Seek immediate medical care if you experience severe shortness of breath, profound fatigue, an irregular heartbeat or palpitations, sudden weight gain (three or more pounds in one day), increased swelling of the legs and ankles, or swelling or pain in the abdomen. Other signs that should be promptly reported to your doctor are loss of appetite, a hacking cough, confusion, and trouble sleeping, including waking up short of breath.
Several self-care techniques, such as losing weight, getting more exercise, and learning to relax improve survival and quality of life. Patients are encouraged to lose weight, exercise, and to decrease alcohol consumption. Try to restrict the use of salt in cooking and at the table, and to eat a low-fat, low-cholesterol diet that includes lots of fruits and vegetables. Smaller, more frequent meals may help you obtain optimal nourishment. The doctor may also limit your fluid intake. Increasing physical activity helps reduce many of the risk factors for congestive heart failure. Check with your doctor about appropriate forms of exercise.
Following the prescribed diet and taking medications as directed are critical to your well-being. Salt can cause the body to retain fluid, and excess fluid makes your heart work that much harder. A low-salt diet is extremely important for managing your heart failure. Foods such as bacon, ham, and sausage contain high amounts of salt. Packaged foods, like TV dinners and canned goods, are typically high in sodium, which is found in table salt. Read the labels before purchasing. With canned foods, draining and rinsing helps eliminate some of the sodium. Over-the-counter medications, such as some antacids, may also contain sodium.
Learn as much as you can about your medications and their side effects. Notify the doctor if you start to experience any unusual symptoms that may be related to your heart failure or its treatment.
Pace your activities to allow time for rest and exercise. Your heart won’t need to work so hard if you give it a chance to rest. Avoid packing the day full of activities or overdoing things.
Once the initial symptoms are under control, check with your doctor about starting an exercise program; then start slowly. Gradually build up to your desired goal. Do not exceed your comfort zone. Physical activity is good for most people. Moderate exercise can help the heart grow stronger. Walking and swimming can be paced to individual tolerance. The doctor may recommend cardiac rehabilitation. Rehab programs allow patients to start increasing physical activity while being carefully monitored. Avoid exercises in which you hold your breath, bear down, or need sudden bursts of energy and competitive contact sports such as football.
Check your blood pressure and weigh yourself every day. Weigh yourself at the same time each day; first thing in the morning, after using the bathroom but before breakfast, is a good time. Report any increases or significant changes to the doctor. A rapid increase in weight often indicates additional fluid retention. Notify your doctor if you gain more than three pounds in one day, five pounds in a week, or whatever amount your doctor has specified. Alert the doctor to any changes in blood pressure readings.
Emotional stress may aggravate your condition. Stress increases the demands made on your heart. Blood pressure and heart rate can rise when you are anxious or angry. Learning to manage stress and anger will help you control and more comfortably live with heart failure. American Heart Association tips include:
• Accept the things you cannot change.
• Express your feelings to family and friends.
• Spend 15 to 20 minutes each day relaxing. Breathe deeply and think restful thoughts.
• Look for the good in life, rather than focusing on the negative.
• Exercise according to your doctor’s recommendations. Increased physical activity decreases stress and improves mood. It also increases energy levels, decreases blood pressure, and aids in maintaining a healthy weight.
• Try to avoid situations you know will upset you. For instance, don’t drive on the interstate at rush hour or over-schedule yourself.
• Learn how to say no.
• Join a support group. Talking about your situation with other people with the same condition often proves beneficial. You may even experience the joy of helping someone else.
Propping yourself up on a pillow may improve your ability to sleep at night.
Ask your doctor about receiving flu and pneumonia vaccinations. Influenza can be more dangerous for people with heart disease. The vaccine helps prevent the infection, and cannot give you the flu. If you catch the flu, your weak heart may make you more susceptible to pneumonia. Flu shots are given annually, the pneumonia shot, generally, once.
You may need to receive antibiotics before having serious dental work done. These are necessary only if abnormalitites of cardiac structures (such as valves or certain congenital abnormalities) are present.
Always tell all of your health care providers about all of the medications you take, including over-the-counter drugs and dietary supplements. Drugs can interact with each other. In order to provide the best care, health care providers need to know what medications you are taking.
Your doctor is the best source of information on the drug treatment choices available to you.
Treating any underlying condition is a mainstay of congestive heart failure management. In addition to treating your primary condition of congestive heart failure, your doctor will also focus on managing other diseases that may be contributing to your heart trouble such as diabetes, thyroid disorders, and anemia.
Procedures to open blocked arteries or replace valves are often helpful in treating the underlying cause of heart failure. During coronary artery bypass grafting, surgeons reroute blood supply to the heart using other blood vessels. An artificial valve replacement can correct leaking valves. Surgery is also in infants and children to correct congenital (birth) defects in the structure of the heart and valves.
Heart transplants are considered only when all other treatment options have failed. Candidates for transplant are screened for other serious medical conditions, and patients with cancer, long-term infections, and immune system diseases are usually ineligible for transplants. Transplant candidates often wait for months or years before receiving a new heart. Many do not survive the wait, but others progress and do well enough on medications to be taken off the transplant list. Patients on transplant lists are sometimes kept alive with a mechanical pump, called a left ventricular assist device, which takes over the functions of the heart. However, such devices are not a permanent means of treating heart failure, but are rather temporary solutions to ensure that a patient survives until a transplant is available. Experimental artificial hearts are being tested but are still years away from being in general use.
Ask your doctor about any dietary supplements you may be considering. Some people recommend herbal remedies for heart conditions. No herbal substance can cure heart failure. Herbs or other remedies may interfere with your regular medications. Always check with the doctor before taking an herb or dietary supplement.
A rare type of heart failure, called peripartum cardiomyopathy, can occur around the time a woman gives birth to a child. The cause is unknown, but the condition is thought to be associated with an autoimmune process, infection, or a family predisposition. Treatment includes resting in bed, restricting salt intake, and taking prescribed medications. Approximately four in 10,000 women develop this condition.
Congestive heart failure cannot be cured, but it is manageable. By working with your doctor, following the recommended dietary and medication plan, and making some other lifestyles changes, many patients experience a high quality of life. Still, half will not survive for five years.
The long-term outlook improves when the underlying conditions are treatable.
Patients with congestive heart failure need regular visits to the doctor. Depending on your medications, you most likely will need regular blood work. Blood tests can measure drug levels in the blood and detect imbalances in normal blood chemistry levels.
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