Dealing with Heart Failure
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Finding out you have congestive heart failure (CHF) can be scary. But CHF just means that your heart does not pump enough blood to meet your body’s energy needs. Slow blood flow causes fluid to back up, or become congested, robbing you of energy. You may feel tired, your feet and ankles swell with extra fluid, and simple activities make you short of breath.
A Winning Hand
You hold the cards to control your symptoms and enjoy your life. Proper treatment and lifestyle changes slow the advance of CHF, help you feel better, live longer and be more active. You can manage your CHF by remembering the key factors of a winning hand:
- The Hand You’re Dealt
- Know your type of heart failure - An ACE Up Your Sleeve
- Take your medicine - Playing Your Cards Right
- Eat a healthy diet - The High Stakes
- Record a log of daily weights - Don’t Gamble With Your Health
- Report early signs of worsening - Stack the Deck
- Keep regular doctor visits
- Running out of energy easily
- Shortness of breath:
- With routine activity
- That wakes you from sleep
- When lying down
- Puffy, swollen legs, ankles or feet
- Poor appetite or nausea
- Weakness
- Dry, nagging cough
- Rapid weight gain (2-4 pounds
over 1-3 days)
The Hand You're Dealt
There are two main types of heart failure.
Because each type is treated differently, you need to know which one you have. To find out which type of heart failure you have, your doctor may order an echocardiagram (ECHO). An ECHO uses ultrasound waves to show an image of your heart as it pumps. Normally, 60 percent of the blood in the heart is pumped out with each heartbeat. This percentage is known as your “ejection fraction,” or EF. An ECHO measures your EF.
Diastolic failure
When your heart is thick and stiff, you have diastolic failure. Your EF may be normal (over 40 percent), but your heart resists filling with blood because it cannot relax. Pumping against high blood pressure is the most common cause of this type of heart failure.Systolic failure
A weak heart muscle is known as systolic heart failure. Your EF is 40 percent or less. Most people with this type of heart failure are heart attack survivors. Their heart muscle is left too damaged to pump well.
An ACE Up Your Sleeve
Main treatment
There are medicines that can help relieve symptoms, boost your energy, keep you out of the hospital and help you live longer. The key is using them faithfully.
- ACE inhibitors relax blood vessels so your heart does not have to pump against too much pressure. ACE Inhibitors are the best tool for treating systolic heart failure. They may be helpful for treating diastolic failure as well.
Tip: Keep your blood pressure under 135/85 to prevent heart failure from getting worse!
Other kinds of medicine may also help:
- Diuretics, also called “water pills,” make you pass more urine, so fluid does not build up in your body.
- Digoxin boosts the strength of your heartbeat and helps control an irregular heart rhythm.
- Beta blockers and spironolactone ease the strain on your heart caused by stress hormones.
When taken correctly, medicine can help you feel better and prevent
further damage to your heart. To get the greatest benefit, take
your medicines exactly as directed.
Tip: Keep a list of your medicines with you at all times.
Tip: Before using over-the-counter treatments like pain relivers, cold remedies, vitamins and herbal products, check with your doctor or pharmacist to make sure they don't interact.
Play Your Cards Right
Develop Healthy Habits
Avoid Sodium! Sodium is a mineral that makes your kidneys retain fluid. Eating too much sodium could land you in the hospital due to fluid overload. Eat no more than 3,000 milligrams (mg) a day (one teaspoon of table salt is equal to 2,000 mg). Giving up salt can be hard, but after a short time, you won’t miss it. Herbs, spices and lemon juice can perk up the flavor of most foods. Before using a salt substitute, ask your doctor which ones are safe.
Tip: Read food labels to check for hidden sodium. Each serving of low sodium food should contain less than 35mg of sodium.
AVOID TOBACCO! If you smoke, STOP. Talk to your doctor about programs and medicine to help with this.
Limit fluids and alcohol. If you have severe heart failure, you may need to limit the fluid you drink to no more than two quarts a day. Alcohol can further weaken your heart’s pumping force.
Eat a good diet. A healthy diet is important for everyone, but above all for you.
Up Your Ante
Moderate exercise. Moderate exercise is safe for you. Walking
can improve your strength and energy level and lift your spirits.
Find a quiet street or road nearby, or try a shopping mall to take
your walks. Many public schools also allow people to walk on their
campuses after hours.
Balance. Rest is just as important as exercise. So pace
yourself and be careful not to overdo it.
Immunizations. Catching the flu or pneumonia is much worse when
you have CHF. Protect yourself by getting an annual flu shot and
a one-time pneumonia vaccine.
The High Stakes
Weight log. Keep a log to record your daily weight. Consult your doctor if you gain over two pounds in a day or three pounds in a week. Weight gain is the earliest sign of worsening. Catch it early so your doctor can adjust your medicines and prevent a costly trip to the hospital.
Weigh yourself every morning
- After you empty your bladder
- On the same scale
- Before eating
- Wearing the same amount of clothing
Don't Gamble With Your Health
Most of the time, trips to the hospital are due to eating too much salt or not taking medicine properly. Report symptoms to your doctor early to avoid a trip to the emergency room or a stay in the hospital.
Report signs and symptoms early.
Consult your
doctor if you have any of the following:
- Weight gain of over two pounds in a day or three pounds in a week
- Shortness of breath that gets worse or wakes you from sleep
- Swollen or puffy feet, ankles or legs
- Dizziness or lightheadedness when you rise
- Feeling exhausted during routine activity
- Any symptoms that concern you
Regular doctor visits help “stack the deck” in your favor!
My Health Contract
- Weigh myself every day
- Call my doctor if I gain too much
- Eat a low-sodium diet
- Limit the amount of fluid I drink
- Avoid alcohol and tobacco
- Take my medicine faithfully
- Report any signs of worsening failure
- Do some exercise most days
- Pace myself and rest when I’m tired
SIGNED ___________________
DATE ___________________
The mission of the Arkansas Foundation for Medical Care
is to promote excellence in health care through evaluation and
education.
©Copyright 2000 AFMC This material was prepared by Arkansas Foundation for Medical Care (AFMC) under contracts with the Arkansas Department of Health & Human Services, Division of Medical Services, and the Centers for Medicare & Medicaid Services (CMS), a federal agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect their policies.