Mercy Fort Smith nurse practitioner Janice Sudbrink doesn’t want to see the “failure” in heart failure. That’s why she works to educate patients experiencing congestive heart failure on how they can change their lifestyle and take steps toward a healthier future.
Congestive heart failure is a condition where heart function is reduced. It’s also a condition that often can be prevented, and through cardiac rehabilitation, patients can continue to live a normal life.
Sudbrink said some of the first signs of congestive heart failure include shortness of breath, fatigue and swelling.
“People usually come to the emergency room because they can’t breathe,” she said. “They’ll say, ‘I’ve noticed I’ve gained weight in the last two weeks or three weeks.' Then, they’ll notice their legs and abdominal area will get a lot of swelling. They even have a hard time walking across the room.”
Patients will be tested to determine the type of heart failure they may have. Systolic heart failure occurs when heart function is reduced and the heart can’t pump properly. Diastolic heart failure is a thickening of the heart to the point where it can’t fill properly. Tests could include an echocardiogram or heart catherization.
“Once we get a working diagnosis, then we go ahead and make sure that their medications are appropriate for their diagnosis. And then we monitor them very closely,” Sudbrink said.
Patients can also get an initial diagnosis from their primary care doctor, many of whom can do an outpatient echocardiogram. Once they see the patient has a diagnosis, they can be referred to a cardiology clinic.
“A lot of these patients become acutely ill, just because their heart suddenly fails and they end up in the emergency room. But usually, the family doctor can diagnose it and refer it out,” Sudbrink said.
Cardiac rehabilitation begins about six weeks after diagnosis. Patients learn more about diet, exercise and general well-being while their heart function is monitored. Sudbrink helps educate heart patients while making sure they’re following the appropriate protocols for congestive heart failure. Some lifestyle changes may include a low-sodium diet, reduced fluid intake and medication.
“Usually, I follow them pretty closely for about two to three months,” she said. Once a patient improves, he or she is sent back to their family doctor for checkups or to follow up with their cardiologist.
Sudbrink called caring for a patient with congestive heart failure a “combination effort.”
“We teach them how to manage their congestive heart failure,” she said. “On the other hand, they have to do their part and follow up with the guidelines. A lot of our patients, it’s more about education and how to take care of themselves when I see them in our congestive heart failure clinic.”
Risk factors for congestive heart failure can include a variety of things, including hypertension, diabetes, congenital defects or viral infections. Sudbrink said cancer patients undergoing chemotherapy or radiation treatments can have heart failure, even several years later. Women sometimes experience heart failure during pregnancy.
Congestive heart failure can affect both men and women equally, Sudbrink said.
“These patients can get better; they can improve,” Sudbrink said. “We can help them improve their symptoms. You develop a relationship with these patients who you see on a regular basis until they can get better.
“I don’t like the term ‘failure,’ because it sounds like their life can’t improve. There are a lot of good interventions and medications that can help them get better and lead a quality life.”
Learn more about Mercy's cardiac rehabilitation program here.