What treatment will I need?
Treatment can improve how well the heart pumps and can help relieve your symptoms, but heart failure cannot be completely cured. An important part of treatment is taking care of any underlying problems, such as lowering high blood pressure or fixing a heart valve. Treatment also includes lifestyle changes and medicine.
What medicines will I need to take?
Many different medicines are used to treat heart failure. You may need one or more medicines, depending on your symptoms. Your doctor will talk about these medicines with you. It may take some time to find the best type of medicine and the best dosage (amount) of medicine for you.
Several kinds of medicines are commonly used to treat heart failure:
- ACE inhibitors. ACE inhibitors help open (dilate) your arteries and lower your blood pressure, improving blood flow.
- Diuretics. Diuretics are often called "water pills" because they cause you to urinate more often and help keep fluid from building up in your body. They can also decrease fluid that collects in your lungs. This will help you breathe easier.
- Beta-blockers. Beta blockers can lower blood pressure and slow a rapid heartbeat. They may also help prevent some heart rhythm problems.
- Digoxin. Digoxin (also called digitalis) helps the heart pump better by strengthening the muscle contractions of the heart.
You might need to take other medicines if you have other problems or if you experience side effects with any of these medicines.
When you're taking medicine for heart failure, you'll also need to have blood tests to check your potassium level and kidney function. How often you need blood tests depends on the type and strength of medicine you are taking. Many patients take heart failure medicines without any problems. However, if you have concerns about the medicine or think you may be having side effects, you should talk to your doctor. It's very important that you take your medicine exactly as your doctor tells you.
How often will I need to see my doctor?
If you’ve just been in hospital for heart failure, be sure to follow up with your doctor within the first week of being home. At first, you may need to be checked as often as every week to see how you're responding to the medicine. Once your doctor has adjusted your medicine and you're feeling better, you may need to be seen less often.
When should I call my doctor?
Talk to your doctor if you have any of the following:
- Shortness of breath that gets worse
- A weight gain of more than 5 pounds in one week
- Leg swelling that is new for you
- Coughing or wheezing in the night, or needing to sleep propped up or sitting up
- Chest pain or a heavy feeling in your chest
- Side effects from the medicine
- Failure to lose weight even though you take more water pills
You should also call your doctor if you have any questions about your condition or medicine.
What can I do to help treat my CHF?
Avoid eating too much salt or too many salty foods (such as canned vegetables or soups, chips and pizza). Salty and high-sodium foods can cause your body to retain water. Talk to your doctor before using salt substitutes because they often contain potassium and may not be good for your health either. This will depend on your kidney function and what medicines you are taking. Some people need extra potassium but other people don’t.
Although drinking a small amount of alcohol (one drink a day) seems to be helpful for some people who have heart disease, drinking too much may cause heart failure and interfere with medicines. Ask your doctor if any amount of alcohol is safe for you.
Keep your blood pressure under control. High blood pressure strains your heart and further weakens it.
You’ll be healthier if you exercise. Ask your doctor to recommend an exercise program for you. Try to reduce the stress in your life and get plenty of sleep. If you smoke, quit! If you are overweight, talk to your doctor about how to lose weight safely.
Also talk to your doctor before you take any medicine. Common arthritis medicines such as naproxen (one brand name: Aleve) and ibuprofen (one brand name: Advil) can cause fluid retention.
Fluid retention and weight gain are one signal that your CHF may not be in good control. Weigh yourself daily at the same time of day and report any unexplained changes to your doctor.
Reducing Readmissions for Congestive Heart Failure by RE Hoyt, CAPT, MC, USN, and LS Bowling, LTCR, MC, USN (American Family Physician May 15, 2001, http://www.aafp.org/afp/20010415/1593.html)
Written by familydoctor.org editorial staff