The heart of the matter: Clinic helps patients rise above congestive heart failure

Saturday, February 17, 2018

The term "heart failure" doesn't mean the heart is no longer working and there's no hope for improvement.

According to The American Heart Association, "the term heart failure ... means that the heart isn't pumping as well as it should be. With congestive heart failure (CHF), that lack of effective pumping can mean blood flow out of the heart slows, blood returning to the heart through the veins backs up, and causes congestion in the body's tissues. Swelling (edema) results. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath."

Mary Beth Corgan, MSN, APRN, FNP-BC, nurse practitioner for the Congestive Heart Failure Clinic and Heart Failure Program at Cardiovascular Consultants, agrees with the American Heart Association's assertion that "failure" doesn't mean there isn't anything more that can be done. In fact, she spends her days making sure that lots of things are done.

Corgan starts the morning doing rounds at the hospital, visiting with heart failure patients and preparing them for life at home after discharge, making sure they understand their medications, know when their appointments are, and checking to see if they have a scale, as gaining 2-3 pounds in 24 hours or 5 pounds within a week is a warning sign that fluid is accumulating. She lets them know that she will call and check in with them every two weeks for the first month after they leave the hospital. Then she moves on to the CHF Clinic at Cardiovascular Consultants.

All of the cardiologists there refer their patients to the clinic, which began three years ago as a way to prevent hospital re-admissions and to improve the quality of life of CHF patients. Open from 1 to 5 p.m. Monday through Friday, the clinic allows patients fast access to cardiac care. She can sometimes offer treatment over the phone, or get a patient in to the clinic that day for an IV treatment of a diuretic like Lasix. Some patients come see her every two to three weeks and others stop in monthly. Cardiologists' schedules can't accommodate such frequent visits for each patient.

While the cardiologists may focus on the biomedical aspects of the heart, Corgan tries to get to the heart of the matter with patients.

"There is a lot of education involved with CHF," she notes. "We need to make sure they keep following the directions of their cardiologist, taking their medications correctly, and maintaining a low-sodium diet and fluid restrictions. They also need to know the warning signs and symptoms that mean they need immediate attention."

Corgan describes how much she finds out by really talking with her patients.

"You can learn so much more about them when they come visit here than when they are in the hospital," she said.

She has observed that if she just asks, "Are you restricting your sodium?" they might say yes. But, if she asks them to list what they ate yesterday, she discovers where salt is sneaking into their diet.

"They don't have a salt shaker on the table and aren't adding salt to anything, but they are drinking tomato juice or eating canned green beans and not realizing how much sodium goes into those products."

While CHF is a chronic condition, patients are living longer with it, avoiding time in the hospital, and enjoying life more, thanks to advances in medicine and the efforts of providers like Corgan and the staff of the CHF clinic.

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