|Note: We use the terms heart failure and congestive heart failure (CHF) interchangeably. They mean the same thing.
Living With Congestive Heart Failure
If you receive a diagnosis of heart failure you may initially feel overwhelmed and have lots of questions for your healthcare team. As the underlying causes of heart failure vary and the symptoms are so diverse, the condition calls for a highly individualized treatment plan. While occasionally CHF can be 'fixed' by correcting the underlying cause, in the vast majority of cases it cannot. Treatment instead focuses on alleviating the symptoms, slowing the progression of the condition, and taking medications to strengthen the pumping action of the heart. Sometimes heart failure surgery is necessary to achieve this. Living with CHF means you will have to have regular checkups with your doctor. You will also need to make some lifestyle changes and take your medications regularly. For most people with moderate CHF, the combination of drugs and lifestyle changes is enough to enable them to enjoy an active life.
Do I Need To Take Medications For The Rest of My Life?
Many people who receive treatment for heart failure are surprised to learn that they need to take so many different types of pills every day. These can include diuretics to help with fluid retention, ACE Inhibitor drugs, calcium channel blockers, beta blockers and even good old fashioned aspirin therapy. So are you likely to need these drugs for the rest of your life? The answer is, probably yes. Fortunately because some of these heart failure medications are so effective you may be able to stop taking one or two - but never stop without first consulting your doctor.
Should I Monitor My Sodium Intake?
Yes, as fluid retention (also called edema) is one of the main symptoms of heart failure and large amounts of sodium (salt) in your diet tends to worsen this condition; your doctor will probably recommend a low sodium diet. You will be told to limit your intake to 1-2 grams a day which is about 1 teaspoon of salt. As many processed foods contain this amount in a single portion, you are best advised to cook all meals from scratch so that you can control the ingredients. Do not add table salt to any food, and be careful with salt substitutes as some are high in potassium which has its own set of problems. Instead opt for spices, herbs and pepper to spice up your meals. If you are eating out, choose restaurants that offer heart friendly menus and if you are eating at friends, don't be afraid to give them a list of your diet restrictions. Most people are more than willing to oblige. Restricting your salt intake has the additional benefit of lowering your blood pressure and maximizes the benefits of your medications. People with advanced CHF may also be told to limit their liquid intake to no more than 2 quarts (4 pints) a day. You may also find it useful to read about coronary heart disease prevention, much of the advice is still relevant, even after the heart has started to fail.
Should I Weigh Myself Regularly?
Yes, it is very important to monitor your weight closely as a sudden gain can indicate the buildup of fluids in your body. It is quite possible to gain water weight before any noticeable sign of swelling occurs. It is important to track your weight in a journal as follows:
1. Ask your doctor to weigh you and tell you what your dry weight is. That is, your weight without retained fluid. Write it down.
2. Weigh yourself EVERYDAY, preferably in the morning, just after urinating. It is normal for weight to fluctuate about 2 pounds on a daily basis depending on activity and how much you ate the night before. Write down the weight.
3. Each day compare your morning weight to your doctor's dry weight (don't compare it to the previous days weight).
4. If you gain more than 2 pounds in one day or more than 4 pounds in one week, or notice more swelling in your ankles, legs or hands than usual, see your doctor immediately. He may:
• Adjust your medication dosage.
• Recommend cutting your sodium intake to less than 1/4 teaspoon a day (500 mg)
• Cut your liquid intake to 1 or 2 cups a day (1/2 quart).
Is Exercise Safe To Do?
Yes, moderate exercise is an excellent way to deal with the tiredness associated with CHF, but always check with your doctor first. If you are not used to exercise, he may recommend joining a cardiac rehabilitation program which can tailor an individual plan to your needs. This is called a cardiac exercise program. Alternatively you can read our home exercise program. If you are not sure what your physical limits are, your doctor may order a treadmill exercise test and based on these results he will be able to give you more guidance. At any time if you experience severe breathing difficulties while exercising, reduce your activity level. You may need to build your endurance level at a slower pace.
What is the prognosis for heart failure?
Living with heart disease.
Living with angina.
Who needs a home defibrillator?
Learn how to give CPR to a loved one:
When is CPR necessary?
How is hands only CPR performed?
For more topics, see womens health questions.
Is It True I Need The Flu Shot?
Yes, everyone with heart failure is encouraged to get the annual flu shot every Fall to protect against the influenza (flu). It is also recommended that they get the anti-pneumococcal vaccination. This is a once off injection and protects against a serious chest infection called pneumococcal pneumonia.
Sleep And Rest
Exhaustion and fatigue are common complaints among heart failure patients. If you notice that the fatigue is becoming worse, this may be a sign your condition is worsening. To reduce the workload on your heart:
1. Save your energy in little ways: sit down and prepare food at the table, even sit down while showering.
2. Napping: Plan your naps during the day, don't wait until you are exhausted to rest.
3. Avoid vigorous exercise: on hot and cold days and directly after a meal.
4. Bathroom trips: If your meds cause you to need the bathroom frequently during the night, talk to your doctor about adjusting the dose.
5. Breathing problems: If you have problems breathing lying down in bed, prop your shoulders and head up with pillows. Some people even find it better to sleep sitting up.
What About Vacations And Flying?
Check with your doctor before booking any vacation or flights. If he gives you the all-clear, think about staying somewhere with accessible accommodation, some hotels in European cities for example do not have elevators. If you are taking a long flight, make sure you get up and walk around regularly, this reduces your risk of developing deep vein thrombosis (DVT), a blood clot in the leg.
Coping With Depression And Anxiety
It is normal to feel anxious or a little low from time to time. You may feel depressed by your limitations or symptoms. Some patients say they feel helpless and down about the lack of control over their life (see effects of depression). One of the best ways to tackle this is to learn as much as possible about your condition. Become involved with the decision process in your treatment and try new lifestyle improvements to help yourself. Also, planning and looking forward to events can also help lift your mood.