Self-Care Guide for the Heart Failure Patient
You have been diagnosed with heart failure, but you are not alone. There are now more than 5 million Americans living with heart failure. Fortunately, with advances in treatment, you may live longer and enjoy a good quality of life.
Heart failure is a serious medical condition that occurs when the heart does not pump enough blood to the rest of the body. It may be caused by many factors, such as heart attacks, infections, high blood pressure, toxins (like alcohol or drugs), or inherited conditions—to name a few. Successful treatment of heart failure requires careful attention to your medications and lifestyle. You, as the patient, are the most important member of the entire care team. Actively taking care of yourself is crucial to the success of your treatment. Creating a heart failure self-care routine is an important undertaking, one that requires a good understanding of the illness and its treatment. You need to know not only how to take medications as prescribed and when to seek help, but also how to limit your salt and fluid intake, as well as monitor your symptoms and weight changes. Gaining the support of a caregiver or a family member can also be very helpful.
Understanding Your Symptoms
When the heart does not work normally, it may not pump enough blood to support your other organs and may cause you to retain fluid. This can cause leg or abdominal swelling, cough, fatigue, and shortness of breath during activity or when lying flat. You should report any symptoms promptly.
Limiting Salt and Fluids and Monitoring Your Weight
Limiting your salt (sodium) and fluids (water, sodas, coffee, soups, etc.) will help avoid fluid buildup. A low-salt diet is suggested for patients, often limited to 2000 mg of sodium per day. Because most foods are prepared with salt, your best chance of staying within the limit is to avoid processed or fast food meals and to read food labels for sodium content. You may need to restrict your fluids to 2 quarts or less per day. Weighing yourself daily is your guide to keeping your fluid balance stable. Keeping a log of your weight, blood pressure, and symptoms will help you and your medical team evaluate your treatment and make adjustments as needed. For example, a weight gain of 2 to 3 pounds in 1 day or 5 pounds in 1 week should be reported.
Important Lifestyle Issues
Maintaining an active lifestyle should be a goal for you. Mild to moderate exercise under the guidance of the medical team is usually safe and encouraged. You may be prescribed a walking program or perhaps cardiac rehabilitation. It is also important that you avoid cigarettes, alcohol, and recreational drugs.
Medications You May Be Prescribed
Research has shown that certain medications, often in combination, can help prolong your life and improve your symptoms. It is important that you take your medications as prescribed. Consider using a medication schedule, list, or pillbox. Table 1 shows examples of medications (and their most common side effects) that might be prescribed for you based on the type and severity of your heart failure.
Other Medical Conditions and Medications
Conditions such as high blood pressure, heart rate irregularities, diabetes mellitus, sleep apnea, and infections may contribute to worsening symptoms of heart failure. Inform your heart team if you have any new medical problems or new medications. For example, nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen, and celecoxib may cause kidney damage and should be avoided. Vaccinations for pneumonia and influenza are recommended.
Additional Heart Failure Treatments
Your heart condition may remain stable long term. However, if your heart function worsens in spite of the best possible self-care and medical treatment, other options may be considered. This might include an implantable pacemaker-defibrillator, a biventricular pacemaker, or referral to an Advanced Heart Disease Center for a mechanical heart pump, a heart transplant, or research studies such as stem cells, experimental devices, or new medications.
Gaining a better understanding of heart failure is your first step to fully embracing self-care. We have included some tips (Table 2) and Web site links to help you develop an effective self-care plan.
References and additional patient education available online:
American Heart Association – www.heart.org/HEARTORG/ (Go to CONDITIONS, select Heart Failure)
Heart Failure Society of America – Web site provides 11 Patient Education modules - www.hfsa.org/heart_failure_education _modules.asp
American Association of Heart Failure Nurses – Web site contains Patient Heart line (856) 539–9006 and Care for the Caregiver Videos - www.aahfnpatienteducation.com/index.php
American College of Cardiology - www.cardiosmart.org/Heart-Conditions/Heart-Failure
- © 2013 American Heart Association, Inc.