Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Heart failure means the heart is failing to pump enough blood to the organs and tissues. One side of the heart (or both) cannot force enough blood out, so blood backs up into the system on the other side. This causes congestion in the tissues or organs. Congestion means that fluid leaks from the blood vessels into the tissues or organs, and blood does not move through the system well. If the left side of the heart fails, the system on the right side becomes congested, and vice versa. The congested side of the heart must work harder to move blood, and it also may eventually fail.

Living With Your Diagnosis
If the left side of the heart is in failure, the system on the right side becomes congested, causing fluid to leak back into the lungs. This causes fatigue, difficulty breathing (especially at night), coughing, or shortness of breath. If the right side of the heart fails, the left system becomes congested. This causes the liver to swell, which may cause pain in the abdomen. There may be swelling in the legs and feet. Heart failure is relatively common; any disease that stresses the heart muscle can cause heart failure. Examples of conditions that cause heart failure are high blood pressure, heart attack, heart muscle disease, heart valve problems, infections, arrhythmias, anemia, thyroid disease, pulmonary disease, or fluid excess in the body. Congestive heart failure is detected with an examination for physical changes such as swelling in the legs or crackling breath sounds. It can be detected with a chest radiograph (x-ray) because the heart looks enlarged and there may be signs that fluid has leaked into the lungs. Curing heart failure means curing the condition that caused the failure. You can manage congestive heart failure if you aggressively control your symptoms and monitor your breathing, swelling, and weight. Losing weight means lowering the fat and calories in your diet. Needing to rest makes exercise difficult, but going for an easy walk can burn a few extra calories and help reduce stress and keep you moving. Ask your doctor if it is safe to exercise. Some patients with heart failure benefit from a nap during the day just to give their heart a break and can do well with normal activities through the rest of the day. Reducing salt and fluid intake means stop adding salt to your meals and choose low-sodium foods. Dieticians and nutritionists can help you plan a diet.

The goal of treatment is to manage the initial symptoms so the failing ventricle does not have to work as hard. It is also important to manage the condition that caused the heart failure. To reduce its workload, the ventricle has to rest, pump less blood, and contract more efficiently. Resting helps reduce the workload. Decreasing fluid and salt in the diet reduces excess fluid in the blood and decreases blood volume. Additional oxygen eases the workload on the lungs. More oxygen is available for the blood, and less blood is needed. Weight loss is important. It means less tissue to pump blood through, less blood volume, and less weight for the muscles to move. This reduces the work of the heart. Smoking also makes the heart work harder. If a heart valve problem is the cause, an operation may be needed to repair or replace the valve. Medications may be prescribed to reduce fluid in the body or help the ventricle contract better. Diuretics help remove fluid. Nitrates help open blood vessels so blood flows more easily. Digitalis helps the ventricle contract efficiently. Blood pressure medications may be used to help reduce the pressure at which the heart has to pump. All these medications have side effects. Diuretics can cause dehydration or decrease electrolyte levels. Levels of digitalis have to be monitored. Digitalis causes low blood pressure, which may cause fatigue, dizziness, fainting, nausea, and vomiting.

The DOs
•Take your medications properly.
•Lose weight.
•Stop smoking.
•Decrease salt and extra fluid in your diet.
•Decrease the stress in your life.
•Get your family involved in your care. It is important that they understand the lifestyle changes that you must make so they can help.

The DON’Ts
•Do not forget to take all your medications as directed.

When to Call Your Doctor
•If you have side effects from your medications.
•If you have new or worsening symptoms, such as increasing shortness of breath, chest pain, or fainting. You will see your doctor often during the early part of treatment. Ask other questions about diet and exercise as your condition improves.