Description

Congestive Heart Failure (CHF) is one of the most frequent causes of recurrent hospitalizations in the United States. Because the heart is a pump, it pumps fluid out of the heart into the rest of your circulatory system. When fluid builds up in the lungs it causes shortness of breath. When fluid backs up into the veins, it causes fluid retention in the extremities (edema.) When the heart is really weak, extra fluid will accumulate in the abdominal cavity (ascites) or into the chest cavity (pleural effusion.)

Understanding the disease process, developing, and adhering to a treatment plan will result in better management of the symptoms and allow care to be adequately managed at home.

Helpful tips

• Monitor fluid status by performing a daily weight and recording this weight on a calendar. Daily weights should be done at the same time every day. Most medical providers recommend using the same scale, upon arising, after urinating, wearing the same type of night clothes.
• Most people will not eat more than 2 pounds of food a day, so if there is a weight gain of over 2 pounds in a 24 hour period, notify your medical provider immediately. Medications dosages may need to be adjusted or instructions given for an "as needed" extra dose of diuretics.
• Make sure medications are taken correctly and on time.
• Medical providers often request that blood pressures be monitored. Automatic blood pressure cuffs are readily available in most drug stores.
• Medical providers will generally request monitoring/restricting of fluid intake. Calibrated glasses can be purchased, or use a "cooks" measuring cup.
• Hot or humid weather or climates can lead to dehydration for people taking diuretics. Symptoms of dehydration include: low blood pressure, lightheadedness on standing, low urinary output, increasing weakness, fast heart rate and confusion. If there is progressive daily weight loss, associated with above symptoms, suspect dehydration. Seek medical attention immediately, as dehydration can lead to acute renal failure and death.
• Most medical providers will suggest limiting salt intake.
• Monitor urinary output. Elderly med with enlarged prostates may have difficulty urinating which may lead to fluid retention. Notify your medical provider immediately.
• Difficulty in sleeping through the night due to increasing shortness of breath or frequent urination at night may be an indication that medications need to be adjusted. Seek medical attention.
• Watch for increasing weakness or decreasing activity tolerance as this may indicate less than adequate management of Congestive Heart Failure.
• Elevate legs when possible to minimized fluid retention (edema.)
• If oxygen has been prescribed, use as instructed. Using oxygen during sleep will minimize symptoms of shortness of breath and reduce the pressure on the heart.

Discussion

Having a clear understanding of Congestive Heart Failure and how to manage the symptoms will result in a better quality of life and will decrease the need for hospitalizations. Congestive Heart Failure requires ongoing medical management and routine scheduled visits. Knowing when to contact the medical provider for changing or worsening symptoms is the key to successful management.

However, no matter how well managed Congestive Heart Failure is, there is always the potential for the heart to decompensate, or for another disease process to occur and result in worsening Congestive Heart Failure symptoms leading to cardiopulmonary failure, arrest and death. Plan for and know when to seek emergency attention (this may include calling 911 if this service is available in your area.)

Related topics

Discussing Congestive Heart Failure
Discussing Chest Pain
Managing Chest Pain
Oxygen Use and Care of Equipment