Heart failure (HF) is a heart disease suffered by approximately 2% of adults under 50 years of age, a figure that increases with age, being greater than 10% in those over 70 years of age. HF occurs when the heart muscle does not pump blood as well as it should. There are multiple causes that can weaken the heart and cause heart failure. When this happens, blood often backs up and fluid can build up in the lungs, abdomen, and legs. The ideal is to be able to resolve this fluid accumulation by using diuretics (urinary pills) on an outpatient basis, but there are situations in which the decompensation is more serious and requires hospital admission.
The moment of discharge from the hospital usually produces mixed feelings in patients: joy at having overcome the most critical moment for their health, but also uncertainty and insecurity about what the evolution will be like at home and what kind of life they will be able to lead. The transition after discharge from an admission for HF is perhaps the most delicate moment in the evolution of the disease, since patients who have suffered an admission due to HF decompensation are those with a higher risk of readmission, mainly in the first post-discharge month.
Although during hospitalization the responsible doctors usually and must provide information about the disease and the care that must be carried out on a daily basis, when the patient arrives home all kinds of doubts begin to arise about how to proceed. adapt your life to the new health situation and you are also worried about doing something that will cause it to worsen. In this sense, professionals dedicated to HF must place special emphasis on making patients feel safe and supported after discharge. For this reason, it is essential to carry out early and frequent outpatient follow-up, where in addition to assessing the medical aspects, it is used to resolve the usual doubts that both the patient and their family have and that are usually related to the prescribed medication (dosage, adverse effects …) and with lifestyle habits, mainly regarding diet and physical activity.
In the hospital, a very controlled lifestyle is followed, with a special diet, frequent blood pressure checks, little physical activity... Therefore, even if the medication administered during admission has been well tolerated, this condition can change once the patient recovers. is at home, making it necessary to modify the treatment or its regimen. In general, it is recommended to carry out an early control telephone consultation, 48-72 hours after discharge, to evaluate how the transition home has been and to verify that the medication is being taken correctly, without incidents. In addition, it is recommended to schedule an in-person review consultation, 7-10 days after discharge, preferably in a Heart Failure Unit.
Heart Failure Units represent an organizational model created to systematize the care of patients with HF. In them, the patient's role is encouraged and they are made to participate in their illness, promoting self-care through health education. It has been shown that knowledge of the disease by the patient improves their quality of life and prognosis. The optimal implementation of these programs for the management of HF requires a multidisciplinary team made up of several specialists, which is active throughout the entire trajectory of the patients' disease: from the onset of HF, the decompensations that occur during the course of their illness, the periods of apparent stability and the terminal stages. Furthermore, it is essential that patients have a fluid relationship with the professionals who make up the unit, so they must be provided with a telephone or email contact to which they can resort if their health condition worsens, in order to provide treatment and prevent needing a new hospital admission.
If you suffer from IC and have recently been hospitalized, do not hesitate to seek medical help, you are not alone in this process, there are many professionals who can help you!
By Dr. Teresa Alvarado