Heart failure (heart failure) is due to structural or functional diseases of the heart caused by a decline in cardiac function caused by a clinical syndrome, according to current research shows that the incidence of heart failure increases with age, the current age of 70 years of age or older hospitalized patients have 20-30% of hospitalized patients due to heart failure or combined heart failure, but the out-of-hospital treatment of heart failure has not been paid attention to. The out-of-hospital treatment of heart failure is the continuation of hospital treatment, is a very important part of heart failure treatment, we today introduce the heart failure patients should pay attention to the usual things. Zhengzhou City People’s Hospital Cardiovascular Internal Medicine Zhang Wenju The patients themselves feel the most direct symptoms of heart failure, the following we first introduce a few common symptoms: decreased physical strength, fatigue and a sense of weakness: appeared earlier, because it is a kind of overall feeling, so it is often ignored, the elderly can also appear memory loss, anxiety, insomnia and the accompanying symptoms. Exertional dyspnea: occurs during heavy physical activity and can be relieved after rest. The frequency of occurrence is also related to the severity of heart failure, and as the degree of heart failure worsens, the chances of experiencing exertional dyspnea will gradually increase. Nocturnal paroxysmal dyspnea: occurs at night, suddenly wakes up with suffocation, feels suffocated and terrified and sits up quickly, feels relief from dyspnea after doing so, may also induce acute heart failure attack, and is also a common manifestation of aggravation of heart failure. Sitting respiration: Dyspnea occurs gradually after lying down, dyspnea can be significantly improved when sitting. Cough, sputum and blood: Coughing due to heart failure occurs mostly at night, and can be relieved in sitting or standing position. It is mostly white foamy, and in severe cases it may be bloodstained or pink foamy. During an acute heart failure attack, there may be a persistent cough, coughing up pink foamy sputum, and even a distinctive rumbling sound may be heard. Changes in urine output: early on, there may be an increase in urination at night, but in severe cases, there is a decrease in urine output and oliguria, which is due to the change in renal blood volume when the heart is not functioning well, and some patients are combined with significant renal insufficiency in the advanced stage of heart failure, which may even lead to renal failure. Digestive system symptoms: loss of appetite, abdominal distension, nausea, vomiting, constipation, epigastric pain and other symptoms. The above symptoms are related to long-term gastrointestinal stasis, which appears with the period of significant aggravation of heart failure. Edema: foot, ankle, and tibialis anterior edema appeared first, and gradually spread upward to the whole body with the aggravation of heart failure, and the development was slow. Early daytime edema, disappear after resting at night, and in the late stage, there is generalized depressed edema, lumbosacral and lower limb edema in bedridden patients. Of course, the above symptoms are not unique to heart failure, such as the occurrence of the above symptoms need to communicate with the doctor in a timely manner, relevant auxiliary examination for identification. When our condition improves with medication, we should pay attention to some problems on the basis of regular medication: First, weight change Above we talked about the common symptoms of heart failure, but the symptoms appear gradually with the aggravation of the disease. Therefore, we can not only rely on symptoms to determine the severity of heart failure, weight is an easy to measure, targeted indicators. It is recommended that you weigh yourself every morning after defecation and before breakfast and record your weight. If you gain more than 2 kilograms in 3 days or more than 1 kilogram per day, it is considered that your heart failure is getting worse and you need to consult your doctor or consult your physician to adjust your medication. Second, monitor blood pressure and heart rate Blood pressure and heart rate are indicators that reflect the basic functional status of the heart, but also reflect the efficacy of drug therapy and adverse effects, as well as the control of risk factors for heart disease, and many blood pressure monitors can be used to measure blood pressure while obtaining the heart rate. It is recommended to measure blood pressure and heart rate and record them after waking up in the morning and before resting at night. Third, regular and limited activity For exercise, many patients with heart failure are at two extremes after discharge from the hospital, one very much wants to return to normal life, what degree of activity feel they can do, one is worried about the activity aggravate the condition, do not do anything.HF-ACTION trial showed that aerobic exercise for relatively young, NYHA class II-III, LVEF ≤ 35% of the stable heart failure patients are beneficial and safe. The desired exercise program can be specified accordingly to one’s condition. Generally speaking, for patients with stable conditions, they can walk several times a day for 5-10 minutes each time, and gradually extend the walking time as appropriate. If you need bed rest during the decompensation period, or for bedridden patients, you can give massage or passive exercise to prevent muscle wasting atrophy and prevent deep vein thrombosis. Fourth, nutrition and diet, heart failure patients suitable for low-fat low-salt diet. Sodium intake in mild heart failure should be controlled at 2-3g/day, equivalent to 5-7.5g of salt; sodium intake in moderate and severe heart failure should be less than 2g/day. If combined with hyponatremia should be based on the restriction of water intake, moderate increase in sodium intake. If overweight should reduce weight, such as obvious emaciation should be given nutritional support, serious cases can be given albumin. Fifth, water restriction The total amount of liquid in daily dietary water should be controlled at 1.5-2.0L, such as severe heart failure requires strict control of the amount of water intake, including treatment infusion. Sixth, oxygen inhalation There is no indication for oxygen inhalation in heart failure, but for those with sleep apnea and respiratory diseases, low-flow oxygen inhalation can be given to improve hypoxemia, and high-flow or high-purity oxygen inhalation cannot be used. Seventh, quit smoking and limit alcohol. Heart failure patients are absolutely prohibited from smoking, you can drink a small amount of alcohol, the average person can drink up to 100 milliliters of wine per day, or white wine 1 two; such as alcoholic cardiomyopathy caused by heart failure, you must completely stop drinking. Eighth, psychological and psychiatric treatment Some heart failure patients are accompanied by depression, anxiety and loneliness and other psychological disorders, appropriate psychological counseling, regular life, rich spare time can improve the above mental problems to a certain extent, to reduce the heart failure; serious cases can be given anti-anxiety or antidepressant drugs as appropriate. Ninth, regular review For patients with inadvertent stabilization of their condition and simple heart failure symptoms despite regular treatment, outpatient review or hospitalization is recommended in 3-6 months. Stabilized patients can undergo outpatient review 1-2 years depending on the situation. The tests performed are routine: liver and kidney function, electrolytes, electrocardiogram, and cardiac ultrasound. It is advisable to repeat cardiac ultrasound in patients who have been admitted to the clinic or hospitalized for other diseases to assess the severity of cardiac remodeling. In addition to the above matters should pay attention to, make reasonable living arrangements, should also try to avoid the following situations: # overwork and physical labor, emotional and mental overstress and other stressful state. # Colds, respiratory tract or other kinds of infections. #Discontinuation and reduction of medication without following medical advice #Improper diet, such as unclean diet, excessive diet #Addition of other medications, such as non-steroidal anti-inflammatory drugs, hormones, anti-arrhythmic drugs without the consent of a specialist physician #Unnecessary intravenous fluid therapy