Chronic Heart Failure (CHF) refers to a physiological situation under which the heart is incapable of pumping adequate blood that can meet metabolic requirements that a human’s body needs (National Collaborating Centre for Chronic Conditions (Great Britain) & Royal College of Physicians of London, 2003). It describes the results of what happens when the heart does not pump enough blood to body parts. In layman’s language, heart failure occurs when the heart cannot carry out the workload it has. The most common symptom of CHF includes shortness of breath and tiredness (Matzo & Sherman, 2010). Individuals with CHF usually look tired and cannot carry out tasks that involve much energy. In most cases, CHF is caused by a heart attack, even though there are other causes. Heart attack has the effect of damaging the muscles of the left Ventricle. The damage of the muscles of the left ventricle results in systolic dysfunction, hence chronic heart failure (Ellis & Holmes, 2006). The other cause of CHF is coronary artery disease. This simply refers to when arteries that supply the heart with blood become narrow (Ellis & Holmes, 2006).
The previous occurrence of heart attack can also lead to CHF. A previous attack, also known as myocardial infarction, can leave damage to muscles making the muscles not work normally (Jones & Cowie, 2006). The other cause can be high blood pressure, also commonly referred to as hypertension. Blood pressure is the force exerted against the arteries as blood is pumped. Congenital heart diseases can also result in CHF. Congenital heart diseases are defects to the heart that an individual had at birth (McDonagh, 2011). Finally, the other cause of CHF includes endocarditis or myocarditis, a condition that affects the heart valves or the muscles of the heart (Vijayalakshmi, 2011). However, there are times when the cause of CHF is not known and cannot be established.
The main symptoms of CHF’s existence are breathlessness and exhaustion or fatigue. The shortness of breath is commonly referred to as dyspnoea and mainly occurs when an individual is lying down (Christensen, 2004). The other common symptom is the swelling of the feet, especially the ankles. These symptoms can also be accompanied by sudden weight increase. However, these changes or symptoms can be a result of another condition. It is, therefore, advisable for individuals to contact a medical professional in case they notice these symptoms so that the doctor can examine the existence of CHF. Health professionals classify CHF depending on the severity of the symptoms that an individual has. They can use New York Heart Association (NYHA) scale to classify CHF with the focus being on the ability of individuals to carry out the physical activity (Mondoa, 2005).
Doctors usually examine pulse rate and blood pressure to assist them in properly diagnose the disease. The doctors can also examine the existence of conditions such as anemia, damage of kidneys and liver, or thyroid disease when diagnosing CHF (Mondoa, 2005). An X-ray on the chest can also be done to properly diagnose the disease. This is done to reveal pulmonary congestion and other abnormalities in the chest region. All individuals with suspected CHF should go for an echocardiogram to authenticate the diagnosis made (Sochalski, Jaarsma, Krumholz, Laramee McMurray, Naylor, Stewart, 2009). Treatment for CHF can be pharmacological or nonpharmacological. Nonpharmacological treatment usually involves lifestyle changes to enable easy management of the condition (Smiseth & Tendera, 2008).
Common Experiences of People with Chronic Heart Failure
Patients with chronic heart disease usually experience a lot of changes in their lives. CHF is considered to be a long-term condition and is thus associated with depression. Depression has been identified as a condition that accompanies many long-term conditions (Carrier, 2009). Thus, individuals with CHF are likely to experience depression. Individuals with depression frequently experience anxiety, and therefore individuals with CHF and are depressed are likely to experience anxiety too. Depression is also likely to make the symptoms of a long-term condition worse. This has the effect of making individuals seek health care services more frequently. This means that in case an individual has CHF and is depressed, the severity of CHF symptoms may increase and this will make the individual seek hospitalization more regularly (Sochalski et al., 2009). This is a critical provision when considered critically in various contexts.
Individuals with CHF are also likely to experience changes in their relationships. In cases when the CHF is severe, an individual may become dependent on other people. The individual may feel helpless as he or she may need assistance in doing most vital activities (Carrier, 2009). Social interactions may change due to adjustments that patients must undergo. Individuals with CHF may also feel rejected by their spouses. Dependency, helplessness, and changes in social interactions are likely to jeopardize relationships individuals have with their spouses (Carrier, 2009). In addition to these, individuals with CHF may experience a reduction in income. This may be related to either loss of work, reduction in social contacts, or lifestyle changes. This can further complicate a spousal relationship, especially during these hard economic periods.
The symptoms of CHF, especially fatigue, make individuals with the condition experience loss of motivation. This is mainly due to interference with the physical functioning of their bodies (Carrier, 2009). The low motivation of individuals also leads to interference with individuals’ work, family relationships, and social activities. Reduction in sexual activity is also experience individuals with CHF undergo. This is also a consequence of fatigue, a condition associated with CHF. In addition, psychological issues these individuals undergo can result in the reduction of sexual activities (Quinn, 2006). These psychological issues can be possibilities of further complication of the condition and loss of self-esteem. They can also be body changes and avoidance of discussions about sex with a partner (Carrier, 2009).
Social isolation is the other experience that individuals with CHF may undergo. Social isolation is likely to result from lifestyle changes and reduction in social interactions (Ng, Chan, Chan, Lee, Yau, Chan & Lau, 2006). These are due to the shortness of breath that they experience. The medication that these people take and fear can also be contributing factors to social isolation. Some of the individuals with CHF are likely not to be involved in social interactions due to their limited ability to participate, limited socialization opportunities, and discrimination due to dietary restrictions (Rosdahl & Kowalski, 2008). Social isolation is also experienced by these individuals due to pharmacological effects. Some of the medication results in frequent urination and this make these people prefer to stay at home (Ng, Chan, Chan, Lee, Yau, Chan & Lau, 2006). The medication can worsen the fatigue experienced and thus the inability to socialize regularly.
Additionally, patients with CHF experience fear. They live with the fear of death, pain, and their future life. Some experience fear of dying while they sleep and therefore prefer to stay awake. They also experience a sense of control loss. Sense of control is usually experienced when individuals feel they can direct the direction their lives take. However, individuals with CHF, they feel incapable of doing this (Johnson & Lehman, 2008).
Self Management Activities for Persons with Chronic Heart Failure
There are activities that people with CHF can engage in and those that they should not. This helps in the proper management of the condition (Francis, Feyer & Smith, 2007). The activities include actions that improve the health of patients, dietary behaviors and management of patients’ emotions (McAdam & Lewis, 2009). There is also self-management program that may be used in managing the condition. These programs are structured depending on experiences people with CHF undergo and are done within the setting of the community of individuals. The programs are also implemented and supervised by individuals who are experienced in managing CHF, have the condition, and are health or counseling professionals. Individuals with CHF are expected not to engage in alcohol drinking. This is because it can increase the severity of the condition. They should also not indulge in smoking and taking other drugs that can complicate their breathing capabilities (Hales, 2008).
Individuals with CHF should exercise to improve their physical abilities and the quality of their lives (Luckson, 2009). However, the intensity of exercise they do should be guided by the severity of symptoms. This depends on the classification of the condition on the NYHA scale. Those who do not have severe CHF conditions, (that is level 2 or 3 on the scale), can exercise. The symptoms they have dictate the limits within which they should exercise. The activities they can engage in include walking, running, playing less energy demanding games, and dancing among others.
Individuals with CHF can also get involved in sharing experiences with others to assist them in coping with the disease. They should engage in activities of support groups and attend their sessions. These are usually within the communities that they live in (Baliga, Pitt & Givertz, 2008). This shows that they have accepted the condition and are willing to adjust their lives. Sharing benefits these patients by enabling them to get support, psychologically, emotionally, and physically. Sharing their experiences enables them to obtain advice from people who had undergone the same (Baliga, Pitt & Givertz, 2008).
There are resources available for CHF patients in Australia with the main one being the National Heart Foundation (NHF). Through this, patients can obtain information and assistance (Chang & Johnson, 2008). There is also the Australian Chronic Disease Prevention Alliance (ACDPA), which is an alliance of health organizations that seek to reduce the prevalence of chronic diseases, including CHF (Chang & Johnson, 2008). In addition, there is also the Queensland Heart Failure Services, which is a community organization that aims at improving the quality of life of individuals with CHF in Australia. These Australian community organizations educate CHF patients, provide medication and provide training programs for health practitioners (Pearson, Cowie & Royal College of Physicians of London, 2005). In addition, they undertake research aiming at improving the management of the condition.
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