AGuideto Living With Congestive Heart Failure

Dealing

HeartFailure

with

HeartFailureHeartFailure

DealingwithDealingwith

inding out you have Congestive Heart Failure (CHF) can be scary. But CHF just means that your heart does not pump enough blood to meet your body’s

energy needs. Slow blood flow causes fluid to back up, or become congested, robbing you of energy. You may feel tired, your feet and ankles swell with extra fluid, and simple activities make you short of breath.

1

Dealing withHeart FailureDealing withHeart FailureDealing withHeart Failure

The Hand You’re Dealt• Know Your Type of Heart Failure

An ACE Up Your Sleeve• Take Your Medicine

Playing Your Cards Right• Eat a Healthy Diet

The High Stakes• Record a Log of Daily Weights

Don’t Gamble With Your Health• Report Early Signs of Worsening

Stack the Deck• Keep Regular Doctor Visits

ou hold the cards to control your symptoms and enjoy your life. Proper treatment and lifestyle changes slow the advance of CHF,

help you feel better, live longer and be more active. You can manage your CHF by remembering the key factors of A Winning Hand:

2

A Winning HandA Winning HandA Winning Hand

3

■ Running out of energy easily

■ Shortness of breath:

• With routine activity

• That wakes you from sleep

• When lying down

■ Puffy, swollen legs, ankles or feet

■ Poor appetite or nausea

■ Weakness

■ Dry, nagging cough

■ Rapid weight gain

(2-4poundsover1-3days)

Whatare theSymptoms?

Whatare theSymptoms?

Whatare theSymptoms?

There are two main types of heart failure.Because each type is treated differently, you needto know which oneyou have.

To find out which type of heart failure you have, your doctor may order an echocardiagram (ECHO). An ECHO uses ultrasound waves to show an image of your heart as it pumps. Normally, 60% of the blood in the heart is pumped out with each heartbeat. This percentage is known as your “ejection fraction,”or EF. An ECHO measures your EF.

4

The HandYou’re DealtThe HandYou’re DealtThe HandYou’re Dealt

When your heart is thick and stiff, you have diastolic failure. Your EF may be normal (over 40%), but your heart resists filling with blood because it cannot relax. Pumping against high blood pressure is the most common cause of this type of heart failure.

5

Diastolic Failure

Thick heart walls area sign of Diastolic Failure

A weak heart muscle is known as systolic heart failure. Your EF is 40% or less. Most people with this type of heart failure are heart attack survivors. Their heart muscle is left too damaged to pump well.

6

Systolic Failure

Thin heart walls area sign of Systolic Failure

Main TreatmentThere are medicines that can help relieve symptoms, boost your energy, keep you out of the hospital and help you live longer. The key is using them faithfully.

• ACE Inhibitors relax blood vessels so your heart does not have to pump against too much pressure. ACE Inhibitors are the best tool for treating systolic

heart failure. They may be helpful for treating diastolic failure as well.

• ARBs (angiotensin receptor blockers) are an acceptable alternative to ACE Inhibitors.

7

An ACEUp Your SleeveAn ACEUp Your SleeveAn ACEUp Your Sleeve

TIP: Keep your blood pressure under 135/85 to prevent heart failure from getting worse!

HeartSmart

Other kinds of medicine may also help:

• Diuretics are also called “water pills.” They make you pass more urine, so fluid does not build up in your body.

• Digoxin boosts the strength of your heartbeat and helps control an irregular heart rhythm.

• Beta Blockers and Spironolactone ease the strain on your heart caused by stress hormones.

When taken correctly, medicine can help you feel better and prevent further damage to your heart. To get the greatest benefit, take your medicines exactly as directed.

8

TIP: Keep a list of your medicines with you atall times.

TIP: Before using over-the-counter treatmentslike pain relievers, cold remedies, vitamins and herbal products, checkwith your doctor or pharmacist to make sure they don’t interact.

HeartSmart

DevelopHealthy HabitsAvoid Sodium! Sodium is a mineral that makes your kidneys retain fluid. Eating too much sodium could land you in the hospital due to fluid overload. Eat no more than 3,000 milligrams (mg) a day (one teaspoon of table salt is equal to 2,000mg). Giving up salt can be hard, but after a short time, you won’t miss it. Herbs, spices and lemon juice can perk up

9

Play YourCards Rig htPlay YourCards Rig htPlay YourCards Rig ht

the flavor of most foods. Before using a salt-substitute, ask your doctor which ones are safe.

TIP: Read food labels to check for hidden sodium. Each servingof low sodium food should containless than 35mgof sodium.

AVOID TOBACCO! If you smoke, STOP. Talk to your doctor about programs and medicine to help with this.

Limit fluids and alcohol. If you have severe heart failure, you may need to limit the fluid you drink to no more than two quarts a day. Alcohol can further weaken your heart’s pumping force.

A Good Diet. A healthy diet is important for everyone, but above all for you.

10

Spicy Seasoning Mix3 Tbs. Chili powder2 tsp. Ground coriander1½ tsp. Garlic powder2 tsp. Ground cumin¾ tsp. Dried oregano½ tsp. Chili pepper flakes

Combine all ingredients. Store in airtight container. Shake before using to blend. Rub on tender cuts of meat to add flavor. Makes enough to season2 lbs. of meat.

HeartSmart

Moderate Exercise. Moderate exercise is safe for you! Walking can improve your strength and energy level, and

lift your spirits! Find a quiet street or road nearby, or try a shopping mall to take your walks. Many public schools also allow people to walk on their campuses after hours.

Balance. Rest is just as important as exercise. So pace yourself and be careful not to overdo it!

Immunizations. Catching the flu or pneumonia is much worse when you have CHF. Protect yourself by getting an annual flu shot and a one-time pneumonia vaccine.

11

Up Your AnteUp Your AnteUp Your Ante

Weight Log. Keep a log to record your daily weight. Consult your doctor if you gain over 2 pounds in a day or 3 pounds in a week. Weight gain is the earliest sign of worsening. Catch it early so your doctor can adjust your medicines and prevent a costly trip to the hospital.

12

The High StakesThe High StakesThe High Stakes

Weigh yourself every morningat the same time.• After you empty your bladder.• On the same scale.• Before eating.• Wearing the same amount of clothing.

HeartSmart

Most of the time, trips to the hospital are due to eating too much salt or not taking medicine properly. Report symptoms to your doctor early to avoid a trip to the emergency room or a stay in the hospital.

Report signs and symptoms earlyConsult your doctor if you have

any of the following: • Weight gain of over 2 pounds in a day or 3 pounds in a week.

• Shortness of breath that gets worse or wakes you from sleep.

• Swollen or puffy feet, ankles or legs.

• Dizziness or lightheadedness when you rise.

• Feeling exhausted during routine activity.

• Any symptoms that concern you.

13

Don’t Gamblewith Your HealthDon’t Gamblewith Your HealthDon’t Gamblewith Your Health

I PROMISE TO:

• Weigh myself every day

•Call my doctor if I gain too much

• Eat a low sodium diet

• Limit the amount of fluid I drink

• Avoid alcohol and tobacco

• Take my medicine faithfully

• Report any signs of worsening failure

• Do some exercise most days

• Pace myself and rest when I’m tired

SIGNED ____________________

DATE ____________________

Regular doctor visits help

“stack the deck” in your favor!

Doctor __________________________

Phonenumber __________________________

Emergencynumber __________________________

Targetweight __________________________

This maTerial was prepared by The arkansas FoundaTion For medical care inc. (aFmc), The medicare QualiTy improvemenT organizaTion For arkansas, under conTracT wiTh The cenTers For medicare & medicaid services (cms), an agency oF The u.s. deparTmenT oF healTh and human services. The conTenTs presenTed do noT necessarily reFlecT cms policy. Qb1-chFe.bro,2-5/10

Stack the DeckStack the DeckStack the Deck