Self-management of heart failure patients

Heart failure (often referred to as heart failure) is a late or end-stage transition to various cardiac diseases. Heart failure causes roughly more than 1 million hospitalizations per year, which is most common in patients over 65 years of age, with rehospitalization rates of 25-40% within 6 months of discharge. Although data show that heart failure patients have a mortality rate of only 4% during hospitalization, their mortality rate in the year after discharge is approximately 50%, a rather alarming figure. Therefore, enhancing the self-management of heart failure patients after discharge is the best and most important means to extend the life span of heart failure patients. According to the latest heart failure treatment guidelines, self-management of heart failure patients should include the following aspects: understanding the basic signs and symptoms of heart failure and knowing the clinical manifestations of heart failure exacerbation. The basic signs and symptoms of heart failure include: increased fatigue, decreased exercise tolerance, dyspnea after activity, nocturnal paroxysmal dyspnea (more common at 2:00 or 3:00 at night), and in severe cases, marked dyspnea with light activity, even seated breathing, mostly with rapid heartbeat (15-20 beats/min increase), bilateral lower extremity swelling, and in severe cases, pleural effusion and pericardial effusion. Patients who have been clearly diagnosed with heart failure should pay attention to changes in the above signs and symptoms and contact your physician promptly. Initial understanding of self-adjustment of basic therapeutic drugs. The basic therapeutic drugs for heart failure treatment generally include the following: ① diuretics, such as hydrochlorothiazide, tachyphylaxis, torasemide; ② beta-blockers, such as metoprolol, bisoprolol, carvedilol; ③ ACEI or ARB, ACEI drugs such as perindopril and other **primary drugs, ARB drugs such as valsartan and other *sartan drugs; ④ aldosterone receptor antagonists, such as spironolactone. In principle, without contraindications, the three types of drugs, metoprolol, perindopril or valsartan and spironolactone, must be used, and diuretics are adjusted according to symptoms. Preliminary understanding to master the adjustment method: ① appearing signs of heart failure aggravation (the above heart failure symptoms aggravated), should increase the dose of diuretics; ② according to the heart rate to adjust the dose of β-blockers, generally at rest heart rate at 55-60 times / minute is appropriate; ③ according to blood pressure to adjust the dose of ACEI or ARB, diuretics, etc., systolic blood pressure (i.e., the high value of blood pressure) should not be less than 100mmHg, the elderly preferably in 120mmHg or more, and there should be no dizziness caused by low blood pressure. The following should be avoided as much as possible: ① Avoid overexertion and excessive physical activity, emotional and mental stress; ② Colds, respiratory and other infections; ③ Stop or reduce the dosage without your specialist’s advice; ④ Inappropriate diet such as salty food (salt intake should be below 4g per day), drinking too much water, etc.; ⑤ Add other medications without your specialist’s consent. ⑤Adding other medications, such as painkillers, hormones, etc., without your specialist’s consent. Regular follow-up and review: ① See your specialist once every 1-2 months to let him/her know your daily life and exercise ability, your weight change, alcohol consumption, diet and sodium intake, as well as the dosage of your medications and any adverse reactions; ② Check ECG, BNP or NT-proBNP every 3-6 months, and do chest X-ray and ultrasound if necessary. In conclusion, good self-management of heart failure, maintaining contact and good interaction with your specialist, and timely adjustment of medications according to the situation are the most effective means to prolong the life of a person with heart failure disease.