Congestive Heart Failure (CHF)
By Jon Owens , VP of Management Services, Rocky Mountain Care, Salt Lake City LIVING WELL Magazine
Congestive heart failure (CHF) is a syndrome, not a disease. It is a weakening of the heart muscle, which occurs when there is an underlying heart or blood vessel problem and can occur at any age. Often, it is brought on by a combination of problems, including: weakened or damaged heart muscle (cardiomyopathy), damaged heart valves, heart attack (myocardial infarction) and toxic exposures to alcohol, drugs or other harmful chemicals, infections of the heart valves and/or heart muscle itself, high blood pressure (hypertension), congenital heart diseases, irregular heart beat (arrhythmias) and coronary heart disease.
The “failing” heart keeps working but not as efficiently as it should. People with heart failure cannot exert themselves because they become short of breath and tired. As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. This can lead to swelling (edema) in the extremities. Most often there is swelling in the legs and ankles, but it can occur in other parts of the body as well. Sometimes fluids collect in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down. Heart failure also affects the kidney’s ability to dispose of sodium and water.
Some of the most common symptoms of heart failure include:
- shortness of breath
- cough
- swelling of feet and ankles
- weight gain, irregular or rapid pulse
- difficultly sleeping
- fatigue or weakness
Other symptoms may include:
- Decreased alertness or concentration
- Nausea and vomiting
- Need to urinate at night
The treatment of heart failure depends on the exact cause, but it can usually be treated effectively. The overall goals of treatment are to correct underlying causes, to relieve symptoms, and to prevent worsening of the condition. Specifically, the treatment of heart failure should include a balance of the right medications, cardiac rehabilitation, use of supplemental oxygen and in some cases, surgery or the use of devices that help the heart beat or contract more effectively. Symptoms can be relieved by removing excess fluid from the body, improving blood flow, improving heart muscle function, and increasing delivery of oxygen to the body tissues.
Most people with a serious illness prefer to be at home. Family and caregivers play an important role in helping patients manage their care at home. This includes helping patients recognize and treat symptoms to prevent a medical crisis and to avoid unwanted or unnecessary hospitalizations. Family and caregivers should assist patients to take all medications and encourage medication compliance; weigh themselves daily; follow appropriate diet guidelines and proper nutrition; use oxygen as prescribed; exercise and receive adequate rest.
Medication management plays a vital role in treating the symptoms of congestive heart failure. Some of the common medications that are often prescribed include:
- Angiotensin-converting enzyme (ACE) inhibitors – (i.e., Vasotec, Prinivil, Zestril, Capoten)
- Agiotensin II receptor blockers (ARB) – (i.e., Cozaar, Diovan, Lanoxin)
- Beta Blockers – (i.e., Coreg, Lopressor, Zebeta)
- Diuretics – (i.e., Bumex, Lasix)
- Aldersterone Antagonists – (i.e., Aldactone, Inspra)
Most patients will use two or more medications to manage their symptoms. However, a physician may prescribe other medications such as nitrates (Nitroglycerin) for chest pain and a statin to lower cholesterol such as Atorvastatin (Lipitor) or blood thinning medications (Coumadin) to help prevent blood clots.
Nutrition is also a very important part of managing the symptoms of congestive heart failure. Patients with CHF should consider making changes in their diet to reduce the stress on the heart. Important consideration to make would include reducing your salt intake. Here are a few suggestions:
- Eat plenty of fresh fruits and vegetables
- Choose foods that are low in salt (i.e., fresh meats, legumes, eggs, milk & yogurt)
- Season with herbs, spices and fruit juices
Always read food labels before you buy packaged foods. Check nutrition facts on the label for sodium content per serving. Try to pick packaged foods with sodium content less than 350 milligrams for each serving. It is also useful to check the list of ingredients. If salt or sodium is listed in the first five (5) ingredients, it is too high in sodium.
Rocky Mountain Care has created a program specifically designed to assist patients in managing the symptoms of congestive heart failure. This program provides frequent contact with clinical staff, equipment to monitor vital signs and educational resources to assist in managing symptoms. If you would like more information about this program, please call 1-800-574-7666.
