Patient info sheet

What is congestive heart failure?
The heart works like a pump. It receives blood from the body and pumps it to the lungs, where it receives oxygen. This oxygen-rich blood is then pumped out to nourish the body.
Congestive heart failure occurs when this pumping action is impaired, and the heart cannot pump enough blood to meet the body’s needs. When the heart cannot pump out the blood it receives, excess fluid may back up into the lungs and other body tissues.
The decrease of nourishment to the body, and the overflow of fluid to the lungs, cause symptoms of congestive heart failure.
What causes congestive heart failure?
Congestive heart failure has many causes including heart attack, alcoholism, high blood pressure, and abnormal pregnancy. This condition cannot be cured, but it can be treated effectively.
How the heart works 1. Venous blood flows from the body to theright side of the heart. 2. Blood is then pumpedto the lungs to pick up oxygen. 3. After pickingup oxygen, blood goes to the left side of theheart. 4. Blood is pumped out to nourish thebody.
What are the signs and symptoms of congestive heart failure?
These are the signs and symptoms of congestive heart failure:  sudden weight gain
 swelling of the hands, feet, legs, ankles, or abdomen  irregular heart beats, skipped beats, or palpitations
Patient Education 1 Understanding Congestive Heart Failure
 shortness of breath during rest or activity
 waking during the night with a choking feeling or with shortness of breath
 persistent cough (coughing up mucus or blood)
 excessive tiredness.
Illustration about what happens during congestive heart failure
Illustration about what happens during congestive heart failure Illustration about what happens during congestive heart failure Illustration about what happens during congestive heart failure Illustration about what happens during congestive heart failure Illustration about what happens during congestive heart failure
Can I prevent congestive heart failure?
You can learn from your doctor and nurse how to decrease the chances of developing congestive heart failure. You may ask them any questions that you have about your role in dealing with this syndrome. Here is how you can prevent congestive heart failure:
Keep regular appointments with your doctor or nurse.
To provide you the best care, your doctor needs to monitor your condition. Know the signs and symptoms of congestive
heart failure so that you can report
them promptly to your doctor or nurse.
Maintain normal blood pressure.
Abnormally high blood pressure may add a strain on the heart muscle because there is more resistance to its pumping action.
The strain may cause abnormalities that
will result in congestive heart failure. You
can keep your blood pressure normal by
doing the following:
 Maintain normal weight.
Added weight increases the heart’s workload. The heart becomes overtaxed as it tries to supply blood to extra body mass.
Avoid smoking or cut down on your
habit. Smoking damages the lungs and causes
major problems for the heart. It also
narrows the blood vessels, making the
heart pump against increased force.
The added workload will strain the
heart.
Follow any special diet prescribed for you.
A low sodium (salt) diet may be recommended to keep your blood pressure normal. You may be asked to avoid salt and such salty foods as canned soups and vegetables, luncheon meats, cheese, pickles, and soft drinks containing salt. However, your doctor may allow you to use a salt substitute. You can work with your dietitian to plan enjoyable, salt-free meals. The dietitian can also
Patient Education 2 Understanding Congestive Heart Failure
show you how to check food labels for salt content.
 Find time to do the things you enjoy
and to relax.
Maintain an activity level that does not cause you to have shortness of breath, palpitations, or excessive fatigue. Be sure to leave enough time for rest.
How do medications help control congestive heart failure? Medications help decrease the chance of
developing congestive heart failure. The most commonly used medications for this syndrome decrease fluid in the body and help the heart pump more easily. Other medications help the heart pump more easily by lowering blood pressure.
Are there precautions to follow when I take medications?
The following precautions should be followed:  Inform the health professionals involved
in your care about all your medications. These health professionals include physicians, dentists, nurses, and pharmacists.
 Check with your cardiologist about taking such over-the-counter drugs as aspirin, antacids, or laxatives. These drugs may contain ingredients that could affect your heart, blood pressure, and body fluids. For example, many antacids have a lot
of salt, and laxatives may cause you to lose too much fluid.
 Do not stop taking your medication or change your dose without your doctor’s approval.
 Do not let anyone else use your medication.
 If you think you have been given the wrong medication or dose, check with your doctor or pharmacist. Do not take anything you are unsure about.
Facts about some common medications used to treat congestive heart failure
Diuretics Diuretics, known as “water pills,” enable the heart to pump more easily because they lower the amount of fluid and salt in the body. Loss of excess fluid also lowers blood pressure because there is less fluid for the heart to pump, and there is less force exerted by the blood vessels. The decrease in excess fluid usually lessens or eliminates swelling of various parts of the body.
Precautions
 Some diuretics cause the body to lose too much potassium. Potassium, a normal body element that maintains proper muscle function, is especially important for heart muscle. When potassium is too high or too low, the heart cannot beat properly. Ask your doctor if you need to take a potassium supplement. Since not all diuretics cause potassium loss, do not take a potassium supplement unless your doctor prescribes one.
Patient Education 3 Understanding Congestive Heart Failure
 Try to take your diuretic during the day so that you will not be awakened frequently to urinate at night.
Digoxin Digoxin strengthens the pumping action of the heart. This medication slows down the heart and pulse. Each beat becomes more forceful and circulates more blood throughout the body. With the heart’s increased pumping ability, there is less chance for excess blood to back up into the lungs or into other body tissues.
Precautions Do not substitute one brand of Digoxin for another; always take the brand prescribed for you.  Before taking this drug, you may be asked to check your pulse. Ask your doc-tor what pulse rate is right for you. • Notify your doctor or nurse if you have any of these side effects: n loss of appetite n nausea
n fatigue
n weak muscles
n diarrhea
n vomiting
n headaches
n vision trouble.
 To make sure that you have the right blood level of Digoxin, your blood will be drawn occasionally. ACE inhibitors (Captopril, Enalapril, Lisinipril)
ACE inhibitors are drugs used to control high blood pressure as well as treat congestive heart failure. When given to certain patients with congestive heart failure, an ACE inhibitor may decrease symptoms, decrease hospitalizations, and increase survival. One of the ACE inhibitors is usually given with Digoxin and a diuretic. The medications work together to help the body get rid of excess fluid and salt, and improve the pumping action of the heart.
Precautions
 The most common side effect of ACE inhibitors is low blood pressure, which may
cause dizziness, palpitations, passing out, chest pain, or angina.
 Expect that you will have your blood pressure closely monitored when first taking this medication.
 Learn to rise slowly from a lying to a standing position. Dangle your feet before getting up.
 Take this medication 1 hour before meals.
 Do not take potassium supplements or salt substitutes unless instructed by your doctor.
 If you develop a chronic cough, report this to your doctor or nurse. You may need to be switched to another ACE inhibitor.
 Avoid large amounts of caffeine, tea, coffee, cola, and alcohol.
 Expect that it may take 1 to 2 weeks or longer to feel the full benefit of your medication.
Patient Education 4 Understanding Congestive Heart Failure