What is heart failure?

Heart failure, also called congestive heart failure or CHF, is a condition where the heart has become weak and is not able to pump blood to the rest of the body as well as it should. This may cause fluid to back up in the lungs, liver, or ankles. The words "heart failure" may sound scary, but you should know that you may still live a more normal life by making some changes.

What causes heart failure?

Heart failure often happens slowly over a number of years. It is sometimes the result of a disease such as high blood pressure or heart attacks. You should ask your doctor what caused your heart failure if you don't already know. Sometimes the cause is unknown.

What are the symptoms?

Here are six common symptoms of heart failure. Report any changes to your doctor right away.

1. Shortness of breath, especially after exercise or at night when lying in bed
   
   One of the first things people notice with heart failure is that they get short of breath when they are active. It is also important for you to note:
   
   
   • If shortness of breath wakes you at night.
     
     
   • If shortness of breath happens after you have been lying down for a short time, and then goes away when you sit up.
     
     
   • If you start to get short of breath or if your shortness of breath gets worse, let your doctor know.
   
   
2. Swelling of the feet, ankles, and sometimes the stomach
   
   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 shinbone. If you make a dent in the skin, it means that there is excess fluid. At the same time, notice your daily weight. Gaining weight is another sign that your body is holding too much fluid.
   
   
3. Feeling tired
   
   It is common to feel somewhat tired if you have heart failure. Not enough blood is getting to the tissues and muscles. You may find you have to pace yourself with certain activities and keep from doing too much in one day. It is important to note if your fatigue level suddenly changes. You must report this to your doctor.
   
   
4. Chest discomfort or chest pain (you may not always feel this)
   
   Chest pain (known as angina) can happen if the blood vessels to the muscle of your heart begin to get blocked. This is called coronary artery disease, which in turn can cause heart failure. If you have any kind of discomfort in your chest, talk to your doctor.
   
   
5. Coughing may be a symptom of heart failure
   
   Call your doctor if you are coughing -- but do not stop taking any medicines until you speak to him or her.
   
   
6. Weight gain
   
   If you gain three or more pounds in one week, it may be a sign that your body is building up fluid. If this happens, your doctor will want to know if you are having any other signs of heart failure such as being more tired and short of breath. He or she may need to make changes to your treatment.

What can I do about my heart failure?

It is important that you watch for changes in how you are feeling and that you follow your doctor's orders. You will also need to take medicine and watch what you eat.

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What can I eat?

People with heart failure must eat less salt. Excess salt in the body will draw water into the bloodstream and make extra fluid for the heart to pump. When the heart is weak and not pumping well, the extra fluid will back up into the lungs and ankles. This can cause shortness of breath and swollen ankles.

What about salt?

Ask your doctor how much salt you should take daily. Here are some tips to help cut down on the salt that you eat:

• Remove all salt shakers from the house or fill them with another seasoning.
• Do not use any salt when cooking. Use herbs and spices instead.
• Stay away from foods that are high in salt or sodium.
• Read the food labels and buy foods that are low in sodium.

Your doctor may also ask you to limit the amount of alcohol you drink or to lose weight.

What about weight gain?

To manage heart failure, you must weigh yourself every day.
Here are three handy tips:

1. Weigh yourself every morning after you use the toilet and before you get dressed and have breakfast.
   
   
2. Record your weight to the nearest pound on a daily calendar.
   
   
3. If you gain three or more pounds in one week, call your doctor.

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What kinds of activity can I do?

Your doctor will tell you how active you can be. A simple exercise program will help keep your muscles in shape and may help strengthen your heart. Your doctor may suggest walking, slow biking, and relaxed swimming. Check with your doctor about the best activities for you.

You should stay within the limits set by your doctor. You should also talk with your doctor about how you can stay sexually active. There is usually no reason why you cannot continue sexual activity.

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What about medicine?

Many people with heart failure need to take medicines. Your doctor will ask you to take medicines to help your heart pump better. The medicine may be used alone or together with other medicines. So, it is very important for people with heart failure to

• Know the name, dose, and number of times you should take each of your medicines. Write this down and keep it with you.
  
  
• Make a plan to help you remember to take your medicines.
  
  
• Follow your doctor's orders carefully. Take your medicine as you were told, even if you feel better.

Some of your medicine may have side effects. Tell your doctor about any side effects or worsening symptoms.

What kinds of medicine might I take for heart failure?

Medicine for heart failure works in several ways:

1. It helps you get rid of excess fluid (diuretic or water pill).
   
   
2. It strengthens the heart so that it can pump better (digoxin or heart pill).
   
   
3. It keeps the blood vessels open (ACE inhibitor or another vasodilator).
   
   
4. It helps to reduce how hard the heart has to work (beta-blocker).