Congestive Heart Failure (cont.)
What is the treatment of congestive heart
failure?
Lifestyle modifications
After congestive heart failure is diagnosed, treatment should be started immediately. Perhaps the most important
and yet most neglected aspect of treatment involves lifestyle modifications. Sodium causes an
increase in fluid accumulation in the body's tissues. Because the body is often congested with
excess fluid, patients become very sensitive to the levels of intake of sodium and water.
Restricting salt and fluid intake is often recommended because of the tendency of fluid to
accumulate in the lungs and surrounding tissues. An American "no added salt" diet can
still contain 4 to 6 grams (4000 to 6000 milligrams) of sodium per day. In patients with
congestive heart failure,
an intake of no more than 2 grams (2000 milligrams) of sodium per day is generally advised.
Reading food labels and paying close attention to total sodium intake is very important.
Likewise, the total amount of fluid consumed must be regulated. Although many patients with
congestive heart failure take diuretics to aid in the elimination of excess fluid, the action of these medications
can be overwhelmed by an excess intake of water and other fluids. The maxim that "drinking
eight glasses of water a day is healthy" certainly does not apply to patients with congestive heart failure. In fact, patients with more advanced cases of congestive heart failure are often advised to limit their total daily fluid intake from all sources to 2 quarts. The above guidelines for sodium and fluid intake may vary depending on the severity of congestive heart failure in any given patient and should be discussed with
the patient's physician.
An important tool for monitoring an appropriate fluid balance is the frequent measurement of body weight.
An early sign of fluid accumulation is an increase in body weight. This may occur even before shortness
of breath or swelling in the legs and other body tissues (edema) is detected. A weight gain of
two to three
pounds over two to three days should prompt a call to the physician, who may order an increase in the
dose of diuretics or other methods designed to stop the early stages of fluid accumulation before
it becomes more severe.
Aerobic exercise, once discouraged for congestive heart failure patients, has been shown to be beneficial in
maintaining overall functional capacity, quality of life, and perhaps even improving survival.
Each patient's body has its own unique ability to compensate for the failing heart. Given the
same degree of heart muscle weakness, patients may display widely varying degrees of limitation
of function. Regular exercise, when tailored to the patient's tolerance level, appears to provide
significant benefits and should be used only when the patient is compensated and stable.
Addressing potentially reversible factors
Depending on the underlying cause of congestive heart failure, potentially reversible factors should be explored.
For example, in certain patients whose congestive heart failure is caused by inadequate blood flow to the heart
muscle, restoration of the blood flow through coronary artery surgery or catheter procedures
(angioplasty, intracoronary stenting) may be considered. Congestive heart
failure that is due to severe disease of the valves may be alleviated in appropriate patients by valve surgery. When
congestive heart failure is caused by chronic,
uncontrolled high blood pressure (hypertension), aggressive blood pressure control will often improve the
condition. Likewise, heart muscle weakness that is due to longstanding, severe alcohol abuse can
improve significantly with abstinence from drinking. Congestive heart failure that is caused by other disease states
may be similarly partially or completely reversible by appropriate measures.
Next: Medications »
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Pneumococcal Vaccination - Learn about pneumococcal vaccination (pneumonia vaccine) recommendations and side effects, and find out who should and should not be vaccinated.
- Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause.
Latest Medical News
Heart RSS