Congestive Heart Failure Program

What is Congestive Heart Failure?

Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from:

• narrowed arteries that supply blood to the heart muscle (coronary artery disease)
• past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work
• high blood pressure
• heart valve disease due to past rheumatic fever or other causes
• primary disease of the heart muscle itself, called cardiomyopathy
• heart defects present at birth (congenital heart defects)
• infection of the heart valves and/or heart muscle itself (endocarditis and/or myocarditis)

How is My Heart Affected?

The "failing" heart keeps working, but not as efficiently as it should. People with heart failure cannot over-exert themselves because they become short of breath and tired.

As bloodflow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Swelling (edema) often results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

WakeMed's Congestive Heart Failure Program

The treatment of heart failure is more than providing physical relief.  It’s about managing a chronic disease.  That includes monitoring the patient’s condition and providing education about the disease, as well as giving them emotional support.  That’s exactly what  the WakeMed Congestive Heart Failure Program does.  The program, which started in 1999, is designed to work in conjunction with the patient’s primary care physician and cardiologist. 

When patients enroll in the CHF Program, a cardiovascular educator provides them with educational materials, including a booklet about heart failure, a weight diary, a sodium checkbook and medication cards for recording information about their medicines.  These tools provide valuable information to health care providers on the daily condition of the CHF patient.  Even after a patient has been diagnosed with CHF, hospital readmissions frequently occur because of not knowing how to manage one's lifestyle while suffering from the condition.  It is the program's goal to eliminate that problem.

Follow-Up Care By Phone

A key component of the WakeMed CHF program is follow-up care after a patient goes home from the hospital called ‘telemanagement.’  Patients get a telephone call from a CHF educator on a weekly basis for six weeks. The educators ask patients a number of probing questions about their well-being.  They discuss weight management, blood pressure and medications, as well as how they feel in general.  The CHF educators are rapid responders and listen closely for signs that a patient's condition may be declining.  If they hear a ‘red flag,’ they try to resolve it quickly before the patient has to be readmitted to the hospital.

After six weeks of phone calls, CHF educators taper down the calls to every other week. Eventually, the calls will come only monthly as the patient learns to manage his or her condition.

Not only do patients get calls regarding their physical well being, but they receive calls from a volunteer chaplain about their emotional well being.  The chaplains participate in the support group meeting for people with CHF, helping patients deal with the psychosocial aspects of heart failure.  The chaplain affirms their fears, concerns and anger at having to deal with disease, and lets them know they’re not alone.

For more information about the WakeMed Congestive Heart Failure (CHF) Program, please contact Marian Uy, RN, CHF Program Coodinator, at 350-5732.  To read a CHF patient success story, click here.