or edema of both legs.

• An increase in abdominal girth.

• Veins around the neck will be dilated.

• Heart and lungs sound will be altered due to water collection.

• Both legs swell due to blood being unable to divert towards the Heart.

How to Diagnose Heart Failure?

Diagnosing coronary failure is often challenging, even for trained professionals. Not all patients with coronary failure have the standard symptoms, and therefore the same symptoms are often experienced by patients who do not have heart failure. An accurate diagnosis requires a range of diagnostic tools and information, in conjunction with clinical judgment and expert knowledge of X-Ray, blood test presence of peptides in serum.

What are the Primary Management measures for Heart Failure?

The primary goals of treatment in heart failure are to improve prognosis, reduce mortality, alleviate symptoms, and reduce morbidity by reversing or slowing the cardiac and peripheral dysfunction. For in-hospital patients, in addition to the above goals, other goals of therapy are to reduce the length of stay and subsequent re-admission, prevent organ system damage, and appropriately manage the co-morbidities which will contribute to poor prognosis.

• Follow your doctor's advice.

• Quit smoking if you smoke.

• Take your medicines exactly as prescribed.

• Weigh daily to see for weight gain caused by increased fluid.

• Track your daily fluid intake.

• Monitor your blood pressure daily.

• Lose or maintain your weight supported by your doctor's recommendations.

• Avoid or limit alcohol and caffeine.

• Eat a healthy diet low in sodium and high in fiber.

• Eat less salt and salty foods.

• Be physically active.

• Get adequate rest.

• Drug Treatment: Drugs that decrease the load on the Heart are commonly used. Digitalis (Decrease the load over the Heart), ACE (angiotensin-converting enzyme) inhibitors (Decrease the Blood Pressure), Diuretics (Decrease the Blood Pressure), Nitrates (Decrease the Load over the Heart), Beta-Blockers (Decreases the Heart Rate). International recommendations include diet adaptation, regular exercise, and therapeutic education.

What is the Non-Pharmacological Therapy (Physiotherapy Treatment)?

Advice on Drugs, Salt, Diet, Potassium, Alcohol, and exercise. Medications must be continued as directed.

• Herbal remedies are not recommended for the management of coronary failure, and these substances should be avoided.

• Avoid stopping medications without consulting a physician.

• Digoxin is usually necessary for a healthy heart, and Diuretics are continued in some in a prescribed dose for a lifetime.

• It is strongly advised that one must take medications on time and with each visit so that a physician can recheck them.

• The patient must learn to measure with a low-salt diet.

• To Achieve a Low Salt Intake, Do the Following:

• Do not add salt in cooking or at the table.

• If the taste is a problem, use a salt substitute after testing several preparations on the market.

• Salt substitutes have potassium instead of sodium and are better for you, but they should not be used if you take an ACE inhibitor.

• Cardiac Rehabilitation: A comprehensive cardiac rehabilitation program provides patient evaluation, exercise training, physical activity counseling, cardiovascular risk factor management, psychosocial support, and patient education. This program takes place in a hospital or the community. Cardiac rehab is for patients who are becoming better after heart problems or surgery.

• Exercise training is a core component of the comprehensive rehabilitation program. It is currently recommended with pharmacological therapy for patients with chronic heart failure (CHF) with reduced blood pumping from the left Heart.

• It is evidence-based rehabilitation or training for heart patients to regain the strength & endurance of cardiac muscle, also known as cardiorespiratory endurance.

• This exercise can be given in all the stages of Heart failure.

• Exercise ultimately improves a person's workability for a prolonged period. Exercise will make the heart muscle adapt to a gradual workload to manage normal day-to-day stress easily.

• Exercise prescription aims to reinforce fitness, promote health by reducing risk factors for the disorder, and ensure safety during exercise.

• The principal components of a scientific, individual exercise prescription comprise an appropriate type, intensity, duration, frequency, and progression of exercise.

Conclusion:

Aerobic endurance training that comprises isotonic and rhythmic exercise using large muscles has been proposed as part of an effective rehabilitation strategy for heart failure patients. In the case of heart failure, one needs to minimize the load on the Heart by decreasing blood pressure and decreasing venous return. Therefore, a moderate-intensity workout can be advised for 60 % to 70% of people with heart failure under the close supervision of a skilled physiotherapist.

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