Managing Heart Failure
APRIL 30, 2019
Healthy Choices and Careful Monitoring are Key to Control
Heart failure affects more than 5 million patients in the United States and is one of the most common reasons for hospitalization if you're over 65.
The term can sound frightening, but it doesn't mean that the heart has stopped working.
"Heart failure develops when the heart muscle isn't pumping at full capacity," explains Marwa Sabe, MD, MPH, Acting Director of the Advanced Heart Failure Program at Beth Israel Deaconess Medical Center.
As heart failure progresses, fluid builds up in the body, leading to swelling of the feet, legs and ankles, shortness of breath, and sudden weight gain. The good news is that heart failure can be managed before symptoms become debilitating.
"You don't have to feel tired and worn out and short of breath all the time," says Monique Nestor, NP, Nurse Practitioner in the Advanced Heart Failure Program. "If you have mild to moderate heart failure, you can maintain a good quality of life and avoid hospitalizations by taking care of your health and working closely with your doctors and health care providers."
Pay Attention to Your Body
Learn to recognize symptoms that indicate heart failure may be getting worse — and contact your doctor right away. Warning signs include sudden weight gain, worsening shortness of breath and fatigue, as well as swelling in the abdomen, ankles, legs or feet.
Weigh Yourself Daily
Rapid weight gain can be a sign that fluid is accumulating in your body and may be straining the heart. ";Patients should weigh themselves first thing in the morning every day and keep a record of their weights," says Nestor.
Contact your doctor if you notice:
- weight gain of three pounds or more within three days or,
- weight gain of five pounds or more within five days
Follow Your Prescriptions Carefully
Certain medications can help the heart work more efficiently, reducing strain on the heart muscle and helping to remove fluids from your body. Be sure to take your medications as directed and ask your doctor or pharmacist if you have questions.
Cut Back on Salt
Eating excess salt increases your body's water content, which makes your heart work harder to pump blood and oxygen. The American Heart Association recommends no more than 1,500 milligrams of sodium per day. (A one-quarter teaspoon of salt contains 575mg of sodium.)
"Make small changes at a time and your taste buds will adapt," says Elizabeth Odvarka, MS, RD, LDN, a dietitian in the Advanced Heart Failure Program. "A registered dietitian can provide further guidance and individualized recommendations."
Odvarka recommends these steps:
- Throw away the salt shaker. Flavor your food instead with lemon juice, lime juice, vinegar, and unsalted spices, such as pepper, basil, bay leaf, dill, rosemary, sage, dry mustard, thyme, and paprika.
- Learn to read nutrition labels. Choose foods with 140mg of sodium or less per serving. (The amount of sodium per serving is listed at the top of the nutrition label.)
- Cut back on prepared and processed foods — most of the salt we eat comes from the actual processing of foods.
- Save restaurants for special occasions. When you do eat out, avoid menu items with breading, creamy sauces or dressings, and cheese. Ask for your dishes to be prepared without any additional salt and choose fresh foods (such as steamed vegetables) whenever possible.
Make Lifestyle Changes and Maintain Healthy Habits
"Patients play a big role in managing their heart failure," says Nestor. "Lifestyle changes can make a huge difference to the quality of their lives."
- Avoid or limit alcohol
- Cut back on caffeine
- Quit smoking
- Stay as active as possible (within the guidelines of your health care provider)
- Lose weight, if needed
- Keep blood pressure under control
- Keep fluids to 1.5 to 2 liters per day (48 to 64 ounces)
- Get a flu shot each year
BIDMC's Advanced Heart Failure program provides comprehensive support services to help patients manage their diets, medications and day-to-day lives. The program recently received the Get with the Guidelines Gold Star Award from the American Heart Association.