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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Focus on Fitness Focus on Fitness
 

Living Well With Heart Failure


May 04, 2014

By Paulette Chandler M.D.

Brigham and Women's Hospital


Have you ever had your car break down on the highway? If you had previous problems such as stalling or warning indicators on the dashboard, you may berate yourself for ignoring these warning signals.

Just as there are certain maintenance strategies for keeping a car's engine running smoothly, there are daily tune-up strategies for keeping the engine of the body — the heart — operating optimally even when it has been damaged, as with congestive heart failure (CHF).

CHF is a gradual weakening of the heart muscle that impairs the heart's ability to pump forcefully. Common causes of CHF include coronary artery disease, prior heart attack, long-standing high blood pressure, overuse of alcohol, obesity, diabetes and a faulty heart valve. Shortness of breath and fatigue as blood flow diminishes to the kidneys, brain, skin and other vital tissues are warning signals of CHF. You may also develop swollen feet, legs and belly.

Stress management, healthy eating and daily exercise adjusted to your energy level are essential tools for heart repair and tune-up.

Emotional stress and anxiety make the heart work harder. This can potentially worsen heart failure. Exercise strengthens the heart muscle and cardiovascular system, elevates mood and helps your body use oxygen better relieving heart failure symptoms. Patients with CHF who participate in exercise programs have profound decreases in hospital readmissions for CHF.

Cardiac rehabilitation programs often will include supervised activities such as cycling on stationary bike or using a treadmill. Cardiac "rehab" is an excellent way to improve your ability to enjoy activities of daily living, reduce your heart disease risk factors and increase your knowledge of your disease and how to manage it.

Listed below are some basic guidelines for living well with heart failure.

Try These Energy and Mood Boosters

  • Get out and walk each day.
  • Share your feelings and concerns with friends and caregivers.
  • Take medications each day.
  • Quit smoking or using tobacco.
  • Engage in an activity that you enjoy each day.
  • Take breaks throughout the day. Relax. Use music, meditation, or gentle stretches to decrease stress.

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Save Energy Where You Can

  • Simplify your tasks. Do not schedule too many activities for a day.
  • Get adequate sleep.
  • Use devices to minimize exertion, such as a walker or shower chair.
  • Do grooming (such as shaving, drying your hair) while sitting.

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Keep Your Diet Heart Healthy

  • Limit dietary sodium to 1,500 mg per day. Learn to read food labels carefully to achieve this goal. Make an appointment with a dietician to learn how to optimize your diet.
  • Eat foods high in potassium and magnesium if your kidney function is normal. Potassium- and magnesium-rich foods include bananas, oranges, nuts, spinach and broccoli.
  • Choose foods high in fiber. Include 25 to 35 grams of fiber in your diet each day. Good fiber sources include fruits, vegetables, beans and whole grains such as brown rice and oats.
  • Limit saturated fat and cholesterol. Choose foods rich in omega-3 fatty acids such as salmon and flax-seed oil.
  • Lose weight if you are overweight. Cut your calories and follow a daily exercise program to achieve your ideal body weight.
  • Avoid or limit alcohol use. Alcohol can worsen heart failure. Alcohol also may interfere with medications that you use.

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Monitor Your Heart Failure

  • Check and record your weight daily. Use the same scale and wear similar clothing. Notify your doctor if you gain more than 2 pounds in one day or 5 pounds in one week.
  • Record fluid intake each day if your doctor requires you to restrict fluids. Some foods are considered to be fluids, including pudding, soups, ice cream and gelatin.

Finally, if you have shortness of breath or excessive fatigue during any activity, slow down or stop the activity. Other warning signals are pain or pressure in the chest, neck, back, arm or jaw, or light-headedness. Call doctor if you have symptoms that persist even with rest. ashutoshtest

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Paulette Chandler, M.D., M.P.H., is a clinical instructor of medicine at Harvard Medical School and an attending physician at Brigham and Women's Hospital.

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