What heart and blood pressure follow-up covers
High blood pressure, heart failure, atrial fibrillation and coronary artery disease are managed with medication, daily habits and regular check-ins, usually by a primary care clinician working with a cardiologist.
Blood pressure and heart follow-up at home brings those check-ins to people who struggle to reach an office. A Gateway clinician measures, examines and updates the plan. Gateway arranges the visit and keeps the other members of the care team informed.
What the clinician checks at a visit
The treating clinician decides what is needed. A visit commonly includes:
- Blood pressure and pulse, sometimes taken standing as well as sitting
- Weight, compared with previous visits
- Listening to the heart and lungs
- Looking at the legs, ankles and feet for swelling and skin changes
- Reviewing home readings and symptoms such as breathlessness, tiredness or dizziness
- Going through medications and any side effects
How the heart affects swelling and skin
When the heart does not pump as strongly as it should, fluid can back up in the body. Gravity pulls it to the feet, ankles and lower legs. Kidney disease, vein problems and some medications cause swelling too, and several causes often overlap.
Swollen skin is stretched, fragile and slow to heal. It can blister, weep clear fluid or break open after a minor bump. Our guide on heart failure, swelling and skin explains this in plain terms, and the page on leg swelling and weeping skin describes how those skin problems are cared for.
Why wound care and heart care need to talk
Compression wraps and stockings are a standard treatment for many leg wounds, but they move fluid back toward the heart and are not right for everyone. The clinician decides whether compression therapy is appropriate and how firm it should be, and that decision depends on knowing the state of the heart and the arteries.
It works the other way as well. If a clinician adjusts a water pill, leg swelling may change, and the wound plan may need to change with it. Gateway passes these updates between the wound care clinician and the clinician managing the heart condition, so neither is working from old information.
What to track between visits
Ask your clinician which of these to record and which numbers should prompt a call:
- Blood pressure, taken seated and rested, at the times your clinician suggests
- Weight, each morning on the same scale, if you have heart failure
- Swelling in the feet, ankles, legs or belly
- Breathing, including how many pillows you need to sleep
Some practices offer remote patient monitoring, where a cuff or scale sends readings to the practice. Others enroll patients in chronic care management for check-ins between visits. A written log works too.
What Gateway arranges
Your treating clinician assesses heart health and makes medication decisions. Gateway coordinates the follow-up around that plan:
- Primary care follow-up at home or in a facility with a Gateway clinician, where available
- Communication with your own primary care physician and cardiologist, who stay involved
- A connection to a primary care practice if you do not have one
- Wound care for leg ulcers or weeping skin, including edema and lymphedema management ordered by the clinician
A medication review is often the first step, since heart medications are changed frequently and lists drift apart.
When to call the clinician and when to call 911
Call your clinician promptly for:
- Weight rising quickly over a few days
- Swelling that is new, worse or moving up the legs
- More breathlessness with activity or when lying flat
- Blood pressure readings well above or below your usual range
- Dizziness on standing, or a fall
- Skin on the legs that blisters, weeps or turns red and warm
Call 911 for chest pain or pressure, severe shortness of breath, fainting, a racing or irregular heartbeat with lightheadedness, or signs of a stroke such as a drooping face, weakness in one arm or slurred speech. Gateway is not an emergency service.
How to start
Call 314-325-0126 or send the request care form with a name and phone number only. Patients and family members can call without a referral.
We arrange care across Greater St. Louis and the Metro East. Visit availability is confirmed by location and care setting, and coverage depends on the treating provider and your plan.
Common questions
Why are my legs swollen if the problem is my heart?
When the heart pumps less effectively, blood returning from the body backs up and fluid leaks into the tissues. Because you spend much of the day upright or sitting, that fluid collects in the lowest parts of the body. Other conditions can cause swelling too, so your clinician works out what applies to you.
Is it safe to wear compression stockings if I have heart failure?
That is a question for your clinician. Compression helps many people with leg swelling, but it shifts fluid back into the circulation and can be a problem for some people with heart failure or poor blood flow in the legs. After examining you, the clinician decides whether compression is suitable and at what strength.
Can blood pressure medications affect wound healing?
Good blood pressure control protects blood vessels over time. A few blood pressure medications can cause ankle swelling or dizziness, and water pills change how much fluid sits in the legs. Tell both your prescriber and your wound care clinician about effects like these. Do not stop a medication without the prescriber’s guidance.
Do I still need my cardiologist if a clinician visits me at home?
Yes. Primary care follow-up at home does not replace a cardiologist. The visiting clinician handles day-to-day monitoring and communicates with your specialists, and the cardiologist continues to guide heart treatment and testing. If getting to the cardiology office is hard, tell us, since transportation arrangements or a telehealth visit may be options.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.