Congestive Heart Failure Program

The Congestive Heart Failure Program at Jersey Shore University Medical Center provides comprehensive services for heart failure patients In NJ. Our multidisciplinary team consists of state licensed, board certified nurse practitioners, who work closely with heart failure patients and their physicians to control symptoms and prevent future hospitalizations due to congestive heart failure.

What we do
We use a variety of methods to help congestive heart failure patients manage their recovery, including: telemonitoring calls, clinical visits, and, intravenous medication administration.

• Telemonitoring: These are telephone calls made to you by heart failure center staff. We call several times a week or as needed, to provide close symptom monitoring, dietary and medication compliance tracking, and ongoing education.



• Clinical Visits: The nurse practitioners encourage all patients to come to the Center. Our patients receive ongoing clinical evaluations, focusing on cardiovascular components, as well as psychosocial, economic, and spiritual concerns. The nurse practitioners order appropriate diagnostic and therapeutic interventions and consult members of Jersey Shore's multidisciplinary team for your care.



• Multidisciplinary Team Education: Our multidisciplinary team serves our diverse patient needs being composed of registered dieticians, clinical pharmacists, social workers, cardiac rehabilitation staff, advanced practice nurses in a variety of specialty areas, pastoral care, and doctors. We make sure that you know everything needed to be successful in controlling your heart failure symptoms.



• Infusion Services: Some patients, in addition to heart failure pills, require intermittent intravenous medication to control heart failure. Our infusion center provides these medicines to help maintain your heart health.

How to Enroll
Ask your physician for a referral if you are an appropriate candidate for our services. We work with your referring physician to keep a close eye on your symptoms while providing you with all of the information that you need to remain as healthy as possible.

Patient Education
Heart failure means that the heart has a mechanical problem that prevents sufficient blood to flow from the heart with each heart beat. When blood cannot be pumped forward, fluid and pressure backs up. Often the lungs become congested, and if the condition progresses, the fluid and pressure can back up to the liver, abdomen, and legs.

As a pump, the job of the heart is to push blood forward to feed all of the body's organs and tissues. When forward blood flow is low, organs do not receive enough oxygen rich blood and a cascade of chemical events occurs in the body.

The most common causes of heart failure include:

• Coronary artery disease and heart attack
• Heart muscle diseases
• High blood pressure
• Heart valve disease
• Infection of the heart valves or muscle
• Defects in the heart that are present at birth
• Severe lung disease
• Irregular heart beats or rhythms

Signs and Symptoms:

• Shortness of breath with exertion
• Shortness of breath at rest
• Shortness of breath that wakes you up at night
• Need for more pillows to be comfortable in bed
• Inability to sleep laying down
• Raspy breathing or wheezing
• Persistent cough
• Fatigue and/or weakness
• Dizziness or fainting
• Swollen feet, ankles, and/or legs
• Distended abdomen
• Loss of appetite
• Weight gain of two to three pounds overnight, or five pounds in a week
• Decreased urination or frequent night time urination

Diagnosis
Diagnosis is usually made through cardiac testing, and may include an echocardiogram, nuclear stress test, and/or cardiac catheterization.

• An echocardiogram is a non-invasive test that takes moving pictures of your heart with sound waves. It identifies problems with your heart structure or function.



• A nuclear stress test is designed to see how well your heart handles an increased work load and in this way, can identify if there is a lack of blood supply in the arteries that feed the heart muscle. If performed with a nuclear scan, diagnosis of inadequate heart function or heart failure can be made.



• A cardiac catheterization is a special X-ray test done to locate where a coronary artery is blocked. It can also assess the level of heart muscle function.

Treatment
Treatment for heart failure is based on the cause of disease. Regardless of the cause, low blood flow to the kidneys causes changes in the body chemistry. You will be more likely to retain salt and sodium preservatives. Salt and sodium in the body act like a sponge and soak up water. It is this extra water that strains your heart. Below are ways to improve your heart function:

• Sodium and salt ingestion: It is very important to keep salt and sodium ingestion low, under 2,000 mg daily, in most cases.
• Fluid restriction: For those to whom it is prescribed, maintaining fluid restriction will prevent further flooding of an already fluid overloaded heart.
• Rest and Activity: Alternating rest and activities will be less exhausting than moving steadily until you tire.
• Exercise: Get up and move regularly, increasing your duration of activity as tolerated.
• Daily weights: Monitor your daily weight and record the value. If you gain three pounds overnight, or five pounds in a week, notify your physician to adjust your medication, as appropriate.
• Medication: Remember to take every dose of every pill every day for best results. Missing one dose is all that may be needed to cause an unnecessary hospitalization.

Prevention is Key
Healthy heart living with lifestyle modification to include healthy eating habits and regular exercise helps to prevent coronary artery disease and heart attack. Early diagnosis and control of hypertension and diabetes mellitus, cessation of smoking and excessive alcohol or recreational drug use are essential strategies for prevention of chronic disease.

Clinical guidelines: for treatment of some forms of congestive heart failure are available at ACC.org or HFSA.org.

Ask the heart failure team: call 732-776-4196 for more information about our program in New Jersey.

Support group: The Congestive Heart Failure Program offers a Heart Failure Support Group. Please call the Heart Failure Center for more information on times and location.