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Checklist for Coping With Congestive Heart Failure

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Not long ago congestive heart failure (CHF) was coping with congestive heart barely treatable. Now there are a variety of medications that strengthen heart muscle and lower the heart's workload. Bypass surgery is done routinely to treat the most common cause of heart failure, coronary artery disease. With medication and a comprehensive cardiac rehab plan, patients with congestive heart failure live longer and improve their quality of life. The prognosis depends on the patient's willingness to follow a diet and exercise plan. Survival also depends on the patient's own monitoring of weight fluctuations, swelling, and breathing problems.


The same diet and exercise recommendations to avoid heart disease apply to patients who have congestive heart failure. The difference: damage is already done in heart failure patients. Someone with CHF probably already has advanced coronary artery disease and may have already suffered at least one heart attack. While heart damage is mostly irreversible, remaining healthy heart muscle CAN be strengthened with exercise. Moreover, a heart healthy diet, and the proper cholesterol-lowering drugs (if necessary), will keep the cholesterol level down and may even help to reduce the size of existing plaques that would go on to cause another heart attack. So those with CHF should follow these "lifestyle" recommendations:

  1. Quit smoking. Cigarette smoking is considered the biggest risk factor for sudden cardiac death, when the heart suddenly stops pumping effectively. In someone with CHF, heart muscle is already susceptible to irregular, ineffective contractions. Smoking increases blood pressure, which puts strain on an already weakened heart.
  2. Control your blood pressure. High blood pressure (hypertension) increases the workload of the heart. In CHF, more workload means more backup into the lungs (left-sided failure) or back up into the abdomen and legs (right-sided failure). Keeping sodium to 2 grams per day or less helps to control blood pressure and takes the workload off the heart.
  3. Control your blood cholesterol. The most common cause of congestive heart failure is coronary artery disease. Patients with CHF often have advanced coronary artery disease and have already had one or more heart attacks. However, by adopting a diet that is lower in saturated fat and cholesterol, it is often possible to reduce cholesterol levels and prevent further build-up of cholesterol plaque in the walls of coronary arteries. Medication to help lower cholesterol is usually recommended along with dietary changes.
  4. Increase your physical activity. Regular, moderate to vigorous intensity exercise plays a significant role in strengthening the remaining healthy heart, even if a lot has been damaged by prior heart attacks. Studies have shown that moderate exercise, when done regularly, is beneficial in reducing the risk for a second heart attack in patients who have CHF.

People with congestive heart failure need to be on guard for the following signs:

  • Sudden weight gain.
  • Shortness of breath with your usual activities.
  • Getting up at night with difficulty breathing.
  • Short of breath even when lying down.
  • Coughing and wheezing.
  • Coughing up frothy red sputum (phlegm).
  • Chest pain.
  • Heart palpitations or irregular heart beats.
  • New or increased swelling of the feet or legs.
  • Abdominal pain, nausea or lack of appetite.
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