Congestive Heart Failure

WHAT YOU SHOULD KNOW:

Congestive heart failure (CHF) is a disease that occurs when your heart becomes too weak to pump blood properly. Heart failure is caused by damage to your heart. Over time, the damage causes your heart to work harder and grow larger. The harder your heart works, the weaker it becomes until it cannot work properly.

INSTRUCTIONS:

Medicines:

You may need any of the following:

• ACE inhibitors decrease your symptoms and slow your heart failure. You may need a medicine called an ARB if you cannot take ACE inhibitors. ARBs help your heart beat more strongly.
  
  
• Beta-blockers help your heart pump strongly and regularly.
  
  
• Cardiac glycosides help your heart beat strongly and decrease abnormal heartbeats.
  
  
• Nitrates improve the blood flow through your heart.
  
  
• Diuretics help your body get rid of extra fluid and protect your heart from more damage. Diuretics may make you urinate more often.
  
  
• Blood thinners prevent blood clots. They may make you bruise or bleed more easily. To prevent bleeding, brush your teeth with a soft toothbrush, and shave with an electric shaver.
  
  
• Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your cardiologist or primary healthcare provider as directed:

You will need to have blood tests to check medicine levels and heart function. Write down your questions so you remember to ask them during your visits.

Do not smoke cigarettes or use illegal drugs:

Cigarettes and illegal drugs can worsen your heart failure. Ask your primary healthcare provider for information if you are having trouble quitting.

Cardiac rehabilitation:

Cardiac rehabilitation (rehab) is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. This plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Caregivers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Daily weight:

Rapid weight gain can be a sign of fluid retention. This may mean your CHF is worsening. Weigh yourself at the same time every morning, before you eat and after you urinate. Weigh yourself on the same scale each time, if possible. Record your weights, and the time you weighed yourself. Bring the record to your follow-up visits.

Limit sodium as directed:

You may need to limit the amount of sodium (salt) you eat to 2 grams each day. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can cause health problems. Ask your primary healthcare provider how much sodium and potassium salt are safe for you.

Limit liquids as directed:

You may need to drink less liquid to help balance your fluid level. Ask how much liquid you should drink each day. Limit or avoid alcohol. Alcohol can worsen your heart failure and increase your blood pressure. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Contact your cardiologist or primary healthcare provider if:

• You are more tired than usual.
  
  
• You gain 2 or more pounds in 1 day, or 4 or more pounds in 1 week.
  
  
• You have increased swelling in your legs, ankles, feet, or abdomen.
  
  
• You feel anxious or depressed.
  
  
• You have no appetite, or you lose weight without trying.
  
  
• Your blood pressure is higher or lower than your cardiologist says it should be.
  
  
• You have questions or concerns about your condition or care.

Return to the emergency department if:

• You have any of the following signs of a heart attack:
  
  
  • Squeezing, pressure, fullness, or pain in your chest that lasts longer than a few minutes or returns
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or arm
    
    
  • Shortness of breath or breathing problems
    
    
  • A sudden cold sweat, lightheadedness, dizziness, or nausea, especially with chest pain or trouble breathing
  
  
• Your fingers or toes are cold and pale or blue.
  
  
• You cough up pink, foamy, or bloody sputum, or you have a dry cough.
  
  
• Your heart is fluttering, or is beating faster than normal for you.
  
  
• You have diarrhea or are vomiting and not able to eat or drink.
  
  
• Your neck veins are bulging.
  
  
• You are urinating very little, or not at all.

Learn more about Congestive Heart Failure (Aftercare Instructions)