BHF Heart Failure

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Beating Heart Disease Together

Information for South Asians

HEART FAILURE


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2 | Heart ailure

About this bookletThis booklet is or South Asian people who have heart ailure.

The booklet explains:

what heart ailure is what causes it

the symptoms

how it is diagnosed

how it is treated, and

what you can do to help yoursel.

The inormation in this booklet is not a substitute or the advice your doctormay give you based on his or her knowledge o your condition.

This booklet is available in Bengali, Gujarati, Hindi, Punjabi and Urdu.This English version has been produced to help relatives, carers and healthproessionals who do not read these languages.

AcknowledgementsThe British Heart Foundation would like to thank:

Haslemere Allotments

Gordon House Surgery, and

Proessor Jaspal S Kooner, Dr Nabeel Ahmed and Ealing Hospital

or their continued support.


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What is heart ailure? 5

What are the symptoms o heart ailure, and how is it diagnosed? 8

What can be done or heart ailure? 15

Medicines to treat heart ailure 16

What you can do to help yoursel 24

Other treatments that can help some people with heart ailure 38

Heart ailure and your quality o lie 39

I you look ater someone with heart ailure 42

For more inormation 44

Technical terms

Index 47

Contents


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Heart ailure | 5

what is heart failure?

The heart is a pump which delivers blood and oxygen aroundthe body. Heart ailure is the term used when the heartbecomes less efcient at pumping blood around the body,either while you are resting or active.

Heart ailure is a name or a collection o symptoms. These symptomsare all caused by your heart not being able to pump as much bloodand oxygen around your body as it should do.

The term heart ailure is unortunate because it implies that the hearthas actually ailed. In act, it means that the heart muscle is not workingas well as it should be. But many people can have some control over theircondition with a combination o medicines and making changes to theirliestyle, or sometimes with other medical treatments.

the heart

arteries

arteries

what is heart failure?

How a normal heart works

Your heart is a muscle about thesize o your fst. Your body needsa constant supply o oxygen tokeep it going. Your heart pumpsblood containing oxygen throughyour arteries to all the parts oyour body, so that each partgets the oxygen it needs.

The movement o the bloodthrough the heart is regulatedby a system o our valves. Thesemake sure that the blood owsin the correct direction.


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What causes heart ailure?

The most common causes o heart ailure are:

A heart attackcauses damage to the heart muscle. This happens whenthe heart muscle is deprived o oxygen and blood because the arterieshave become blocked, as in coronary heart disease. (For more inormationon coronary heart disease, see our booklet Living with angina and heart

disease. See page 44.)

High blood pressure is when the pressure o the blood in the arteriesis too high. People with high blood pressure rarely have symptoms, but ithe high blood pressure is not treated, it can lead to heart ailure. Knowingwhat causes high blood pressure can help to reduce your risk o thishappening to you. We explain more about high blood pressure on page 26.

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heart attacks or high blood pressure.


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Other possible causes o heart ailure are:

In some cases the cause is not known.

Can heart ailure be cured?

With the right treatment and by making changes to your liestyle, your

heart ailure can be managed so that you can have a longer and better lie.However, these changes are unlikely to reverse your condition.

The most important thing is to manage your symptoms well. Many peoplein the early stages o heart ailure can lead ull and active lives. And thosewith more advanced heart ailure can learn to work within their limits andget as much out o lie as possible.

Heart ailure | 7

a viral inection

a disease o the heart muscle called cardiomyopathy

heart valves that either leak or are too narrow

an abnormal heart rhythm (an arrhythmia)

drinking too much alcohol

thyroid gland disease, or

anaemia (a lack o iron in the blood).


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The main signs and symptoms o heart ailure are:

Symptoms may come on suddenly, or they may develop slowly overweeks or even months. They may also happen ater a heart attack.However, these symptoms can also be caused by other medicalconditions, so it is important to talk to your doctor to get anaccurate diagnosis.

BreathlessnessI you have heart ailure, breathlessness is most likely to happen whenyou are active or when you are lying at in bed. It may even wake youup at night, and you may need to sit up, with pillows to support you,or go to the window or some resh air. The breathlessness is caused bya build-up o uid in the lungs, which can make you wheeze or cough.Being breathless can be very rightening, which can make thebreathlessness worse.

8 | Heart ailure

What are the symptoms of heart failure,and how is it diagnosed?

breathlessness

swelling o the ankles and eet, and

tiredness, which can be mild or severe.


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Heart ailure | 9

Swelling o the ankles and eet

People with heart ailure oten have swelling o the ankles and eet.Sometimes the swelling may spread to the legs, thighs and groin andeven to the abdomen. One o the jobs o our kidneys is to keep the right

balance o water, salt and potassium in our bodies. I your heart is notpumping enough blood to the kidneys, your kidneys cannot do their

job properly and uid builds up in dierent parts o your body. This iswhat causes the swelling.

One way to check i you are retaining uid is to weigh yoursel atthe same time every day. I you fnd you have put on 2 to 3 pounds(1 to 2 kilos) over two to fve days, the weight gain may be due to uid

retention. I you put on this amount o weight over a couple o weeks,it is more likely to be due to an increase in body mass (at).

Tiredness

The tiredness can be mild or severe. For some people, it can be quiteoverwhelming, making it dicult to carry on as normal. The tirednessis caused by your muscles not getting enough oxygen, or because youare not sleeping properly.

We explain how to help control these symptoms o heart ailure onpage 15.

I you have these symptoms and they are getting worse, you should

speak to your doctor or nurse immediately. I the symptoms are

very bad, you should call 999 or an ambulance.


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How is heart ailure diagnosed?

Your doctor may be able to tell you i you have heart ailure by doing acareul physical examination. You may have to have some other testsdone too. Your doctor will:

Your doctor will also do blood tests to fnd out i you have early signso anaemia, kidney damage or thyroid disease.

The other tests you will have are an electrocardiogram (ECG), anechocardiogram (see photo opposite) and a chest X-ray.

An electrocardiogram (ECG)

An ECG is a test that records the rhythm and electrical activity o yourheart. Several small sticky patches are put onto your arms, legs and chest.

The patches are connected to wires which lead to the ECG recordingmachine. This recording machine picks up the electrical signals produced

by each heartbeat and records several beats onto paper. The ECGmachine only records signals rom your heart. I t does not aect yourheart in any way. The whole test takes about fve minutes and is notuncomortable at all.

An echocardiogram

An echocardiogram is a test to check the pumping action o your heart.A recorder (probe) is placed on your chest and a pulse o high-requency

10 | Heart ailure

examine your heart rate and rhythm

take your blood pressure

check whether you have uid in your lungs, legs and

in other parts o your body

listen to sounds made by your heart valves, and

check i the blood pressure in your neck is high.


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sound is passed through the skin o your chest. Lubricating jelly isrubbed on your chest frst, to help make a good contact with the probe.

The probe then picks up the echoes reected rom various parts o theheart and shows them as a picture on a screen. The test can take up toan hour. It doesnt hurt at all.

How do I know i I have mild or severe heart ailure?

Doctors divide heart ailure into our classes.

Your doctor will classiy your heart ailure into one o these groupsby examining you, doing some o the tests described on page 10 andtalking to you about your symptoms.

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Class 3 Moderate heart ailure

People with Class 3 heart ailure are quite limited in

what they do, and fnd that they are breathless andbecome exhausted easily. They are usually comortablewhen they are resting.

Class 4 Severe heart ailurePeople with Class 4 heart ailure are breathless evenwhen they are not very active or example, whenwalking around the house or even while resting.

They may be unable to sleep lying down because theyget breathless or because it makes them cough.

Class 2 Mild heart ailure

People with Class 2 heart ailure may get breathlesswhen they do everyday activities.

Class 1 Very ew or no obvious symptomsIn people with Class 1 heart ailure, the heart is notworking as well as it should be, but they should be

able to do everything that they normally do.


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Heart ailure | 13

Will my heart ailure get worse over time?

You can help to slow down the progression o your heart ailure i youlook ater yoursel and set realistic goals to manage your symptoms.Your doctor or heart ailure nurse will help you to do this. Sometimes,

managing your symptoms can improve the pumping action o yourheart and help to overcome some o the problems you are experiencing.

In some cases, with good management, it is possible to prevent yourheart ailure getting worse or many years.

It is normal or you and your amily to be concerned about your condition.You should talk to your health proessionals who will be able to help youand your amily to live as normal a lie as possible.

How do I know that my symptoms are due to

heart ailure?

The symptoms o heart ailure breathlessness, swelling and tiredness are not always caused by heart ailure.

Breathlessness

It is normal to become breathless when you are physically active.Breathlessness is only a problem i you fnd that you are becomingincreasingly breathless doing activities that you could previously do easily such as walking, climbing stairs, shopping or hoovering. Breathlessnessis also common in smokers. And people who are very overweight mayget very out o breath when they are physically active.

Swelling

Ankle-swelling can be caused by varicose veins, especially in women.It can also be a side eect o some medicines. People who are overweightmay get swollen ankles even i they do not have heart ailure.

Tiredness

Tiredness can be a result o a number o conditions, such as anaemia or anunderactive thyroid gland. It can also be a side eect o some medicines.


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Heart ailure | 15

What can be done for heart failure?

It is possible to help control the symptoms o heart ailure.This can be done in these our ways.

Your doctor can give you medicines to help.See page 16.

There are things you can do to help yoursel.See page 24.

A pacemaker can help a small number o people withheart ailure. See page 38.

In a very small number o cases, people with heartailure may be oered a heart transplant i their heartailure is severe, but this is rare. See page 38.


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You may need to take several dierent medicines or yourheart ailure.

Taking the right pills properly:

Your doctor may prescribe one or more o these medicines or you:

You may also be given nitrates. And you may be given statins, to loweryour cholesterol level. (For more inormation on nitrates and statins,see our booklet Taking medicines for your hear t. See page 44.)

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Medicines to treat heart failure

will help to control the symptoms o your heart ailure

may treat the cause o your heart ailure, and

may make you eel better and live longer.

diuretics

ACE inhibitors

beta-blockers

anti-platelet drugs

digoxin

anticoagulants.


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On the ollowing pages we explain what the medicines do to help yourheart ailure.

For inormation on the side eects o these medicines, see our bookletTaking medicines for your heart. (See page 44.) Serious side eects are rare.

I you do get any side eects, tell your doctor so that he or she can changeyour dose, or perhaps give you a dierent medicine instead.

Most people with heart ailure will have regular blood tests to make surethat the levels o important substances in the blood such as potassiumand sodium remain within the normal limits. People who have heartailure may need to have these blood tests more requently than peoplewho are taking the same drugs but who do not have heart ailure.

Dont stop taking your medication without speaking to yourdoctor rst, as it can make your symptoms worse.

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Complementary medicines

Some homeopathic or herbal remedies, and ood supplementssuch as vitamins and minerals, may interact with your medicines.Beore taking any o these you should discuss them with yourdoctor, nurse or pharmacist.


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18 | Heart ailure

Diuretics

Diuretics are also called water tablets.

How does this medicine help people with heart ailure?Diuretics help your kidneys to work. They increase the amount o waterand salt passed rom the kidneys into the urine. So they can be a greathelp in relieving any ankle-swelling and breathlessness caused by heartailure. They also help to control your blood pressure, and help othermedicines such as ACE inhibitors and beta-blockers to work better.

Other information

You should tell your doctor or nurse i you:

have diculty passing urine

pass less urine than normal

are constipated

begin to eel dizzy or aint (i this is a new symptom or you,or i it becomes worse).

You will need to have a blood test about every six months to makesure that your kidneys are working properly. Some people may havea test more requently, depending on their condition.

I you have heart ailure, you should avoid eating salt and salty ood(see page 34). Salt can also counteract the eect o the diuretics.So, i you are taking these medicines, avoid salty oods, and dont addany salt or salt substitute to ood, either during cooking or at the table.


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Heart ailure | 19

ACE inhibitors

How does this medicine help people with heart ailure?

ACE inhibitors relax the blood vessels, and help improve the ow o

blood to the heart muscle, making it easier or the heart to pumpblood around your body. They also reduce the risk o having a heartattack or o dying rom heart ailure. ACE inhibitors can lower yourblood pressure dramatically so, when you start taking these medicines,you will have your blood pressure checked regularly.

ACE inhibitors are not suitable or everyone with heart ailure.

Other information

I you have heart ailure and are taking ACE inhibitors, you shouldavoid drinking alcohol as it can lead to dizziness.

You should avoid salt substitutes as they contain potassium. And donttake potassium supplements or other supplements that containpotassium.

ACE inhibitors can sometimes cause a dry, irritating cough. I thishappens to you, you should tell your doctor about it. He or she maybe able to prescribe another medicine instead.

Beta-blockers


Beta-blockers prevent the heart rom beating as quickly and orceullyas usual. They also increase the amount o blood that your heart canpump with each beat, and reduce the risk o dying rom heart ailure.

Beta-blockers are usually given to people with mild to moderateheart ailure. When you frst start taking them, your symptoms mayseem worse or a while. It can take a couple o months beore youeel the benefts.


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20 | Heart ailure

I you have asthma or suer rom wheezing, your doctor will need tochoose your beta-blocker careully, as some types tend to narrow theair passages.

Other information

Dont stop taking beta-blockers suddenly without medical advice asthis can make your symptoms much worse.

Anti-platelet drugs

How does this medicine help people with heart ailure?Anti-platelet drugs such as aspirin help to reduce blood clotting, bystopping blood platelets (cells in the blood) rom sticking together.

They also reduce the risk o having a heart attack.

Other information

I you cannot take aspirin, your doctor may prescribe another drug,

called clopidogrel, or you. This has the same eect as aspirin.

You normally have to take aspirin or the rest o your lie. Some peoplemay need to take other anti-platelets or dierent lengths o time,depending on their condition.

You should not take any remedies that contain aspirin such asmedicines or muscle and joint pains, and some remedies that peopletake or colds and u as they can reduce the eect o the aspirin

you are taking to protect your heart. And you should avoid all othermedicines that contain aspirin. I you need to take something or atemperature or to relieve pain, ask your pharmacist or doctor whichtype o medicines is suitable or you.

Always try and take your aspirin with or ater ood.


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Heart ailure | 21

Digoxin


Digoxin slows the heart rate and strengthens the orce o the heartbeat.

It can help your heart to pump blood around the body more ecientlyand help to control irregular heart rhythms.

Other information

Digoxin may not be suitable or people who already have a slowheartbeat or or people with certain heart conditions such as someabnormal slow heart rhythms.

Anticoagulants


Anticoagulants make your blood thinner, so they help to stop clots inthe blood rom orming. This means that they can help to prevent aheart attack or stroke.

Other information

I you are taking anticoagulants, you should always carry with youanAnticoagulant record cardthat has details o the anticoagulantmedicines you are taking. Your doctor will give you this card. Also,i you are having any tests or treatment, tell any doctors or nurses thatyou are taking anticoagulants.

You will need to have regular blood tests to check that you have theright dose o anticoagulant. These tests are usually done at yourdoctors or at an anticoagulant clinic at the hospital.

Some anticoagulants interact with other medicines. So, check with yourdoctor or pharmacist beore you take any other medicines.

You should not drink cranberry juice i you are taking anticoagulants.


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Heart ailure | 23

Taking your medicines

Below is a guide to taking your medicines saely and makingsure that they have the best possible eect in relieving yoursymptoms.

Write out a list o your medicines, the doses, and whenyou take them. At least once a month, or whenever youget a new prescription, check that your list o medicinesmatches the medicines you are taking.

Have a fxed routine or taking your tablets so that youknow which you can take together and what time is the

best time or you to take them. I you miss a dose or cant remember taking it, dont

take a double dose. Wait until you are next due to takethe medicine. It is saer to take too little medicine ratherthan too much.

Always check with the pharmacist or your doctor beoretaking over-the-counter medicines.

Tell your doctor about any unwanted side eects youthink you are experiencing.

Never share your medicines with other people or takeother peoples medication. They may be taking dierentdoses or preparations o the medicine.

Dont stop taking any medication without talking toyour doctor rst.


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It makes good sense to do everything you can to stop or slowdown any progression o your heart ailure. These are thethings that you can do to help yoursel.

We explain more about these things on the next pages.

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What you can do to help yourself

Control your blood pressure.

I you smoke, stop smoking.

Be physically active, within the limits advised byyour doctor.

Work towards a sensible body weight.

Eat a healthy diet.

Watch the amount o uid that you drink.

I you drink alcohol, keep within sensible limits.

Take your medicines regularly, as advised byyour doctor.


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Control your blood pressure

We know that high blood pressure is one o the most common causes oheart ailure. People with high blood pressure rarely have any symptoms,and the only way you can tell i you have high blood pressure is by havingyour blood pressure measured.

I you have high blood pressure, it is important that you take your bloodpressure medication properly.

Other things you can do to help control your blood pressure are:

We explain more about all these things on the next pages.

For more inormation on blood pressure, see our booklet Blood pressure and how to control it. (See page 44.)

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Eat a healthy diet avoiding salt or salt substitutes and

making sure your diet is high in ruit and vegetables.

Manage how much uid you have.

Limit how much alcohol you have.

Keep as active as your symptoms allow.


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I you smoke, stop smoking

Stopping smoking is the single most important thing a smoker can do tolive longer.

I you stop smoking, you are likely to:

I you have tried to stop smoking and have gone back to smoking again,there are things that can help you. Ask your doctor about products to help

you stop smoking. I you need extra help with stopping smoking, you cancall Quitline or the NHS Smoking Helpline.

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eel more alert

increase your energy levels and ftness

sleep better

improve your circulation and oxygen levels

improve your symptoms, and

reduce your risk o having a heart attack or stroke.

Quitline

English: 0800 00 22 00

Bengali: 0800 00 22 44Mondays 1pm to 9pm

Gujarati: 0800 00 22 55Tuesdays 1pm to 9pm

Hindi: 0800 00 22 66Wednesdays 1pm to 9pm

Punjabi: 0800 00 22 77Thursdays 1pm to 9pm

Urdu: 0800 00 22 88

Sundays 1pm to 9pm

NHS Smoking Helpline

English: 0800 169 0 169

Bengali: 0800 169 0885Tuesdays 1pm to 9pm

Gujarati: 0800 169 0884Tuesdays 1pm to 9pm

Hindi: 0800 169 0883Tuesdays 1pm to 9pm

Punjabi: 0800 169 0882Tuesdays 1pm to 9pm

Urdu: 0800 169 0881

Tuesdays 1pm to 9pm


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Be physically active, within the limits advised by

your doctor

The type o activity that is recommended or good heart health ismoderate, rhythmic (aerobic) exercise such as brisk walking or cycling.

Walking and cycling are particularly good as you can oten build theminto your daily routine. Or, i your mobility is limited, you can do exerciseswhile you are sitting in a chair. Get advice rom your doctor or heart ailurenurse about how much activity you should do to start with.

The benefts o physical activity are that it is likely to:

I you have heart ailure, you will have good and bad days. On the gooddays, you will eel that you can do lots o things. But you need to fnd abalance between doing too much and doing too little. Plan what youknow you can do in a day. Then, each day, do what you planned to do,not what you eel you can do. This is because, i you do too much, youll

eel tired the next day and you wont be able to do what you had plannedor that day.

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raise your energy levels and make you eel less tired

improve your breathing

improve your blood pressure

lower your cholesterol

improve your weight, and

make you eel better mentally and physically.


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W k d ibl b d i h


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Work towards a sensible body weight

I you are overweight, you need to lose some weight. Dont try to losethe extra weight too quickly. Losing weight slowly and steadily about apound, or hal a kilo, a week is more healthy, and youre more likely tokeep the weight o or good.

Eat a healthy diet

Eating healthily can help you to control your weight, your blood pressure,your blood sugar and your cholesterol.

What you can do

We explain all these things on the next pages. You can still eat youravourite dishes. You just need to make small and gradual changes inwhat you eat. For more inormation, see our booklet Looking after yourheart, and the healthy recipes in our Asian cookbookHealthy meals,healthy heart. (See page 44.)

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Eat at least fve portions o ruit and vegetables a day.

Eat less at, particularly saturated at.

Eat one or two portions o fsh a week.One o these should be oily fsh.

Eat less salt.


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Is a vegetarian diet better than a

non-vegetarian diet?

Both a vegetarian and a non-vegetarian diet can be healthy,provided they are balanced. Vegetarians need to make sure thatthey are getting enough protein in their diet or example,rom beans, pulses, tou or Quorn. These oods are low in at andalso provide fbre. Eating these oods, combined with eatingmore ruit and vegetables as part o a balanced diet, will ensureyou get all the nutrients you need, as well as helping to keepyour heart healthy.

Vegetarians should also ollow the advice to have a diet that

is low in at (especially saturated at), sugar and salt (see pages33 and 34). Some vegetarians use a lot o butter and ghee intheir cooking, which adds a lot o saturated at. Try using a smallamount o olive oil or rapeseed oil instead. Use a spoon tomeasure the oil rather than pouring it. Also, some vegetariansadd salt to give oods extra avour. Instead o salt, use otheravourings or oods such as lemon juice, chilli and other herbsand spices.

Eat at least ve portions o ruit and vegetables a day


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Eat at least ve portions o ruit and vegetables a day

Eating a diet that is rich in a range o vegetables and ruits lowers the risko heart disease. Eat at least fve portions o ruit and vegetables a day.

Try to eat a wide variety o ruit and vegetables. They can be resh, rozenor tinned. Dried and juiced also count, but only once a day.

Eat less at, particularly saturated at

There are two main types o ats in oods: saturated ats and unsaturatedats. A diet that is low in saturated ats can lower your blood cholesterollevel, help prevent you putting on weight, and can reduce the risk ocoronary heart disease or stroke.

Saturated fats are ound mostly in oods rom animal sources such asatty meat, and in dairy products such as butter, ghee, cheese, creamand ull-at milk. Palm oil, coconut oil, coconut cream and coconut milkare also high in saturated at.

Unsaturated fats are mainly ound in vegetable oils and plant oils suchas corn oil, sunower oil, olive oil and rapeseed oil.

Eat one or two portions o sh a week

Eating oily fsh regularly can help to protect your heart. The particular oilin fsh that has these good eects is called omega-3. It is ound mainlyin oily fsh such as trout, sardines, herrings, mackerel or resh tuna. Aim tohave two portions o fsh a week. One o these portions should be oily fsh.

I you dont eat oily fsh, there are some vegetarian sources o omega-3that you can include in your diet. These include axseed oil, rapeseed oil,

ax seeds, rape seeds, and walnuts. However, we dont know or certain ithese sources o omega-3 give the same benefts as oily fsh.

Avoid salt


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Avoid salt

Most o the salt we eat is hidden in processed oods and in pre-cookedor pre-prepared meals, which are sometimes very salty. When choosingthese oods, choose ones that are labelled low salt or reduced salt.But you should still check the labels to see whether they are actuallylow in salt. See the box below.

Avoid adding salt when cooking or at the table. Use spices, herbs orlemon juice or avour instead.

Dont use any salt substitutes as these may contain large amountso potassium, which is not recommended i you have heart ailure.It is better to try to get used to ood without salt.

34 | Heart ailure

What is a lot and a little salt?

This is a lot(per 100 grams o ood):

1.5 grams osalt or more0.6 grams osodium or more

This is a little(per 100 grams o ood):

0.3 grams osalt or less0.1 gram osodium or less


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Watch the amount o fuid that you drink


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36 | Heart ailure

Chew chewing gum or have a boiled sweetoccasionally.

Rinse your mouth out with water or mouthwashwithout swallowing it.

Add a little lemon juice to one o the glasses o waterrom your daily allowance. The sour taste will quench

your thirst more eectively.

Suck an ice cube, but remember to include that inyour allowance.

Watch the amount o fuid that you drink

Your doctor may have told you to restrict the amount o uid you drink.To check how much uid you have in a day, each time you drink something,pour the equivalent amount into an empty 2-litre bottle or two 1-litrebottles. I you do this or a whole day, you will be able to see how much

you drink in a day. Remember that some oods such as soup contain a loto water, so you have to include that too.

I you have been told to restrict your uid intake, try writing a plan owhen you would most like your drinks, and spread them out throughoutthe day. I you do eel thirsty but your uids are restricted, you could trythe ollowing.

I you drink alcohol, keep within sensible limits


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y , p

Alcohol can alter your uid balance quite dramatically, and it can lead tohigh blood pressure. It can also make some o the symptoms o yourheart ailure worse such as dizziness and tiredness.

Men should drinkno more than 3 units o alcohol a day, and a totalo no more than 21 units a week.

Women should drinkno more than 2 units o alcohol a day, and a totalo no more than 14 units a week.

Avoid binge drinking.

I you have a problem with retaining too much uid, check with yourdoctor how much you can drink, especially beer.

I your heart has already been damaged by alcohol, your doctor hasprobably already told you that it would be better or you to give upalcohol altogether.

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1 unit o alcohol =

a small glass (100ml) o wine(10% ABV [alcohol by volume])

or

hal a pint (300ml) o normalstrength lager, cider or beer

(3% to 5% ABV)or

a pub measure (25ml)o spirits

ther treatments that can help s me


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38 | Heart ailure

Other treatments that can help somepeople with heart failure

PacemakerA small number o people with heart ailure may beneft rom havinga special type o pacemaker, called a bi-ventricular pacemaker, ftted.

This device may help to synchronise the heart rhythm and control theheart rate. It is not suitable or everyone. It is generally used in peoplewith moderate to severe heart ailure who are not responding totheir medication.

Heart transplantIn a very small number o people with severe heart ailure, a hearttransplant may be an option. This orm o treatment is or patientswho have been careully chosen, but it is not suitable or everyone.

I your cardiologist (a doctor who specialises in the heart) thinks thatyou may be suitable or a heart transplant, he or she will ask you togo to a transplant centre or an assessment.

H art fa l r an y r al ty f l f


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Heart failure and your quality of life

Tiredness and breathlessness are common symptoms o heart

ailure and can make it difcult or some people to live theirlives normally. Some people also nd that their mood isaected and may eel more depressed than is usual or them,or lose their condence. Some have chest pain.

Do tell your doctors and nurses about how you eel, and about the waysin which heart ailure is aecting your everyday lie. They may be able toadjust your treatment to help improve the quality o your lie.

Your doctor may be able to reer you to other health proessionals whocan help. For example:

Many areas o the country now have heart ailure nurses. These nursescan see you in hospital and also give you and your amily support,inormation and guidance when you get home. Ask your GP orinormation.

I you have heart ailure and also have angina or have had a heart attack,you may be able to go on a cardiac rehabilitation programme.

This usually involves going once or twice a week or between 6 and 12weeks, or longer. The programme might be run either at your localhospital or at a centre near you. It usually includes exercise sessions toencourage you to do as much physical activity as you can. You will alsoget advice about healthy eating and other ways to help your heart.

To fnd out where your local cardiac rehabilitation programme is,call 0300 330 3311. You will need to check that the programme issuitable or people with heart ailure.

A specialist in palliative care may be able to help improve yoursymptoms and help you and your amily cope with your illness.Your GP can give you inormation about this.

A counsellor may be able to help you cope with your heart ailure.Y GP b bl t t it i ht b ibl t t


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40 | Heart ailure

Your GP may be able to reer you to one, or it might be possible to geta reerral through the hospital. Counselling can be particularly useul orpeople who eel depressed. Your doctor may also be able to prescribemedication to help with depression.

Talking to others can also be very helpul. You may fnd it helpul to joina heart support group. A heart support group gives you, your partnerand amily the chance to meet and talk to people who are goingthrough a similar experience. Groups vary. They may meet every week,every ortnight or every month. The British Heart Foundation keeps anup-to-date list o all heart support groups in England and Wales whichare linked to the British Heart Foundation. To fnd out about the nearest

one to you, call 0300 330 3311.

People with heart ailure can become tired and depressed about theirlimitations, and worried about their uture. Understanding what heartailure is and the medicines used to treat it, and being involved in makingdecisions about your treatment, will all help you to have more controlover your condition.


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If you look after someone with heart failure


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42 | Heart ailure

If you look after someone with heart failure

Looking ater someone who has heart ailure can be very

demanding both physically and emotionally.

I you are caring or someone with heart ailure, it is important that youlook ater your own health and make sure you get regular breaks both or your own wellbeing and or the person you are looking ater.Remember that doctors, nurses, social workers, voluntary groups andriends can all help. Ask or help and support whenever you need it.

I you cannot leave the person you are caring or on their own or long,it may be possible to arrange respite care. This means that the person islooked ater in a care home or a ew days, or example while you havea break. The heart ailure nurse or social worker may be able to help youarrange this.


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For more information


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For more information

British Heart Foundation website

bh.org.uk

For up-to-date inormation on coronary heart disease, theBritish Heart Foundation (BHF) and its services.

Heart HeLPLine

0300 330 3311

A local rate number.

For inormation and support on anything relating to heart health.This service is available in English only.

Booklets

The ollowing booklets are available in Bengali, Gujarati, Hindi,Punjabi and Urdu:

Blood pressure and how to control it

Cholesterol and what you can do about it

Diabetes and how it aects your heart

Heart ailure

Living with angina and heart disease

Looking ater your heart

Taking medicines or your heart

The ollowing booklets are available in English only:

The heart ailure plan

Eating or your heart

Healthy meals, healthy heart

Physical activity and your heart

Smoking and your heart

So you want to lose weight or good

44 | Heart ailure

DVDS

Th ll i DVD il bl i U d Hi di G j ti P j bi d


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How to OrderThe British Heart Foundation also produces other educationalmaterials that may be o interest. To fnd out about these, to ordera Heart health catalogue, or to order publications, please call the BHFOrderline on 0870 600 6566, go to bh.org.uk/publications oremail [email protected]. You can download many o ourpublications rom bh.org.uk/publications

Our publications are ree o charge, but we would welcome a donation.

Heart ailure | 45

The ollowing DVDs are available in Urdu, Hindi, Gujarati, Punjabi andBengali. They are ree, but a donation o 5 per DVD would be welcome.

Living to prevent heart disease

Get t, keep t prevent heart disease Cardiac surgery

Cardiac rehabilitation

Aairs o the heart

Magazines and services

Heart & soul is a glossy liestyle magazine aimed at the South Asian

community. This ree magazine is packed ull o inormation on leadinga healthy liestyle and eatures celebrities talking about their ownhealth, delicious recipes and real-lie stories. To receive your ree copycall 0870 600 6566. Available in English only.

Heart Matters is a ree service designed or anyone who has, or is at risko developing, a heart condition, and or anyone who cares or someonewith a heart problem. Members receive personalised inormation, andcan get specialist support rom cardiac nurses or heart health advisers,either by phone or email. They also get regular issues oHeart healthmagazine, which includes updates on treatment and research and looksat issues related to heart health. To join Heart Matters, either registerat our website bh.org.uk/heartmatters or call 0300 330 3300 (a localrate number). This service is available in English only.

technical terms


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ACE inhibitor A medicine used to treat heart ailure. It relaxes the blood

vessels and helps to improve the ow o blood to the heart muscle.

anticoagulant A medicine used to help stop clots in the blood romorming.

anti-platelet drug A medicine used to help stop clots in the bloodrom orming.

arteries Vessels which carry blood rom the heart to other parts othe body.

beta-blocker A medicine used to treat heart ailure. It prevents theheart rom beating as quickly as usual.

blood pressure The pressure o the blood in the arteries.

cardiomyopathy A disease o the heart muscle.

digoxin A medicine used to treat heart ailure. It slows the heart rate.

diuretic Also known as water tablets. Diuretics increase the output owater and salt in the urine.

ECG See electrocardiogram.

echocardiogram An ultrasound picture o the heart which showsthe structure o the heart and how it is working.

electrocardiogram A test to record the rhythm and electrical activityo the heart. Also called an ECG.

t chnical t rms

46 | Heart ailure

INDEX


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Heart ailure | 47

Have your sayWe would welcome your comments to help us produce the bestinormation or you. Why not let us know what you think? Contactus through our website at bh.org.uk/contact. Or, write to us atthe address on the back cover.

ACE inhibitors 19

activity 29alcohol 37

ankle-swelling 9, 13

anticoagulants 21

anti-platelet drugs 20

aspirin 20

beta-blockers 19

blood pressure 6, 26

breathlessness 8, 13

cardiomyopathy 7

carer 42

causes o heart ailure 6

depression 39, 40

diagnosis 10

diet 31

digoxin 21diuretics 18

drugs 16

eating 31

ECG 10

echocardiogram 10

electrocardiogram 10

exercise 29

at in the diet 33

uid 9, 36healthy eating 31

heart attack 6

high blood pressure 6, 26

medicines 16

nitrates 16

nurses 39

pacemaker 38

quality o lie 39

rehabilitation 39

salt 34

smoking 27

sodium 34

statins 16

support groups 40

swelling 9, 13symptoms o heart ailure 8

tests 10

tiredness 9, 13

transplant 38

treatment 15

water tablets 18

weight 9, 31

The British Heart Foundation is the nations heart charity, saving lives through

pioneering research, patient care and information. We rely on donations to

i i l k If ld lik k d i h B i i h H


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G3161109

British Heart FoundationGreater London House180 Hampstead RoadLondon NW1 7AWPhone: 020 7554 0000

Fax: 020 7554 0100Website: bh.org.uk

British Heart Foundation 2009, a registered charity in England and Wales (225971) and Scotland (SC039426)

continue our vital work. If you would like to make a donation to the British Heart

Foundation, please ring our donation hotline on 0300 330 3322 or contact us

through our website at bh.org.uk/donate or send it to us at the address below.

This booklet is available in Bengali, Gujarati, Hindi, Punjabi and Urdu.

This English version has been produced to help relatives, carers and health

professionals who do not read these languages.

To order further copies, please call the BHF Orderline on 0870 600 6566.

This service is available in English only.

BHF Heart Failure

Documents