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Heart Failure Program

What is Heart Failure?

Heart failure is a condition where the heart is unable to pump blood as well as it should. It does not mean that your heart has stopped working. The heart simply isn't filling with enough blood (diastolic failure) or pumping with enough force (systolic failure) or both. When the heart cannot efficiently pump, blood backs up into the lungs. The resulting fluid collection is responsible for congestion and breathing difficulties. Blood may also collect in veins, especially in the lower extremities, and cannot circulate into tissues. Heart failure usually develops slowly over time. The heart tries to adjust to this by stretching to hold more blood or thickening the wall muscles to pump stronger, but eventually the heart becomes unable to keep up.

One of the most important tests in the diagnosis of Heart Failure is an echocardiogram (echo).  Your EF (ejection fraction) is the percentage of blood being ejected from your heart each time it beats.  A healthy heart has an EF (ejection fraction) of around 60%, while those with Heart Failure most commonly have an EF of 40% or less. CHI Health Good Samaritan has partnered with CHI Health Nebraska Heart to treat heart failure.

Symptoms to Watch for

  • Excessive weakness, fatigue and loss of energy
  • Shortness of breath, especially when lying down
  • Frequent dry, hacking cough
  • Swelling or bloating of the abdomen
  • Swelling of the feet, ankles and legs
  • Weight gain
  • Confusion, can't think clearly
  • Lack of appetite and nausea
  • Increased heart rate

Reasons to Call your Doctor

  • Symptoms are Worsening
  • You gain 3 or more pounds in one day or gain 5 or more pounds in a week
  • Noticeable swelling or bloating
  • Difficulty breathing with activity and when resting
  • Feeling more tired than usual
  • Fever
  • Dry, hacking cough
  • Trouble sleeping (waking up short of breath, using more pillows)


  • Symptoms are Severe
  • Struggling to breathe
  • Unrelieved shortness of breath while sitting still
  • Fainting
  • Chest pain not relieved by nitroglycerin
  • Confusion, can't think clearly
  • Persistent coughing to wheezing
  • Coughing up pink, foaming mucus
  • Feeling that heart is racing


  • Obtain an accurate scale
  • Keep a record of your daily weight
  • Weigh yourself in the morning before breakfast
  • Wear the sameclothing when you are weighing
  • Call your healthcare provider if:
  • you gain 3 or more pounds in one day
  • or gain 5 or more pounds in a week
  • Rapid weight gain may be a sign your body is retaining fluid and may indicate a need for a change in your treatment plan

Watch your Diet

  • Keep track of your daily sodium intake
  • Eat a healthy diet that's low in sodium and saturated fat
  • Read food labels and avoid foods high in salt or sodium
  • Do not use table salt on food or in cooking
  • Add flavor to food with herbs, spices or lemon juice
  • Ask your doctor before using a salt substitute
  • Limit alcohol use
  • Follow your Doctor's directions about how much liquid to drink.


  • Take your medications every day
  • Never skip doses
  • Continue taking medications even when you are feeling well
  • Carry a list of your medications with you at all times
  • Call your pharmacy at least one week in advance to refill Prescriptions
  • Call you doctor before taking over the counter medications
  • Call your doctor before stopping any medications 

Stay Active

  • Talk to your doctor before you start exercising
  • Get regular activity and exercise: you'll feel better
  • Activity is anything that you do: work, play, an exercise program, sexual activity, etc.
  • Exercise: a regular program of walking, biking, swimming, etc.
  • Exercise does not have to be strenuous to be beneficial
  • Go for a walk; visit a friend; do some gardening
  • Know your limits
  • Stop and rest if you feel tired or short of breath

 Related Information
 Instruction Sheet
 Home Monitoring for Heart Failure


Heart Failure Program 
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