Resource for Heart Failure


Below is some of the content from the above listed web site. It is a great resource for helping heart patients to understand the warning signs of heart failure and the actions to take. If you are a heart patient, or the significant other/caregiver take the time to review this site. It is important sometimes the symptoms sneak up on you.



Heart failure can be managed well with the right treatment and lifestyle adjustments, as recommended by your doctor or nurse. However, it is important to monitor all your symptoms on a regular basis as heart failure can progress slowly.


You can use the list on the left or any of the links below to learn more about the symptoms you should be monitoring and what to do if they get worse.


You should call for help immediately if you experience:


Persistent Chest pain that is not relieved by glyceryl trinitrate (GTN / nitroglycerin)

Severe and persistent shortness of breath



You should inform your doctor as soon as possible if you experience:


Increasing shortness of breath


Frequent awakenings due to shortness of breath


Needing more pillows to sleep comfortably


Rapid heart rate or worsening palpitations


And you should discuss any of the symptoms below with your doctor or nurse.


Rapid weight gain


Progressive swelling or pain in the abdomen


Increased swelling of the legs or ankles


Loss of appetite/nausea


Increasing fatigue


Worsening cough


To help you monitor your symptoms, please click on the links below to find useful resources that you can download, print and fill in. You can then take these with you when you see your doctor or nurse and discuss your symptoms.


Symptom and event diary


Monitoring your heart failure chart


Warning signs leaflet




Infection Prevention MRSA

Infection Travel Safety Tips For Summer


Heart patients be alert for signs of infection. Immune systems are often compromised following hospitalizations. Protect your open wounds. Here are some very helpful tips to prevent one of the more challenging infections routinely seen postoperatively, MRSA. At the first sign of infection be sure to be seen by your primary care doctor and/or cardiologist. 

Exercising with heart disease

Start slow and add a little more over time. Make it feel  as if when finished feel like you could have done more easily. Begin exercising at this intensity for several sessions before making large increases in your intensity or effort required to be physically active. . Remember the whole goal is to adapt, and by doing so the body is changing how it responds. In the early recovery stage  the exercise prescription is very light. Do you know What exercise prescription is best for you?

Since exercise should be part of your everyday routine in order to make it a lifelong habit  injury avoidance is important to be aware of overuse signs and symptoms, to rest those muscles when needed.  Occasionally cardiovascular disease patients develop Peripheral Artery Disease and symptoms can present similarly to overuse. Pain should signal the body to be aware that something is going on.  Take some time to evaluate that pain, what happens with it, does it always come on at a certain time or point of the exercise or activity? How long does it take to go away? Can it be avoided while being active by another means for instance switching from walking to biking?  Make sure you communicate these findings with your healthcare practitioner as they could be signals of other health conditions related to heart disease and it’s recovery.

Some exercise and activity is better than none, so start slowly. Even a warmup is better than no exercise session here is why  warming up before strenuous activity helps your heart.

Don’t expect results overnight, but do take small steps each day. Move that blood around, push it through the muscles. Make the muscles use the oxygen in the blood  more efficiently. Exercise helps the the heart recover and stay strong.

You might not notice any big changes—especially in your weight—for a few weeks or even months. It is still good for your heart health! It is not all about weight loss. Forget the scale for a while. In fact many who initially start to exercise following hospitalization are  Sedentary at the start and will gain a couple of pounds. It is their muscles getting pumped up, holding and utilizing more blood flow. Generally the focus on how you feel.

 When not to exercise is if you are presenting with Signs and symptoms of heart problems. Exercise should be avoided if  if you are presenting with congestive heart failure, or are presently sick. When returning to exercise following illness 

Symptoms to be alert for include these.

Infection Prevention

Does your Cardiac Rehabilitation program ensure your leads are clean each time you place them by your fresh wound from open heart surgery?

Do you clean them or does the staff? Infection prevention is important. You are your best advocate for infection prevention. The same goes for the exercise equipment, how do you ensure that the equipment is safe? Do you clean it prior and post exercise or does the staff? Do you trust the person before you cleaned it  thoroughly?

 It is important that everyone take a role in infection control and prevention.

MRSA, C-Diff, Staph Aureus,  VRE are common hospital acquired infections many patients are being treated for these yet may still carry the bugs to the outpatient clinics.  Do your part the next time you are in either inpatient or outpatient. Demand the equipment is cleaned regularly, and ask questions. It is OK  you may feel you are frustrating the healthcare worker, but it is your life and quality of recovery that suffers which is much more important than their feelings. 

Smoking effects results of coronary artery bypass surgery

Patients requiring bypass surgery should immediately quit smoking

Key Points

• Smoking causes dysregulation of enzymes in leg vein used for coronary bypass grafts.

• Smoking cessation does not completely return vein health to normal, even after 1 year.

• Patients who may require bypass surgery should stop smoking immediately to help preserve health and function of graft.

Newswise — Chicago—Smoking cessation even a year prior to coronary artery bypass grafting (CABG) surgery does not fully normalize the changes smoking has made to the saphenous (leg) veins used for the surgery and may lead to later graft failure, according to a study published in the January 2013 issue of The Annals of Thoracic Surgery.

Sun Yongxin, MD and colleagues from Zhongshan Hospital at Fudan University in Shanghai, China, analyzed heart surgery outcomes in 208 patients undergoing elective CABG surgery. After dividing the patients into six groups based on the current quantity smoked and previous smoking status, the researchers found that heavy smoking noticeably increased matrix metalloproteinase enzyme levels in the saphenous vein. These enzymes have been linked to vein graft failure.

The researchers also found that while dysregulation of enzymes may gradually normalize after smoking cessation, a noticeable vein recovery needs at least 6 months, and vein enzymes do not completely return to normal levels even after 1 year.

“Although recovery after smoking cessation appears somewhat disappointing, it illustrates exactly the importance of prompt smoking cessation for patients who will receive CABG,” the researchers wrote.

The ultimate goal of CABG is to achieve complete revascularization with conduits that will remain open for the duration of the patient’s lifetime.

About 1.1 billion people— one in every three adults—are smokers, according to the World Health Organization. China is the world’s largest producer and consumer of cigarettes with more than 350 million residents reporting being current or former smokers.

Understanding Smoking’s Effects May Lead to Treatment Changes
Greater saphenous vein grafts are the most commonly used vessels for CABG surgery. Although the study identifies smoking as a significant risk factor for vein graft failure, the exact mechanisms of this relationship are not entirely understood.

“[This study] may provide the evidence for encouraging the use of more arterial grafts [rather than vein grafts] when heavy smokers undergo CABG,” wrote the authors.

In an accompanying invited commentary in The Annals, Shahab A. Akhter, MD, from the University of Chicago Medicine, said understanding more about how enzymes affect the durability of saphenous vein grafts may lead to new therapies for heart surgery patients with a history of smoking.

In the meantime, Dr. Akhter promoted the value of not smoking. “Smoking cessation is important to maintain cardiovascular health in a preventative manner and also to maximize the results of bypass surgery in patients who will benefit from this operation,” he said.

Cardiac Surgery Patients: Think Posture!

If you just had your chest recently surgically opened, the last thing you want to think about is stretching, but after time it becomes very important. You may not physically remember the pain of surgery but your body does. It gradually rounds the shoulders forward, the head is carried slightly more forward, and these changes make the subtle curve in the low back gradually flatten. Many patients when they first attend cardiac rehabilitation complain of pain and spasm to their upper back and shoulders. When I worked in physical therapy I would have many patients present several years after open heart surgery with low back pain. Many had the characteristic posture I described above.

Here are a few suggestion to help you in the healing process.

Be very aware of your posture – if you are sore, think about what posture you are in. Are you seated with your shoulders slumped and head forward? If so adding a lumbar support to your chair will help to straighten your back posture. Another suggestion is to get up and move more frequently.

Pain in the shoulder blade region?

If so begin with gentle chest stretching and shoulder stretching. It is very important you avoid pain. I usually wait until my patients are approximately 6 weeks in recovery before initiating this. Do not take any stretch to pain. Do not bounce stretches.

There are three different postures to get the different muscle groups of the chest. One leg is forward simply to maintain the curve of the low back. Hold the stretch 10 to 15 seconds, repeat 1-2 times. It is ok to do this stretch a few times per day.

   These are other good stretches for the chest

Upper back stretching

The muscles act very similar to pulleys. If one side shortens the other side lengthens. If the muscles of the chest are short the muscles of the upper back are stretched. Prolonged stretch leads to muscle spasm, and this makes many people feel like they have knots in their upper back. There is a great stretch for this.


Reach down grasp opposite knee with hand (left hand grasp right knee). Relax your head pull up gently, hold 10-15 seconds. Repeat with opposite hand/knee. repeat one to two times.

Use a lumbar support in your favorite chair, while driving, or sitting for a prolonged time. You can either purchase one at your local medical supply/pharmacy, or you can simply roll up a small towel and put it in the small of your low back.