Note: cardiac conditions are inherently unstable.Encyclopedia Entry for Heart :Heartland fever - Heartland virus (phlebovirus)- transmitted by lone star tick- only two reported cases in Northwest MissouriEncyclopedia Entry for Heart :Heart and vascular services. The heart's main job is to pump oxygen-rich blood to the body after it pumps oxygen-poor blood to the lungs. It normally does this 60 to 100 times a minute, 24 hours a day. The heart is made of four chambers: The right atrium receives oxygen-poor blood from the body. That blood then flows into the right ventricle, which pumps it to the lungs. The left atrium receives oxygen-rich blood from the lungs. From there, the blood flows into the left ventricle, which pumps blood out of the heart to the rest of the body. Together, the arteries and veins are referred to as the vascular system. In general, arteries carry blood away from the heart and veins carry blood back to the heart. The cardiovascular system delivers oxygen, nutrients, hormones, and other important substances to cells and organs in the body. It plays an important role in helping the body meet the demands of activity, exercise, and stress. It also helps maintain body temperature, among other things. CARDIOVASCULAR MEDICINE Cardiovascular medicine refers to the branch of health care that specializes in the treatment of diseases or conditions dealing with the heart and vascular systems. Common disorders include: Abdominal aortic aneurysm Congenital heart defects Coronary artery disease , including angina and heart attack Heart failure Heart valve problems High blood pressure and high cholesterol Irregular heart rhythms (arrhythmias) Peripheral artery disease (PAD) Stroke Physicians involved in the treatment of circulatory or vascular diseases include: Cardiologists: Doctors who have received extra training in the treatment of heart and vascular disorders Vascular surgeons: Doctors who have received extra training in blood vessel surgery Cardiac surgeons: Doctors who have received extra training in heart-related surgery Primary care doctors Other health care providers who are involved in the treatment of circulatory or vascular diseases include: Nurse practitioners (NPs) or physician assistants (PAs), who focus on heart and vascular diseases Nutritionists or dietitians Nurses who receive special training in the management of patients with these disorders Imaging tests that may be done to diagnose, monitor or treat diseases of the circulatory and vascular system include: Cardiac CT Cardiac MRI Coronary angiography CT angiography (CTA) and magnetic resonance angiography (MRA) Echocardiogram PET scan of the heart Stress tests (many different types of stress tests exist) Vascular ultrasound, such as carotid ultrasound Venous ultrasound of the arms and legs SURGERIES AND INTERVENTIONS Less invasive procedures may be done to diagnose, monitor or treat diseases of the heart and vascular system. In most of these types of procedures, a catheter is inserted through the skin into a large blood vessel. In most cases, such procedures do not need general anesthesia. Patients often do not need to stay in the hospital overnight. They recover in 1 to 3 days and can most often return to their normal activities within a week. Such procedures include: Ablation therapy to treat cardiac arrhythmias Angiogram (using x-rays and injected contrast dye to evaluate blood vessels) Angioplasty (using a small balloon to open a narrowing in a blood vessel) with or without stent placement Cardiac catheterization (measuring pressures in and around the heart) Heart surgery may be needed to treat certain heart or blood vessel problems. This may include: Heart transplant Insertion of pacemakers or defibrillators Open and minimally invasive coronary artery bypass surgery Repair or replacement of heart valves Surgical treatment of congenital heart defects Vascular surgery refers to surgical procedures that are used to treat or diagnose problems in a blood vessel, such as a blockage or rupture. Such procedures include: Arterial bypass grafts Endarterectomies Repair of aneurysms (dilated/enlarged portions) of the aorta and its branches Procedures may also be used to treat arteries that supply the brain, kidneys, intestines, arms and legs. CARDIOVASCULAR PREVENTION AND REHABILITATION Cardiac rehabilitation is therapy used to prevent heart disease from getting worse. It is usually recommended after major heart-related events such as a heart attack or cardiac surgery. It may include: Cardiovascular risk assessments Health screenings and wellness exams Nutrition and lifestyle counseling, including smoking cessation and diabetes education Supervised exercise.Circulatory system; Vascular system; Cardiovascular system.Bope ET, Kellerman RD. The cardiovascular system.Encyclopedia Entry for Heart :Heart attack - discharge. You were in the hospital because you had a heart attack. A heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. Acute MI.You may feel sad. You may feel anxious and as though you have to be very careful about what you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.You should know the signs and symptoms of angina. You may feel pressure, squeezing, burning, or tightness in your chest. You may also notice these symptoms in your arms, shoulders, neck, jaw, throat, or back. Some people also feel discomfort in their back, shoulders, and stomach area. You may have indigestion or feel sick to your stomach. You may feel tired and be short of breath, sweaty, lightheaded, or weak. You may have angina during physical activity, such as climbing stairs or walking uphill, lifting, sexual activity, or when you are out in cold weather. It can also happen when you are resting or it can wake you up when you are sleeping. Know how to treat your chest pain when it happens. Talk with your health care provider about what to do. Take it easy for the first 4 to 6 weeks. Avoid heavy lifting. Get some help with household chores if you can. Take 30 to 60 minutes to rest in the afternoon for first 4 to 6 weeks. Try to go to bed early and get plenty of sleep. Before starting to exercise , your provider may have you do an exercise test and recommend an exercise plan. This may happen before you leave the hospital or soon afterward. DO NOT change your exercise plan before talking with your provider. Your provider may refer you to cardiac rehabilitation program. There, you will learn how to slowly increase your exercise and how to take care of your heart disease. You should be able to talk comfortably when you are doing any activity, such as walking, setting the table, and doing laundry. If you cannot, stop the activity. Ask your provider about when you can return to work. Expect to be away from work for at least a week. Talk to your provider before engaging in sexual activity. Ask your provider when it is OK to start again. DO NOT take Viagra, Levitra, Cialis or any herbal remedy for erection problems without checking with your provider first. How long you will have to wait to return to your normal activities will depend on: Your physical condition before your heart attack The size of your heart attack If you had complications The overall speed of your recovery.DO NOT drink any alcohol for at least 2 weeks. Ask your provider when you may start. Limit how much you drink. Women should have only 1 drink a day, and men should have no more than 2 a day. Try to drink alcohol only when you are eating. If you smoke, stop. Ask your provider for help quitting if you need it. DO NOT let anybody smoke in your home, since second-hand smoke can harm you. Try to stay away from things that are stressful for you. If you are feeling stressed all the time, or if you are feeling very sad, talk with your provider. They can refer you to a counselor. Learn more about what you should eat to make your heart and blood vessels healthier. Avoid salty foods. Stay away from fast food restaurants.Have your drug prescriptions filled before you go home. It is very important that you take your drugs the way your provider told you to. DO NOT take any other drugs or herbal supplements without asking your provider first if they are safe for you. Take your medicines with water. DO NOT take them with grapefruit juice, since it may change how your body absorbs certain medicines. Ask your provider or pharmacist for more information about this. The medicines below are given to most people after they have had a heart attack. Sometimes there is a reason they may not be safe to take, though. These medicines help prevent another heart attack. Talk with your provider if you are not already on any of these medicines: Antiplatelets drugs (blood thinners), such as aspirin , clopidogrel (Plavix), warfarin (Coumadin), prasugrel (Efient), or ticagrelor (Brilinta) to help keep your blood from clotting. Beta-blockers and ACE inhibitor medicines to help protect your heart. Statins or other drugs to lower your cholesterol. DO NOT suddenly stop taking these medicines for your heart. DO NOT stop taking medicines for your diabetes, high blood pressure, or any other medical conditions you may have without talking with your provider first. If you are taking a blood thinner such as warfarin (Coumadin), you may need to have extra blood tests on a regular basis to make sure your dose is correct.Call your provider if you feel: Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw Shortness of breath Gas pains or indigestion Numbness in your arms Sweaty, or if you lose color Lightheaded Changes in your angina may mean your heart disease is getting worse. Call your provider if your angina: Becomes stronger Happens more often Lasts longer Occurs when you are not active or when you are resting Medicines do not help ease your symptoms as well as they used to.Myocardial infarction - discharge; MI - discharge; Coronary event - discharge; Infarct - discharge; Acute coronary syndrome - discharge; ACS - discharge.Acute MI Acute MI.Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718. Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):e354-e471. PMID: 23166211 www.ncbi.nlm.nih.gov/pubmed/23166211. Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation acute coronary syndromes.Encyclopedia Entry for Heart :Heart attack - what to ask your doctor. What are the signs and symptoms that I am having angina? Will I always have the same symptoms? What are the activities that can cause me to have angina? How should I treat my chest pain or angina when it happens? When should I call the doctor? When should I call 911? How much activity is ok for me? Can I walk around the house? Is it ok to go up and down stairs? When can I start light housework or cooking? How much can I lift or carry? How much sleep do I need? Which activities are better to start with? Are there activities that are not safe for me? Is it safe for me to exercise on my own? Should I exercise inside or outside? How long and how hard can I exercise? Do I need to have a stress test? Do I need to go to a cardiac rehabilitation program? When can I return to work? Are there limits on what I can do at work? What should I do if I feel sad or very worried about my heart disease? How can I change the way I live to make my heart healthier? What is a heart-healthy diet? Is it ok to ever eat something that is not heart healthy? How can I make heart-healthy choices when I go eat out? Is it OK to drink alcohol? How much? Is it OK to be around other people who are smoking? Is my blood pressure normal? What is my cholesterol? Do l need to take medicines for it? Is it OK to be sexually active? Is it safe to use sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) for erection problems? What medicines am I taking to treat angina? Do they have any side effects? What should I do if I miss a dose? Is it ever safe to stop taking any of these medicines on my own? If I am taking a blood thinner such as aspirin, clopidogrel (Plavix), can I use medicines such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) for arthritis, headaches, or other pain problems?.What to ask your doctor about your heart attack.Acute MI Acute MI.Anderson JL. St segment elevation acute myocardial infarction and complications of myocardial infarction.Encyclopedia Entry for Heart :Heart attack first aid. A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle becomes starved for oxygen and begins to die.Symptoms of a heart attack can vary from person to person. They may be mild or severe. Women, older adults, and people with diabetes are more likely to have subtle or unusual symptoms. Symptoms in adults may include: Changes in mental status, especially in older adults. Chest pain that feels like pressure, squeezing, or fullness. The pain is most often in the center of the chest. It may also be felt in the jaw, shoulder, arms, back, and stomach. It can last for more than a few minutes, or come and go. Cold sweat. Lightheadedness. Nausea (more common in women). Numbness, aching, or tingling in the arm (usually the left arm, but the right arm may be affected alone, or along with the left). Shortness of breath. Weakness or fatigue, especially in older adults and in women.If you think someone is having a heart attack: Have the person sit down, rest, and try to keep calm. Loosen any tight clothing. Ask if the person takes any chest pain medicine, such as nitroglycerin, for a known heart condition, and help them take it. If the pain does not go away promptly with rest or within 3 minutes of taking nitroglycerin, call for emergency medical help. If the person is unconscious and unresponsive, call 911 (or your local emergency number), then begin CPR. If an infant or child is unconscious and unresponsive, perform 1 minute of CPR, then call 911.Do NOT leave the person alone except to call for help, if necessary. Do NOT allow the person to deny the symptoms and convince you not to call for emergency help. Do NOT wait to see if the symptoms go away. Do NOT give the person anything by mouth unless a heart medicine (such as nitroglycerin) has been prescribed.Call 911 or your local emergency number immediately if the person: Does not respond to you Is not breathing Has sudden chest pain or other symptoms of a heart attack.Adults should take steps to control heart disease risk factors whenever possible. If you smoke, quit. Smoking more than doubles the chance of developing heart disease. Keep blood pressure, cholesterol, and diabetes in good control and follow your health care provider's orders. Lose weight if obese or overweight. Get regular exercise to improve heart health. (Talk to your provider before starting any new fitness program.) Eat a heart-healthy diet. Limit saturated fats, red meat, and sugars. Increase your intake of chicken, fish, fresh fruits and vegetables, and whole grains. Your provider can help you tailor a diet specific to your needs. Limit the amount of alcohol you drink. One drink a day is associated with reducing the rate of heart attacks, but two or more drinks a day can damage the heart and cause other medical problems.First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest.Heart attack symptoms Heart attack symptoms Symptoms of heart attack Symptoms of heart attack.Jneid H, Anderson JL, Wright RS, et al. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2012;60(7):645-681. PMID: 22809746 www.ncbi.nlm.nih.gov/pubmed/22809746. Kurz MC, Mattu A, Brady WJ. Acute coronary syndrome.Encyclopedia Entry for Heart :Heart attack. A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack may occur when: A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack. A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked. In either case, there is not enough blood flow to the heart muscle and heart muscle dies. The cause of heart attack is not always known. Progressive build-up of plaque in coronary artery Heart attack may occur: When you are resting or asleep After a sudden increase in physical activity When you are active outside in cold weather After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack.A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away. DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack. Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back Heart attack symptoms The pain can be severe or mild. It can feel like: A tight band around the chest Bad indigestion Something heavy sitting on your chest Squeezing or heavy pressure The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back. Other symptoms of a heart attack can include: Anxiety Cough Fainting Lightheadedness, dizziness Nausea and vomiting Palpitations (feeling like your heart is beating too fast or irregularly) Shortness of breath Sweating , which may be very heavy Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A 'silent heart attack' is a heart attack with no symptoms.A health care provider will perform a physical exam and listen to your chest using a stethoscope. The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur , or other abnormal sounds. You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low. You will have an electrocardiogram (ECG) to look for heart damage. Most of the time, certain changes on the ECG indicate you are having a heart attack. Sometimes these changes are not present, even though other tests indicate you have had a heart attack. This can be called non-ST elevation myocardial infarction (NSTEMI). A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. You will likely have this test 3 times over the first 6 to 12 hours. Coronary angiography may be done right away or when you are more stable. This test uses a special dye and x-rays to see how blood flows through your heart. It can help your doctor decide which treatments you need next. Other tests to look at your heart that may be done while you are in the hospital: Echocardiography with or with stress testing Exercise stress test Nuclear stress test Heart CT scan or heart MRI.IMMEDIATE TREATMENT You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen so that your heart doesn't have to work as hard. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats ( arrhythmias ) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet How to be active and exercise safely What to do when you have chest pain How to stop smoking Strong emotions are common after a heart attack. You may feel sad You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program.Many people benefit from taking part in support groups for people with heart disease.After a heart attack, you have a higher chance of having another heart attack. How well you do after a heart attack depends on several factors such as: The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attack If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening. Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you.Myocardial infarction; MI; Acute MI; ST - elevation myocardial infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack.Angioplasty and stent - heart - discharge Cholesterol - drug treatment Cholesterol - what to ask your doctor Heart attack - discharge Heart attack - what to ask your doctor Heart failure - what to ask your doctor High blood pressure - what to ask your doctor Taking warfarin (Coumadin, Jantoven) - what to ask your doctor Taking warfarin (Coumadin).Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Progressive build-up of plaque in coronary artery Progressive build-up of plaque in coronary artery Acute MI Acute MI Post myocardial infarction ECG wave tracings Post myocardial infarction ECG wave tracings Posterior heart arteries Posterior heart arteries Anterior heart arteries Anterior heart arteries Heart attack symptoms Heart attack symptoms Jaw pain and heart attacks Jaw pain and heart attacks.Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718. Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction.Encyclopedia Entry for Heart :Heart block. Heart block may be caused by: Medicine side effects. Heart block can be a side effect of digitalis, beta-blockers, calcium channel blockers, and other medicines. A heart attack that damages the electrical system in the heart. Heart diseases, such as heart valve disease and cardiac sarcoidosis. Some infections, such as Lyme disease. Heart surgery. You may have heart block because you were born with it. You are more at risk for this if: You have a heart defect. Your mother has an autoimmune disease, such as lupus.Talk to your health care provider about your symptoms. The symptoms are different for first, second, and third-degree heart block. You may not have any symptoms for first-degree heart block. You may not know you have heart block until it shows up on a test called an electrocardiogram (ECG). If you have second-degree or third-degree heart block, symptoms may include: Chest pain Dizziness Feeling faint Tiredness Heart palpitations -- Palpitations are when your heart feels like it is pounding, beating irregularly, or racing.Your provider will most likely send you to a heart doctor (cardiologist) to check for heart block. The cardiologist will talk to you about your medical history and the medicines you are taking. The cardiologist will also: Do a complete physical exam. The provider will check you for signs of heart failure, such as swollen ankles and feet. Do an ECG test to check the electrical signals in your heart. You may need to wear a heart monitor for 24 to 48 hours or longer to check the electrical signals in your heart.The treatment for heart block depends on the type of heart block you have and the cause. If you do not have serious symptoms and have a milder type of heart block, you will most likely need to: Have regular checkups with your provider. Check your pulse every day. Be aware of your symptoms and know when to call your provider if symptoms change. If you have second- or third-degree heart block, you may need a pacemaker to help your heart beat regularly. A pacemaker is smaller than a deck of cards and may be as small as a wristwatch. It is put inside the skin on your chest. It gives off electrical signals to make your heart beat at a regular rate and rhythm. Sometimes, if the heart block is expected to resolve in a day or so, a temporary pacemaker will be used. This type of device is not implanted in the body. Instead a wire may be inserted through a vein and directed to the heart and connected to the pacemaker. A temporary pacemaker may also be used in an emergency before a permanent pacemaker can be implanted. Heart block caused by a heart attack or heart surgery may go away as you recover. If medicine is causing heart block, changing medicines can fix the problem. DO NOT stop taking any medicine unless your provider tells you to do so.With regular monitoring and treatment, you should be able to keep up most of all of your usual activities.Heart block may increase the risk for: Other kinds of heart rhythm problems ( arrhythmias ), such as atrial fibrillation. Talk to your provider about symptoms of other arrhythmias. Heart attack. If you have a pacemaker, you cannot be near magnetic fields. You need to let people know that you have a pacemaker. DO NOT go through the usual security station at an airport, courthouse, or other place that requires people to walk through a security screening. Tell the security personnel you have a pacemaker and ask for an alternate type of security screening. DO NOT get an MRI without telling the MRI technician about your pacemaker.Call your provider if you feel: Dizzy Weak Faint Racing heart beat Skipped heart beat Chest pain Call your provider if you have signs of heart failure: Weakness Swollen legs, ankles, or feet Feel short of breath.AV Block; Arrhythmia; First-degree heart block; Second-degree heart block; Mobitz type 1; Wenckebach's block; Mobitz type II; Third-degree heart block; Pacemaker - heart block.Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. J AmColl Cardiol. 2013;61(3):e6-e75. PMID: 23265327 www.ncbi.nlm.nih.gov/pubmed/23265327. Olgin JE, Zipes DP. Specific arrhythmias: diagnosis and treatment.Encyclopedia Entry for Heart :Heart bypass surgery - discharge. Your surgeon took a vein or artery from another part of your body to create a detour, or bypass, around an artery that was blocked and could not bring enough blood to your heart. Your surgery was done through an incision (cut) in your chest. If the surgeon went through your breastbone, the surgeon repaired it with wire and a metal plate, and your skin was closed with stitches. You also had an incision made in your leg or arm, where the vein was taken to be used for the bypass.After surgery, it takes 4 to 6 weeks to completely heal and start feeling better. It is normal to: Have pain in your chest area around your incision Have a poor appetite for 2 to 4 weeks Have mood swings and feel depressed Have swelling in the leg that the vein graft was taken from Feel itchy, numb, or tingly around the incisions on your chest and leg for 6 months or more Have trouble sleeping at night Be constipated from pain medicines Have trouble with short-term memory or feel confused ('fuzzy-headed') Be tired or not have much energy Have some shortness of breath. This may be worse if you also have lung problems. Some patients may use oxygen when they go home. Have weakness in your arms for the first month.You should have someone stay with you in your home for at least the first 1 to 2 weeks after surgery. Learn how to check your pulse, and check it every day. Taking your carotid pulse Radial pulse Do the breathing exercises you learned in the hospital for 4 to 6 weeks. Shower every day, washing the incision gently with soap and water. DO NOT swim, soak in a hot tub, or take baths until your incision is completely healed. Follow a heart-healthy diet. If you feel depressed, talk with your family and friends. Ask your health care provider about getting help from a counselor. Continue to take all your medicines for your heart, diabetes, high blood pressure, or any other conditions you have. DO NOT stop taking any medicine without first talking with your provider. Your provider may recommend antiplatelet (blood-thinning) drugs such as aspirin , clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) to help keep your artery graft open. If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests to make sure your dose is correct. Know how to respond to angina symptoms.Stay active during your recovery, but start slowly. DO NOT stand or sit in the same spot for too long. Move around a little bit. Walking is a good exercise for the lungs and heart after surgery. DO NOT be concerned about how fast you are walking. Take it slow. Climbing stairs is OK, but be careful. Balance may be a problem. Rest halfway up the stairs if you need to. Light household chores, such as setting the table, folding clothes, walking, and climbing stairs, should be OK. Slowly increase the amount and intensity of your activities over the first 3 months. DO NOT exercise outside when it is too cold or too hot. Stop if you feel short of breath, dizzy, or any pain in your chest. DO NOT do any activity or exercise that causes pulling or pain across your chest, such as using a rowing machine or weight lifting. Keep your incision areas protected from the sun to avoid sunburn. DO NOT drive for at least 4 to 6 weeks after your surgery. The twisting involved in turning the steering wheel may pull on your incision. Ask your provider when you may return to work, and expect to be away from work for about 6 to 8 weeks. DO NOT travel for at least 2 to 4 weeks. Ask your provider when travel is OK. Also ask your provider before starting sexual activity again. Most of the time it is OK after 4 weeks. You may be referred to a formal cardiac rehabilitation program. You will get information and counseling regarding activity, diet, and supervised exercise.For the first 6 weeks after your surgery, you must be careful about using your arms and upper body when you move. DO NOT reach backward. DO NOT let anyone pull on your arms for any reason -- for instance, if they are helping you move around or get out of bed. DO NOT lift anything heavier than 5 to 7 pounds (2 to 3 kilograms). DO NOT do even light housework for at least 2 to 3 weeks. Check with your provider before using your arms and shoulder more. Brushing your teeth is OK, but DO NOT do other activities that keep your arms above your shoulders for any period of time. Keep your arms close to your sides when you are using them to get out of bed or a chair. You may bend forward to tie your shoes. Always stop if you feel pulling on your breastbone. Your provider will tell you how to take care of your chest wound. You will likely be asked to clean your surgical cut every day with soap and water, and gently dry it. DO NOT use any creams, lotions, powders, or oils unless your provider tells you it is OK. If you had a cut or incision on your leg: Keep your legs raised when sitting. Wear elastic TED hose for 2 to 3 weeks until the swelling goes away and you are more active.Call your provider if: You have chest pain or shortness of breath that does not go away when you rest. Your pulse feels irregular -- it is very slow (fewer than 60 beats a minute) or very fast (over 100 to 120 beats a minute). You have dizziness, fainting, or you are very tired. You have a severe headache that does not go away. You have a cough that does not go away You are coughing up blood or yellow or green mucus. You have problems taking any of your heart medicines. Your weight goes up by more than 2 pounds (1 kilogram) in a day for 2 days in a row. Your wound changes. It is red or swollen, it has opened, or there is more drainage coming from it. You have chills or a fever over 101 F (38.3 C).Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery bypass surgery - discharge; Coronary bypass surgery - discharge; CAD - bypass discharge; Coronary artery disease - bypass discharge.How to take your pulse How to take your wrist pulse Taking your carotid pulse Taking your carotid pulse.Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):3097-3137. PMID: 23166210 www.ncbi.nlm.nih.gov/pubmed/23166210. Fleg JL, Forman DE, Berra K, et al. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation. 2013;128(22):2422-2446. PMID: 24166575 www.ncbi.nlm.nih.gov/pubmed/24166575. Fraker TD Jr, Fihn SD; 2002 Chronic Stable Angina Writing Committee, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol. 2007;50(23):2264-2274. PMID: 18061078 www.ncbi.nlm.nih.gov/pubmed/18061078. Gopaldas RR, Chu D, Bakaeen FG. Coronary insufficiency.Encyclopedia Entry for Heart :Heart bypass surgery - minimally invasive - discharge. You had minimally invasive coronary artery bypass surgery on one or more of your coronary arteries. Your surgeon used an artery from your chest to create a detour, or bypass, around arteries that were blocked and could not bring blood to your heart. A 3- to 5-inch-long (7.5 to 12.5 centimeters) cut (incision) was made in the left part of your chest between your ribs. This allowed your doctor to reach your heart.You may be able to leave the hospital 2 or 3 days after surgery. You may also be able to return to normal activities after 2 or 3 weeks. After surgery, it is normal to: Feel tired. Have some shortness of breath. This may be worse if you also have lung problems. Some patients may use oxygen when they go home. Have pain in the chest area around the wound.You may want to have someone stay with you in your home for the first week. Learn how to check your pulse, and check it every day. Taking your carotid pulse Radial pulse Do the breathing exercises you learned in the hospital for the first 1 to 2 weeks. Weigh yourself every day. Shower every day, washing your incision gently with soap and water. DO NOT swim, soak in a hot tub, or take baths until your incision is completely healed. Follow a heart-healthy diet. If you are feeling depressed, talk with your family and friends. Ask your health care provider about getting help from a counselor. Continue to take all your medicines for your heart, diabetes, high blood pressure, or any other conditions you have. DO NOT stop taking any medicine without talking with your provider. Your provider may recommend antiplatelet drugs (blood thinners) -- such as aspirin , clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) -- to help keep your artery graft open. If you are taking a blood thinner such as warfarin (Coumadin), you may have extra blood tests to make sure your dose is correct. Know how to respond to angina symptoms.Stay active during your recovery, but start slowly. Ask your provider how active you should be. Walking is a good exercise after surgery. DO NOT worry about how fast you walk. Take it slow. Climbing stairs is OK, but be careful. Balance may be a problem. Rest halfway up the stairs if you need to. Light household chores, such as setting the table and folding clothes should be OK. Slowly increase the amount and intensity of your activities over the first 3 months. DO NOT exercise outside when it is too cold or too hot. Stop if you feel short of breath, dizzy, or any pain in your chest. Avoid any activity or exercise that causes pulling or pain across your chest, such as using a rowing machine or weight lifting. Keep your incision area protected from the sun to avoid sunburn. Be careful how you use your arms and upper body when you move around for the first 2 or 3 weeks after your surgery. Ask your provider when you may return to work. For the first week after surgery: DO NOT reach backward. DO NOT let anyone pull on your arms for any reason -- for instance, if they are helping you move around or get out of bed. DO NOT lift anything heavier than about 10 pounds (4.5 kilograms). (This is a little more than a gallon, or 4 liters, of milk.) Avoid other activities in which you need to keep your arms above your shoulders for any period of time. DO NOT drive. The twisting involved in turning the steering wheel may pull on your incision. You may be referred to a cardiac rehabilitation program. You will get information and counseling about activity, diet, and exercise.Call your provider if: You have chest pain or shortness of breath that does not go away when you rest. Your pulse feels irregular -- it is very slow (fewer than 60 beats a minute) or very fast (over 100 to 120 beats a minute). You have dizziness, fainting, or you are very tired. You have a severe headache that does not go away. You have a cough that does not go away. You are coughing up blood or yellow or green mucus. You have problems taking any of your heart medicines. Your weight goes up by more than 2 pounds (1 kilogram) in a day for 2 days in a row. Your wound is red or swelling, it has opened, or there is more drainage coming from it. You have chills or a fever over 101 F (38.3 C).Minimally invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole heart surgery - discharge; Coronary artery disease - MIDCAB discharge; CAD - MIDCAB discharge.Heart bypass surgery incision Heart bypass surgery incision Taking your carotid pulse Taking your carotid pulse Radial pulse Radial pulse.Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):3097-3137. PMID: 23166210 www.ncbi.nlm.nih.gov/pubmed/23166210. Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;58(24):e123-e210. PMID: 22070836 www.ncbi.nlm.nih.gov/pubmed/22070836. Omer S, Cornwell LD, Bakaeen FG. Acquired heart disease.Encyclopedia Entry for Heart :Heart bypass surgery - minimally invasive. To perform this surgery: The heart surgeon will make a 3- to 5-inch (8 to 13 centimeters) surgical cut in the left part of your chest between your ribs to reach your heart. Muscles in the area will be pushed apart. A small part of the front of the rib, called the costal cartilage, will be removed. The surgeon will then find and prepare an artery on your chest wall (internal mammary artery) to attach to your coronary artery that is blocked. Next, the surgeon will use sutures to connect the prepared chest artery to the coronary artery that is blocked. You will not be on a heart-lung machine for this surgery. However, you will have general anesthesia so you will be asleep and not feel pain. A device will be attached to your heart to stabilize it. You will also receive medicine to slow the heart down. You may have a tube in your chest for drainage of fluid. This will be removed in a day or two.Your doctor may recommend a minimally invasive coronary artery bypass if you have a blockage in one or two coronary arteries, most often in the front of the heart. When one or more of the coronary arteries become partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease or coronary artery disease. It can cause chest pain ( angina ). Your doctor may have first tried to treat you with medicines. You may have also tried cardiac rehabilitation or other treatments, such as angioplasty with stenting. Coronary artery disease varies from person to person. Heart bypass surgery is just one type of treatment. It is not right for everyone. Surgeries or procedures that may be done instead of minimally invasive heart bypass are: Angioplasty and stent placement Coronary bypass.Your doctor will talk to you about the risks of surgery. In general, the complications of minimally invasive coronary artery bypass are lower than with open coronary artery bypass surgery. Risks related to any surgery include: Blood clots in the legs that may travel to the lungs Blood loss Breathing problems Heart attack or stroke Infection of the lungs, urinary tract, and chest Temporary or permanent brain injury Possible risks of coronary artery bypass include: Memory loss, loss of mental clarity, or 'fuzzy thinking.' This is less common in people who have minimally invasive coronary artery bypass than in people who have open coronary bypass. Heart rhythm problems (arrhythmia). A chest wound infection. This is more likely to happen if you are obese, have diabetes, or have had coronary bypass surgery in the past. Low-grade fever and chest pain (together called postpericardiotomy syndrome), which can last up to 6 months. Pain at the site of the cut. Possible need to convert to conventional procedure with bypass machine during surgery.Always tell your doctor what drugs you are taking, even drugs or herbs you bought without a prescription. During the days before the surgery: For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. They include aspirin, ibuprofen (such as Advil and Motrin), naproxen (such as Aleve and Naprosyn), and other similar drugs. If you are taking clopidogrel (Plavix), ask your surgeon when you should stop taking it before surgery. Ask your doctor which drugs you should still take on the day of the surgery. If you smoke, try to stop. Ask your doctor for help. Contact your doctor if you have a cold, flu, fever, herpes breakout, or any other illness. Prepare your home so you can move around easily when you return from the hospital. The day before your surgery: Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. On the day of the surgery: You will most often be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the drugs your doctor told you to take with a small sip of water. Your doctor will tell you when to arrive at the hospital.You may be able to leave the hospital 2 or 3 days after your surgery. The doctor or nurse will tell you how to care for yourself at home. You may be able to return to normal activities after 2 or 3 weeks.Recovery from surgery takes time, and you may not see the full benefits of your surgery for 3 to 6 months. In most people who have heart bypass surgery, the grafts remain open and work well for many years. This surgery does not prevent a blockage from coming back. However, you can take steps to slow it down. Things you can do include: Do not smoke. Eat a heart-healthy diet. Get regular exercise. Treat high blood pressure, high blood sugar (if you have diabetes), and high cholesterol. You may be more likely to have problems with your blood vessels if you have kidney disease or other medical problems.Minimally invasive direct coronary artery bypass; MIDCAB; Robot-assisted coronary artery bypass; RACAB; Keyhole heart surgery; CAD - MIDCAB; Coronary artery disease - MIDCAB.Angina - discharge Angina - what to ask your doctor Angina - when you have chest pain Angioplasty and stent - heart - discharge Antiplatelet drugs - P2Y12 inhibitors Aspirin and heart disease Bathroom safety for adults Being active after your heart attack Being active when you have heart disease Butter, margarine, and cooking oils Cardiac catheterization - discharge Cholesterol and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass surgery - minimally invasive - discharge Heart disease - risk factors Heart pacemaker - discharge How to read food labels Low-salt diet Mediterranean diet Preventing falls Surgical wound care - open.Heart, front view Heart, front view Posterior heart arteries Posterior heart arteries Anterior heart arteries Anterior heart arteries Coronary artery stent Coronary artery stent Heart bypass surgery - series Heart bypass surgery - series.Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124(23):e652-e735. PMID: 22064599 www.ncbi.nlm.nih.gov/pubmed/22064599. Mick S, Keshavamurthy S, Mihaljevic T, Bonatti J. Robotic and alternative approaches to coronary artery bypass grafting.Encyclopedia Entry for Heart :Heart bypass surgery. Before your surgery, you will get general anesthesia. You will be asleep (unconscious) and pain-free during surgery. Once you are unconscious, the heart surgeon will make an 8 to 10-inch (20.5 to 25.5 cm) surgical cut in the middle of your chest. Your breastbone will be separated to create an opening. This allows your surgeon to see your heart and aorta, the main blood vessel leading from the heart to the rest of your body. Most people who have coronary bypass surgery are connected to a heart-lung bypass machine, or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart and lungs while your heart is stopped for the surgery. The machine adds oxygen to your blood, moves blood through your body, and removes carbon dioxide. Another type of bypass surgery does not use the heart-lung bypass machine. The procedure is done while your heart is still beating. This is called off-pump coronary artery bypass, or OPCAB. To create the bypass graft: The doctor will take a vein or artery from another part of your body and use it to make a detour (or graft) around the blocked area in your artery. Your doctor may use a vein, called the saphenous vein, from your leg. To reach this vein, a surgical cut will be made along the inside of your leg, between your ankle and groin. One end of the graft will be sewn to your coronary artery. The other end will be sewn to an opening made in your aorta. A blood vessel in your chest, called the internal mammary artery (IMA), can also be used as the graft. One end of this artery is already connected to a branch of your aorta. The other end is attached to your coronary artery. Other arteries can also be used for grafts in bypass surgery. The most common one is the radial artery in your wrist. After the graft has been created, your breastbone will be closed with wires. These wires stay inside you. The surgical cut will be closed with stitches. This surgery can take 4 to 6 hours. After the surgery, you will be taken to the intensive care unit.You may need this procedure if you have a blockage in one or more of your coronary arteries. Coronary arteries are the vessels that supply your heart with oxygen and nutrients that are carried in your blood. When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease, or coronary artery disease (CAD). It can cause chest pain ( angina ). Coronary artery bypass surgery can be used to improve blood flow to your heart. Your doctor may have first tried to treat you with medicines. You may have also tried exercise and diet changes, or angioplasty with stenting. CAD is different from person to person. The way it is diagnosed and treated will also vary. Heart bypass surgery is just one type of treatment. Other procedures that may be used: Angioplasty and stent placement Heart bypass surgery -- minimally invasive.Risks for any surgery include: Bleeding Infection Death Possible risks from having coronary bypass surgery include: Infection, including chest wound infection, which is more likely to happen if you are obese, have diabetes, or have already had this surgery Heart attack Stroke Heart rhythm problems Kidney failure Lung failure Depression and mood swings Low fever, tiredness, and chest pain, together called postpericardiotomy syndrome, which can last up to 6 months Memory loss, loss of mental clarity, or 'fuzzy thinking'.Always tell your health care provider what drugs you are taking, even drugs or herbs you bought without a prescription. During the days before your surgery: For the 1-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. They include aspirin, ibuprofen (such as Advil and Motrin), naproxen (such as Aleve and Naprosyn), and other similar drugs. If you are taking clopidogrel (Plavix), talk with your surgeon about when to stop taking it. Ask which drugs you should still take on the day of the surgery. If you smoke , try to stop. Ask your provider for help. Contact your provider if you have a cold, flu, fever, herpes breakout, or any other illness. Prepare your home so you can move around easily when you return from the hospital. The day before your surgery: Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. Make sure that you dry yourself off. On the day of the surgery: You will be asked not to drink or eat anything after midnight the night before your surgery. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take any medicines that you have been told to take with a small sip of water. You will be told when to arrive at the hospital.After the operation, you will spend 3 to 7 days in the hospital. You will spend the first night in an intensive care unit (ICU). You will probably be moved to a regular or transitional care room within 24 to 48 hours after the procedure. Two to three tubes will be in your chest to drain fluid from around your heart. They are most often removed 1 to 3 days after surgery. You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV) lines for fluids. You will be attached to machines that monitor your pulse, temperature, and breathing. Nurses will constantly watch your monitors. You may have several small wires that are connected to a pacemaker, which are pulled out prior to your discharge. You will be encouraged to restart some activities and you may begin a cardiac rehab program within a few days. It takes 4 to 6 weeks to start feeling better after surgery. Your providers will tell you how to take care of yourself at home after the surgery.Recovery from surgery takes time. You may not see the full benefits of your surgery for 3 to 6 months. In most people who have heart bypass surgery, the grafts stay open and work well for many years. This surgery does not prevent the coronary artery blockage from coming back. You can do many things to slow this process down, including: Not smoking Eating a heart-healthy diet Getting regular exercise Treating high blood pressure Controlling high blood sugar (if you have diabetes) and high cholesterol.Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - CABG.Angina - discharge Angina - what to ask your doctor Angina - when you have chest pain Angioplasty and stent - heart - discharge Antiplatelet drugs - P2Y12 inhibitors Aspirin and heart disease Bathroom safety for adults Being active after your heart attack Being active when you have heart disease Butter, margarine, and cooking oils Cardiac catheterization - discharge Cholesterol and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass surgery - discharge Heart disease - risk factors Heart pacemaker - discharge How to read food labels Low-salt diet Mediterranean diet Preventing falls Surgical wound care - open When you have nausea and vomiting.Heart, front view Heart, front view Posterior heart arteries Posterior heart arteries Anterior heart arteries Anterior heart arteries Atherosclerosis Atherosclerosis Heart bypass surgery - series Heart bypass surgery - series.Al-Atassi T, Toeg HD, Chan V, Ruel M. Coronary artery bypass grafting.Encyclopedia Entry for Heart :Heart CT scan. You will be asked to lie on a narrow table that slides into the center of the CT scanner. You will lie on your back with your head and feet outside the scanner on either end. Small patches, called electrodes are put on your chest and connected to a machine that records your heart's electrical activity. You may be given medicine to slow your heart rate. Once you are inside the scanner, the machine's x-ray beam rotates around you. A computer creates separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. 3D (three-dimensional) models of the heart can be created. You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time. The entire scan should only take about 10 minutes.Certain exams require a special dye, called contrast, to be delivered into the body before the test starts. Contrast helps certain areas show up better on the x-rays. Contrast can be given through a vein (IV) in your hand or forearm. If contrast is used, you may also be asked not to eat or drink anything for 4 to 6 hours before the test. Before receiving the contrast: Let your health care provider know if you have ever had a reaction to contrast or any medicines. You may need to take medicines before the test in order to safely receive this substance. Tell your provider about all your medicines, because you may be asked to hold some, such as the diabetes medicine metformin (Glucophage), prior to the test. Let your provider know if you have kidney problems. The contrast material can cause kidney function to worsen. If you weigh more than 300 pounds (135 kilograms), find out if the CT machine has a weight limit. Too much weight can cause damage to the scanner's working parts. You will be asked to remove jewelry and wear a hospital gown during the study.Some people may have discomfort from lying on the hard table. Contrast given through an IV may cause a: Slight burning sensation Metallic taste in the mouth Warm flushing of the body These sensations are normal and usually go away within a few seconds.CT rapidly creates detailed pictures of the heart and its arteries. The test may diagnose or detect: Plaque build-up in the coronary arteries to determine your risk for heart disease Congenital heart disease (heart problems that are present at birth) Problems with the heart valves Blockage of the arteries that supply the heart Tumors or masses of the heart Pumping function of the heart.Results are considered normal if the heart and arteries being examined are normal in appearance. Your 'calcium score' is based on the amount of calcium found in the arteries of your heart. The test is normal (negative) if your calcium score is 0. This means the chance of having a heart attack over the next 2 to 5 years is very low. If the calcium score is very low, you are unlikely to have coronary artery disease.Abnormal results may be due to: Aneurysm Congenital heart disease Coronary artery disease Heart valve problems Inflammation of the covering around the heart (pericarditis) Narrowing of one or more coronary arteries (coronary artery stenosis) Tumors or other masses of the heart or surrounding areas If your calcium score is high: It means you have calcium buildup in the walls of your coronary arteries. This is usually a sign of atherosclerosis, or hardening of the arteries. The higher your score, the more severe this problem may be. Talk to your provider about lifestyle changes you can make to decrease the risk of heart disease.Risks of CT scans include: Being exposed to radiation Allergic reaction to contrast dye CT scans do expose you to more radiation than regular x-rays. Having many x-rays or CT scans over time may increase your risk for cancer. However, the risk from any one scan is small. You and your provider should weigh this risk against the benefits of getting a correct diagnosis for a medical problem. Some people have allergies to contrast dye. Let your provider know if you have ever had an allergic reaction to injected contrast dye. The most common type of contrast given into a vein contains iodine. If a person with an iodine allergy is given this type of contrast, nausea or vomiting , sneezing , itching , or hives may occur. If you absolutely must be given such contrast, you may need to take steroids (such as prednisone) or antihistamines (such as diphenhydramine) before the test. You may also need to take a histamine blocker (such as ranitidine). The kidneys help remove iodine out of the body. Those with kidney disease or diabetes may need to receive extra fluids after the test to help flush the iodine out of the body. Rarely, the dye may cause a life-threatening allergic response called anaphylaxis. If you have any trouble breathing during the test, you should notify the scanner operator immediately. Scanners come with an intercom and speakers, so the operator can hear you at all times.CAT scan - heart; Computed axial tomography scan - heart; Computed tomography scan - heart; Calcium scoring; Multi-detector CT scan - heart; Electron beam computed tomography - heart; Agatston score; Coronary calcium scan.CT scan CT scan.Taylor AJ. Cardiac computed tomography.Encyclopedia Entry for Heart :Heart disease - resources. Resources - heart disease.Coronary artery blockage Coronary artery blockage Prevention of heart disease Prevention of heart disease.Encyclopedia Entry for Heart :Heart disease - risk factors. A risk factor is something about you that increases your chance of getting a disease or having a certain health condition. Some risk factors for heart disease you cannot change, but some you can. Changing the risk factors that you have control over may help you live a longer, healthier life.Some of your heart disease risks that you CANNOT change are: Your age. Risk of heart disease increases with age. Your gender. Men have a higher risk of getting heart disease than women who are still menstruating. After menopause, the risk for women gets closer to the risk for men. Your genes or race. If your parents had heart disease, you are at higher risk. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk for heart problems.Some of the risks for heart disease that you CAN change are: Not smoking. If you do smoke, quit. Controlling your cholesterol through diet, exercise, and medicines. Controlling high blood pressure through diet, exercise, and medicines, if needed. Controlling diabetes through diet, exercise, and medicines, if needed. Exercising at least 30 minutes a day. Keeping to a healthy weight by eating healthy foods, eating less, and joining a weight loss program, if you need to lose weight. Learning healthy ways to cope with stress through special classes or programs, or things like meditation or yoga. Limiting how much alcohol you drink to 1 drink a day for women and 2 a day for men. Good nutrition is important to your heart health and will help control some of your risk factors. Choose a diet rich in fruits, vegetables, and whole grains. Choose lean proteins, such as chicken, fish, beans and legumes. Choose low-fat dairy products, such as 1% milk and other low-fat items. Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods. Eat fewer animal products that contain cheese, cream, or eggs. Read labels, and stay away from 'saturated fat' and anything that contains 'partially-hydrogenated' or 'hydrogenated' fats. These products are usually loaded with unhealthy fats. Follow these guidelines and the advice of your health care provider to lower your chances of developing heart disease.Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk factors.Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guidelines on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922. Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology.Encyclopedia Entry for Heart :Heart disease and depression. Heart disease and depression are linked in a number of ways. Some symptoms of depression, such as lack of energy, can make it harder to take care of your health. People who are depressed may be more likely to: Drink alcohol, overeat, or smoke to deal with feelings of depression Not exercise Feel stress, which increases your risk for abnormal heart rhythms and high blood pressure. Not take their medicines correctly All of these factors: Increase your risk of having a heart attack Increase your risk of dying after a heart attack Increases the risk of being readmitted to the hospital Slow down your recovery after a heart attack or heart surgery.It is pretty common to feel down or sad after having a heart attack or heart surgery. However, you should start to feel more positive as you recover. If the sad feelings do not go away or more symptoms develop, do not feel ashamed. Instead, you should call your health care provider. You may have depression that needs to be treated. Other signs of depression include: Feeling irritable Having trouble concentrating or making decisions Feeling tired or not having energy Feeling hopeless or helpless Trouble sleeping, or sleeping too much A big change in appetite, often with weight gain or loss A loss of pleasure in activities you usually enjoy, including sex Feelings of worthlessness, self-hate, and guilt Repeated thoughts of death or suicide.Treatment for depression may depend on how severe it is. There are two main types of treatments for depression: Talk therapy. Cognitive behavioral therapy (CBT) is a type of talk therapy commonly used to treat depression. It helps you change thinking patterns and behaviors that might add to your depression. Other types of therapy may also be helpful. Antidepressant medicines. There are many kinds of antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are two of the most common used to treat depression. Your provider or therapist can help you find one that works for you. If your depression is mild, talk therapy may be enough to help. If you have moderate to severe depression, your provider may suggest both talk therapy and medicine.Depression can make it hard to feel like doing anything. But there are ways you can help yourself feel better. Here are a few tips: Move more. Regular exercise can help reduce depression. However, if you are recovering from heart problems, you should get your doctor's OK before starting to exercise. Your doctor may recommend joining a cardiac rehabilitation program. If cardiac rehab is not right for you, ask your doctor to suggest other exercise programs. Take an active role in your health. Studies show that being involved in your recovery and overall health can help you feel more positive. This includes taking your medicines as directed and sticking to your diet plan. Reduce your stress. Spend time each day doing things you find relaxing, such as listening to music. Or consider meditation, tai chi, or other relaxation methods. Seek social support. Sharing your feelings and fears with people you trust can help you feel better. It can help you better handle stress and depression. Some studies show it may even help you live longer. Follow healthy habits. Get enough sleep and eat a healthy diet. Avoid alcohol, marijuana, and other recreational drugs.Call 911, a suicide hotline, or go to a nearby emergency room if you have thoughts of harming yourself or others. Call your health care provider if: You hear voices that are not there. You cry often without cause. Your depression has affected your ability to participate in your recovery, or your work, or family life for longer than 2 weeks. You have 3 or more symptoms of depression. You think one of your medicines may be making you feel depressed. DO NOT change or stop taking any medicines without talking to your provider.Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350-1369. PMID: 24566200 www.ncbi.nlm.nih.gov/pubmed/24566200. Vaccarino V, Bremner JD. Psychiatric and behavioral aspects of cardiovascular disease.Encyclopedia Entry for Heart :Heart disease and diet. A healthy diet and lifestyle can reduce your risk for: Heart disease , heart attacks, and stroke Conditions that lead to heart disease, including high cholesterol , high blood pressure, and obesity Other chronic health problems, including type 2 diabetes , osteoporosis , and some forms of cancer This article makes recommendations that can help prevent heart disease and other conditions that can affect the health of your heart. People who currently have a heart condition, such as heart failure, or other health problems, such as diabetes, should talk with their health care provider about what type of diet is best. You may need to make certain changes to your diet that are not included in these recommendations.FRUITS AND VEGETABLES Fruits and vegetables are part of a heart-healthy diet. They are good sources of fiber , vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol. Eat 5 or more servings of fruits and vegetables per day. Get more fiber by eating whole fruits instead of drinking juice. Fruits and vegetables GRAINS Include whole wheat bread and pasta, brown rice, and starchy vegetables (such as peas, potatoes, corn, winter squash, and lima beans). These foods are high in the B vitamins, iron, and fiber. Choose whole grain foods (such as whole-wheat bread, cereal, crackers, and pasta or brown rice) for at least half of your daily grain intake. Grain products provide fiber, vitamins, minerals, and complex carbohydrates. Eating too many grains, especially refined gain foods (such as white bread, pasta, and baked goods) can cause weight gain. Limit high-fat baked goods such as butter rolls, cheese crackers, and croissants, and cream sauces for pasta. Avoid packaged snacks that contain partially hydrogenated oils or trans fats. EATING HEALTHY PROTEIN Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, B vitamins, iron, and other vitamins and minerals. Fish in diet You should: Limit high-fat proteins. These include meats such as duck, goose, prime cuts of steak, organ meats such as kidneys and liver, and prepared meats such as sausage, hot dogs, and high-fat lunch meats. Trim off all visible fat before cooking the meat. Eat at least 2 servings of low-mercury fish per week. Cook by baking, broiling, roasting, steaming, boiling, or microwaving instead of deep frying. For the main entree, use less meat or have meatless meals a few times a week. Get protein from plant-based protein foods instead. Use skinless turkey, chicken, fish, or lean red meat to reduce the amount of saturated fat in your diet. Milk and other dairy products are good sources of protein, calcium, the B vitamins niacin and riboflavin, and vitamins A and D. Use skim or 1% milk. Cheese, yogurt, and buttermilk should be low-fat or non-fat. FATS, OILS, AND CHOLESTEROL Some types of fat are healthier than others. A diet high in saturated and trans fats causes cholesterol to build up in your arteries (blood vessels). This puts you at risk for heart attack, stroke, and other major health problems. Avoid or limit foods that are high in these fats. Polyunsaturated and monounsaturated fats that come from vegetable sources have many health benefits. Obesity and health You should: Limit total fat intake to 25% to 35% of your total daily calories. The American Heart Association recommends eating a healthy diet that limits 5% to 6% of calories from saturated fat. Foods with a lot of saturated fats include animal products such as butter, cheese, whole milk, ice cream, sour cream, lard, and fatty meats such as bacon. Some vegetable oils (coconut, palm, and palm kernel oils) also contain saturated fats. These fats are solid at room temperature. Limit trans fats as much as possible by avoiding hydrogenated or partially hydrogenated fats. These are often found in packaged snacks and solid margarine. Eat less than 300 mg of dietary cholesterol each day. (One egg yolk contains an average of 184 mg of cholesterol.) Think about the following when choosing a margarine: Choose soft margarine (tub or liquid) over harder stick forms. Choose margarines with liquid vegetable oil as the first ingredient. Even better, choose 'light' margarines that list water as the first ingredient. These are even lower in saturated fat. Read the package label to choose a margarine that does not have trans fats. Trans fatty acids are unhealthy fats that form when vegetable oil undergoes hydrogenation. Trans fats can raise LDL (bad) cholesterol level in your blood. They can also lower your HDL (good) cholesterol level. To avoid trans fats, limit fried foods, commercial baked goods (donuts, cookies, and crackers), and hard margarines. OTHER TIPS TO KEEP YOUR HEART HEALTHY You may find it helpful to talk to a dietitian about your eating choices. The American Heart Association is a good source of information on diet and heart disease. Balance the number of calories you eat with the number you use each day to maintain a healthy body weight. You can ask your doctor or dietitian to help you figure out a good number of calories for you. Limit your intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that contain a lot of sugar. The American Heart Association recommends that sodium intake be no more than 2,300 milligrams (about 1 teaspoon, or 5 mg) a day with an ideal limit of no more than 1,500 mg per day for most adults. Cut down on salt by reducing the amount of salt you add to food when eating and cooking. Also limit packaged foods that have salt added to them, such as canned soups and vegetables, cured meats, and some frozen meals. Always check the nutrition label for the sodium content per serving and be sure to pay attention to the number of servings per container. Season foods with lemon juice, fresh herbs or spices instead. Foods with more than 300 mg of sodium per serving may not fit into a reduced sodium diet. Exercise regularly. For example, walk for at least 30 minutes a day, in blocks of 10 minutes or longer. Try to move at least 30 minutes most, if not all, days of the week. Limit the amount of alcohol you drink. Women should have no more than 1 alcoholic drink per day. Men should not have more than 2 alcoholic drinks each day. One drink is defined as 12 ounces (355 milliliters, mL) of beer, 5 ounces (148 mL) of wine, or a 1 1/2-ounce (44 mL) shot of liquor.Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet.Cholesterol - drug treatment.Healthy diet Healthy diet Fish in diet Fish in diet Fruits and vegetables Fruits and vegetables Obesity and health Obesity and health.Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922. Heimburger DC. Nutrition's interface with health and disease.Encyclopedia Entry for Heart :Heart disease and intimacy. Both you and your provider may be concerned that having sex will bring on a heart attack. Your provider can tell you when it is safe to have sex again. After a heart attack or heart procedure: You may have an exercise test, to see how your heart reacts to exercise. Sometimes, at least the first 2 weeks or so after a heart attack, your provider may advise avoiding sex. Make sure you know the symptoms that could mean your heart is working too hard. They include: Chest pain or pressure Feeling lightheaded, dizzy, or faint Nausea Trouble breathing Uneven or fast pulse If you have any of these symptoms during the day, avoid sex and talk to your provider. If you notice these symptoms during (or soon after) having sex, stop the activity. Call your provider to discuss your symptoms.After heart surgery or a heart attack, your provider may say it is safe to have sex again. But your health issues may change the way you feel about or experience sex and close contact with your partner. Besides being worried about having a heart attack during sex, you may feel: Less interested in having sex or being close with your partner Like sex is less enjoyable Sad or depressed Feel worried or stressed Like you are a different person now Women may have trouble feeling aroused. Men may have trouble getting or keeping an erection, or have other problems. Your partner may have the same feelings you are having and may be afraid to have sex with you.If you have any questions or concerns about intimacy, talk to your provider. Your provider can help you find out what is causing the problem and suggest ways to deal with it. It may not be easy to talk about such private things, but there may be a treatment that could help you. If you find it hard to talk to your heart doctor about these topics, talk to your primary care provider. If you are depressed, anxious, or afraid, medicine or talk therapy may help. Classes in lifestyle change, stress management, or therapy may help you, family members, and partners. If the problem is caused by side effects of medicine you are taking, that medicine may be adjusted, changed, or another medicine may be added. Men who have trouble getting or keeping an erection may be prescribed a medicine to treat this. These include medicines like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). The above medicines may not be safe if you are taking other medicine. DO NOT take them if you are taking nitroglycerin or nitrates. Taking both kinds of these medicines can lead to a life-threatening drop in blood pressure. DO NOT buy these medicines through the mail or another doctor who does not know your full health history. To get the right prescription, talk to the doctor who knows your health history and all the medicines you take.If you have new symptoms of heart trouble during sexual activity, stop the activity. Call your provider for advice. If the symptoms do not go away within 5 to 10 minutes, call 911.Levine GN, Steinke EE, Bakaeen FG, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2012;125(8):1058-1072. PMID: 22267844 www.ncbi.nlm.nih.gov/pubmed/22267844. Morrow DA, de Lemos JA. Stable ischemic heart disease.Encyclopedia Entry for Heart :Heart disease and women. CAD - women; Coronary artery disease - women.Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Acute MI Acute MI Healthy diet Healthy diet.Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130(19):1749-1767. PMID: 25070666 www.ncbi.nlm.nih.gov/pubmed/25070666. Gulati M, Bairey Merz CN. Cardiovascular disease in women.Encyclopedia Entry for Heart :Heart failure - discharge. You were in the hospital to have your heart failure treated. Heart failure occurs when the muscles of your heart are weak or have trouble relaxing, or both. Your heart is a pump that moves fluids through your body. As with any pump, if the flow out of the pump is not enough, fluids do not move well and they get stuck in places they should not be. In your body, this means that fluid collects in your lungs, abdomen, and legs. While you were in the hospital: Your health care team closely adjusted the fluids you drank or received through an intravenous (IV) line. They also watched and measured how much urine you produced. You may have received medicines to help your body get rid of extra fluids. You may have had tests to check how well your heart was working.Your energy will slowly return. You may need help taking care of yourself when you first get home. You may feel sad or depressed. All of these things are normal.Weigh yourself every morning on the same scale when you get up -- before you eat but after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it. Throughout the day, ask yourself: Is my energy level normal? Do I get more short of breath when I am doing my everyday activities? Are my clothes or shoes feeling tight? Are my ankles or legs swelling? Am I coughing more often? Does my cough sound wet? Do I get short of breath at night or when I lie down? If you are having new (or different) symptoms, ask yourself: Did I eat something different than usual or try a new food? Did I take all of my medicines the right way at the right times?.Your health care provider may ask you to limit how much you drink. When your heart failure is not very severe, you may not have to limit your fluids too much. As your heart failure gets worse, you may be asked to limit fluids to 6 to 9 cups (1.5 to 2 liters) a day. You will need to eat less salt. Salt can make you thirsty, and being thirsty can cause you to drink too much fluid. Extra salt also makes fluid stay in your body. Lots of foods that DO NOT taste salty, or that you DO NOT add salt to, still contain a lot of salt. You may need to take a diuretic, or water pill. DO NOT drink alcohol. Alcohol makes it harder for your heart muscles to work. Ask your provider what to do on special occasions where alcohol and foods you are trying to avoid will be served. If you smoke, stop. Ask for help quitting if you need it. DO NOT let anybody smoke in your home. Learn more about what you should eat to make your heart and blood vessels healthier. Avoid fatty foods. Stay away from fast-food restaurants. Avoid some prepared and frozen foods. Learn fast food tips. Try to stay away from things that are stressful for you. If you feel stressed all the time, or if you are very sad, talk with your provider who can refer you to a counselor.Have your entire drug prescriptions filled before you go home. It is very important that you take your drugs the way your health care provider told you to. DO NOT take any other drugs or herbs without asking your provider about them first. Take your drugs with water. DO NOT take them with grapefruit juice, since it may change how your body absorbs certain medicines. Ask your provider or pharmacist if this will be a problem for you. The drugs below are given to many people who have heart failure. Sometimes there is a reason they may not be safe to take, though. These drugs may help protect your heart. Talk with your provider if you are not already on any of these drugs: Antiplatelet drugs (blood thinners) such as aspirin , clopidogrel (Plavix), or warfarin (Coumadin) to help keep your blood from clotting Beta blocker and ACE inhibitor medicines to lower your blood pressure Statins or other drugs to lower your cholesterol Talk to your provider before changing the way you take your medicines. Never just stop taking these drugs for your heart, or any drugs you may be taking for Diabetes, high blood pressure, or other medical conditions you have. If you are taking a blood thinner, such as warfarin (Coumadin), you will need to have extra blood tests to make sure your dose is correct.Your provider may refer you to cardiac rehabilitation program. There, you will learn how to slowly increase your exercise and how to take care of your heart disease. Make sure you avoid heavy lifting. Make sure you know the warning signs of heart failure and of a heart attack. Know what to do when you have chest pain, or angina. Always ask your provider before starting sexual activity again. DO NOT take sildenafil (Viagra), or vardenafil (Levitra), tadalafil (Cialis), or any herbal remedy for erection problems without checking first. Make sure your home is set up to be safe and easy for you for you to move around in and avoid falls. If you are unable to walk around very much, ask your provider for exercises you can do while you are sitting.Make sure you get a flu shot every year. You may also need a pneumonia shot. Ask your provider about this. Your provider may call you to see how you are doing and to make sure you are checking your weight and taking your medicines. You will need follow-up appointments at your provider's office. You will likely need to have certain lab tests to check your sodium and potassium levels and monitor how your kidneys are working.Call your provider if: You gain more than 2 pounds (lb) (1 kilogram, kg) in a day, or 5 lb (2 kg) in a week. You are very tired and weak. You are dizzy and lightheaded. You are more short of breath when you are doing your normal activities. You have new shortness of breath when you are sitting. You need to sit up or use more pillows at night because you are short of breath when you are lying down. You wake up 1 to 2 hours after falling asleep because you are short of breath. You are wheezing and having trouble breathing. You feel pain or pressure in your chest. You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit. Your have swelling in your feet, ankles or legs. You have to urinate a lot, especially at night. You have stomach pain and tenderness. You have symptoms that you think may be from your medicines. Your pulse, or heartbeat, gets very slow or very fast, or it is not steady.Congestive heart failure - discharge; CHF - discharge; HF - discharge.Januzi JL, Mann DL. Clinical assessment of heart failure.Encyclopedia Entry for Heart :Heart failure - fluids and diuretics. When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you drink too many fluids, you may get symptoms such as swelling, weight gain, and shortness of breath. Limiting how much you drink and how much salt (sodium) you take in can help prevent these symptoms. Your family members can help you take care of yourself. They can keep an eye on how much you drink. They can make sure you are taking your medicines the right way. And they can learn to recognize your symptoms early. Your health care provider may ask you to lower the amount of fluids you drink: When your heart failure is not very bad, you may not have to limit your fluids too much. As your heart failure gets worse, you may need to limit fluids to 6 to 9 cups (1.5 to 2 liters) a day.Remember, some foods, such as soups, puddings, gelatin, ice cream, popsicles and others contain fluids. When you eat chunky soups, use a fork if you can, and leave the broth behind. Use a small cup at home for your liquids at meals, and drink just 1 cupful (240 mL). After drinking 1 cup (240 mL) of fluid at a restaurant, turn your cup over to let your server know you DO NOT want more. Find ways to keep from getting too thirsty: When you are thirsty, chew some gum, rinse your mouth with cold water and spit it out, or suck on something such as hard candy, a slice of lemon, or small pieces of ice. Stay cool. Getting overheated will make you thirsty. If you have trouble keeping track of it, write down how much you are drinking during the day. Eating too much salt can make you thirsty, which can make you drink too much. Extra salt also makes more fluid stay in your body. Many foods contain 'hidden salt,' including prepared, canned and frozen foods. Learn how to eat a low-salt diet.Diuretics help your body get rid of extra fluid. They are often called 'water pills.' There are many brands of diuretics. Some are taken 1 time a day. Others are taken 2 times a day. The three common types are: Thiazides: Chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hydrochlorothiazide (Esidrix, HydroDiuril), and metolazone (Mykrox, Zaroxolyn) Loop diuretics: Bumentanide (Bumex), furosemide (Lasix), and torasemide (Demadex) Potassium-sparing agents: Amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium) There are also diuretics that contain a combination of two of the drugs above. When you are taking diuretics, you will need to have regular checkups so that your provider can check your potassium levels and monitor how your kidneys are working. Diuretics make you urinate more often. Try not to take them at night before you go to bed. Take them at the same time every day. Common side effects of diuretics are: Fatigue, muscle cramps, or weakness from low potassium levels Dizziness or lightheadedness Numbness or tingling Heart palpitations, or a 'fluttery' heartbeat Gout Depression Irritability Urinary incontinence (not being able to hold your urine) Loss of sex drive (from potassium-sparing diuretics), or inability to have an erection Hair growth, menstrual changes, and a deepening voice in women (from potassium-sparing diuretics) Breast swelling in men or breast tenderness in women (from potassium-sparing diuretics) Allergic reactions -- if you are allergic to sulfa drugs, you should not use thiazides. Be sure to take your diuretic the way you have been told.You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body. Weigh yourself every morning on the same scale when you get up -- before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it. Call your provider if your weight goes up by more than 2 to 3 pounds (1 to 1.5 kilograms, kg) in a day or 5 pounds (2 kg) in a week. Also call your provider if you lose a lot of weight.Call your provider if: You are tired or weak. You feel short of breath when you are active or when you are at rest. You feel short of breath when you lie down, or an hour or two after falling asleep. You are wheezing and having trouble breathing. You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit. You have swelling in your feet, ankles, or legs. You have to urinate a lot, especially at night. You have gained or lost weight. You have pain and tenderness in your belly. You have symptoms that you think might be from your medicines. Your pulse, or heartbeat, gets very slow or very fast, or it is not steady.HF - fluids and diuretics; CHF - ICD discharge; Cardiomyopathy - ICD discharge.Januzi JL, Mann DL. Clinical assessment of heart failure.Encyclopedia Entry for Heart :Heart failure - home monitoring. Knowing your body and the symptoms that tell you your heart failure is getting worse will help you stay healthier and out of the hospital. At home, you should watch for changes in your: Blood pressure Heart rate Pulse Weight When watching out for warning signs, you can catch problems before they get too serious. Sometimes these simple checks will remind you that you forgot to take a pill, or that you have been drinking too much fluid or eating too much salt. Be sure to write down the results of your home self-checks so that you can share them with your health care provider. Your doctor's office may have a 'telemonitor,' a device you can use to send your information automatically. A nurse will go over your self-check results with you in a regular (sometimes weekly) phone call. Throughout the day, ask yourself: Is my energy level normal? Am I getting more short of breath when I am doing my everyday activities? Are my clothes or shoes feeling tight? Are my ankles or legs swelling? Am I coughing more often? Does my cough sound wet? Do I get short of breath at night? These are signs that there is too much fluid building up in your body. You will need to learn how to limit your fluids and salt intake to prevent these things from happening.You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body. Weigh yourself every morning on the same scale when you get up -- before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it. Call your provider if your weight goes up by more than 3 pounds (about 1.5 kilograms) in a day or 5 pounds (2 kilograms) in a week. Also call your provider if you lose a lot of weight.Know what your normal pulse rate is. Your provider will tell you what yours should be. You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of your other hand to find your pulse. Use a second hand and count the number of beats for 30 seconds. Then double that number. That is your pulse. Radial pulse Your provider may give you special equipment to check your heart rate.Your provider may ask you to keep track of your blood pressure at home. Make sure you get a good quality, well-fitting home device. Show it to your doctor or nurse. It will probably have a cuff with a stethoscope or a digital readout. Practice with your provider to make sure you are taking your blood pressure correctly. Blood pressure Watch this video about: Blood pressure.Call your provider if: You are tired or weak. You feel short of breath when you are active or when you are at rest. You have shortness of breath when you lie down, or an hour or two after falling asleep. You are wheezing and having trouble breathing. You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit. You have swelling in your feet, ankles, or legs. You have to urinate a lot, especially at night. You have gained or lost weight. You have pain and tenderness in your belly. You have symptoms you think might be from your medicines. Your pulse or heartbeat gets very slow or very fast, or it is not regular. Your blood pressure is lower or higher than is normal for you.HF - home monitoring; CHF - home monitoring; Cardiomyopathy - home monitoring.Radial pulse Radial pulse.Januzzi JL, Mann DL. Clinical assessment of heart failure.