Living with
Heart Failure
Heart Failure Education Series
What is heart failure?
Heart failure, also called congestive heart failure
or CHF, is a condition where the heart is unable
to pump blood to the rest of the body as well as
it should. This may cause fluid to backup in the
lungs, liver, or ankles. This backup of fluid is a
result of congestion and can cause something
known as edema. While the term heart failure
may sound scary, you should know that you can
still live a full life by making some changes.
What causes
heart failure?
Heart failure usually develops over a
period of years and can sometimes be
the result of an earlier illness. For
example, high blood pressure that is
not treated properly for a number of
years may cause the heart to get
bigger. The heart then becomes weak
and no longer pumps well.
Sometimes a heart attack damages the
heart muscle, making it harder for
the heart to pump blood to the rest of
the body. Diseased heart valves may
prevent the right amount of blood
from being pumped forward. Blood
may then leak back into other parts
of the heart. You should ask your
doctor what caused your heart failure
if you don’t already know. Sometimes
the cause is unknown.
What are the signs and
symptoms of heart
failure?
If the heart doesn’t pump blood well,
the lungs, kidneys, and other organs
can be affected. Certain signs and
symptoms can develop, including the
following:
▼ Shortness of breath, especially
after exercise or at night while
lying in bed
▼ Swelling of the feet, ankles, and
sometimes the abdomen (belly)
▼ Tiredness
▼ Coughing
▼ Chest discomfort
(not always present)
▼ Weight gain
It is important that you follow the
advice in this booklet for managing
heart failure to help you feel better
and live longer.
If you have chest discomfort or
notice a change in how it feels, how
long it lasts, or how often
it happens, then speak to your
doctor. There are many people,
however, who have heart failure who
never have chest discomfort.
Other Symptoms
While these symptoms are the most
common ones, you may notice a few
others. Coughing may be a symptom
of heart failure, but it can also occur
if you are taking medicines in the
vasodilator class known as ACE
inhibitors. You should report this
symptom to your doctor, but DO
NOT stop taking any medicines.
Less common symptoms include loss
of appetite, dizziness when changing
positions, irregular heartbeats, and a
fast or slow pulse. Be sure your
doctor is aware of these symptoms.
Can heart failure be cured?
Although heart failure is not
curable, your heart function may
improve with proper treatment.
If you help your doctor to manage
your condition, your quality of life
should also be greatly improved and
you may live a long time.
Talk to your doctor about other
options.
Managing Heart Failure
Managing heart failure means getting
good care, taking medicine, and
watching your diet. Taking
an active role in your care and
following your doctor’s orders will
help to reduce your symptoms. It will
also help by cutting down the
number of visits to the hospital or
emergency room.
Medicines
Your doctor may ask you to take
medicines to help your heart pump
better. Some of these medicines are
listed on the next page. They may be
used alone, or in combination with
other medicines. Because many
patients with heart failure are asked
to take several medicines, you
should pay attention to the following
points:
✔ Know the name, strength,
dosage, and number of times
each day you should take
each of your medicines.
Write this information down
and keep it with you.
✔ Develop a plan for
remembering to take your
medicines. Find a specific
reminder that will help you:
set the alarm on your watch,
put your pills near your
toothbrush, or on the
windowsill in your kitchen.
✔ Follow your doctor’s orders
carefully. Take your
medicines as prescribed
every day, even if you feel
better. Be aware that there
may be some side effects
from heart medicines. Report
side effects to your doctor.
Medicines and How
They Work
Diet
Diuretic (water pill):
Rids your body of excess fluid.
People with heart failure must lower
their intake of salt. A low- sodium diet
for heart failure includes the following:
Digoxin (heart pill):
Increases the pumping action
of your heart.
▼ Remove all salt shakers from the
house or fill them with another
seasoning.
ACE Inhibitor:
Help to keep blood vessels open to
improve the circulation, which helps to
limit excess fluid accumulation (these
agents are also used to treat high blood
pressure.)
Beta Blockers:
Improve heart function by preventing
the heart from working too hard.
Other Medications:
Your doctor may prescribe other
medications to treat your heart failure
either in addition to or as an alternative
to those above. Examples are nitrates
and hydralazine which are often given
together and work by opening up
blood vessels and reducing the work
that the heart has to do. Additionally
you may receive medication for other
conditions such as nitrates for angina
and calcium channel blockers for high
blood pressure.
▼ Do not use any salt when cooking.
Use herbs and spices instead.
▼ Avoid foods that are high in sodium.
▼ Select lower-sodium foods
by reading food labels.
With heart failure, excess sodium stays
in the body. This can cause shortness of
breath due to fluid backing up in the
lungs. There may also be swelling in
the ankles. You will be asked to keep
your sodium intake under 2000
milligrams a day. You may also be
asked to limit alcohol use or to lose
weight.
Exercise
Your doctor will determine if you are
able to exercise. A simple exercise
program will help keep your muscles in
shape and may also improve heart
function. Walking, slow biking, and
relaxed swimming are activities that
your doctor may recommend.
Check with your doctor about the best
activities for you. You should stay
within the limits that he or she may set.
Sexual activity is also a form of exercise.
It is important to discuss with your
doctor how you can remain sexually
active. There is usually little reason why
you cannot continue sexual activity.
Daily Weights
Weighing yourself daily is very
important in managing your
condition. If you gain three or more
pounds within one week, your body
may be building up fluid. If this
happens, your doctor will want to
know if you have other symptoms
and you may need to take extra
medicine. Here are three tips for
weighing yourself:
▼ Weigh yourself every morning
after you use the toilet and before
you get dressed and have
breakfast.
▼ Record your weight to the nearest
pound on a daily calendar.
▼ If you gain three or more pounds
within one week, call your doctor.
Be sure to tell your doctor whenever
you notice a weight gain or a change
in your symptoms. Communicating
these changes allows your doctor to
provide the best treatment for you.
Monitoring Symptoms
You should also be aware of changes
in other symptoms, such as increased
shortness of breath, chest discomfort,
or tiredness. Remember to report the
following changes to your doctor
right away:
Shortness of Breath
(Winded, Can’t Catch Breath)
One of the first symptoms people
experience when they develop heart
failure is shortness of breath with
activity. It is also important for you
to note if shortness of breath
awakens you at night or occurs after
you have been lying down for a short
time and goes away when you sit up.
If you notice shortness of breath
developing or getting worse, let your
doctor know, especially if you also
notice a weight gain.
Swelling of the Feet, Ankles,
or Abdomen (Belly)
Swelling in your feet or ankles
usually means that your body is
holding too much fluid. You may
notice this at the end of the day
when you take your shoes off.
Another way to check is to push
your finger against the lower end of
the shin bone. If you make a dent in
the skin it means that there is excess
fluid. At the same time notice your
daily weight. Increasing weight is
another sign that your body is
holding on to too much fluid. Talk to
your doctor if you notice any of
these signs.
Feeling Tired
It is common to feel somewhat tired
if you have congestive heart failure.
Not enough blood is getting to
tissues and muscles. You may find
you have to pace yourself with
certain activities and avoid doing too
much in one day.
It is important to note if your fatigue
level suddenly changes. This requires
a call to your doctor.
Chest Discomfort
Coronary artery disease with or
without a heart attack is a common
cause of heart failure. Chest
discomfort (angina) may be one of
the symptoms of coronary artery
disease. If you have chest discomfort,
pay attention to the following
questions:
▼ What does it feel like? Is it a
burning, a tightness, pressure,
or aching feeling?
▼ Where do you feel it? Does it
move down your arm, into your
neck, across your chest, or into
your back?
▼ When does it happen and
how often? Does it happen
at night, during exercise,
or after meals?
Remember:
▼ Know the signs and symptoms of heart failure and
which ones need to be reported to your doctor.
▼ Know the name of each medicine you are taking
and develop a plan for remembering to take these
medicines each day.
▼ Learn everything you can about the sodium content of foods, and stick to a very low-sodium diet.
▼ Weigh yourself daily, and record your weight on a
daily calendar.
Provided as an educational service by AstraZeneca Pharmaceuticals LP
207651 5/02
© 2002 AstraZeneca Pharmaceuticals LP