Congestive heart failure

Heart failure is when the heart does not fill and pump blood in the heart like it should. It can occur due to coronary heart disease (the heart arteries becoming clogged or hardened) and consistent high blood pressure leaving the heart too weak to perform its normal pumping and filling duty.

The picture above is from the website:

  • About 5.1 million people in the United States have heart failure
  • One in 9 deaths in 2009 included heart failure as contributing cause
  • About half of people who develop heart failure die within 5 years of diagnosis
  • Heart failure costs the nation an estimated $32 billion each year

Some major causes of CHF (congestive heart failure) are:

  • Coronary artery disease (clogging or hardening of the heart arteries) and heart attack
  • High blood pressure (hypertension)
  • Faulty heart valves
  • Damage to the heart muscle (cardiomyopathy)
  • Myocarditis (inflammation in the middle layer of the  heart usually from a virus)
  • Heart defects you’re born with (congenital heart defects)
  • Abnormal heart rhythms (heart arrhythmias)

Symptoms and signs may include:

  • Legs swelling
  • Shortness of breath
  • Decreased ability to exercise/decreased endurance
  • Rapid heart beat
  • Chest pain
  • Increased urination at night
  • Increased fluid retention

Risk factors that increase risk of CHF (Congestive heart failure)

  • Diabetes
  • Obesity
  • Hypertension
  • Heart attack
  • Irregular heart beat
  • Sleep apnea

Ejection fraction is the percentage of blood in the heart that is pumped per each beat. Normal ejection fraction is about 55 to 70%. In general though if the ejection fraction is less than 40% this usually a confirmation of heart failure.  There are many tests your Dr can perform to help confirm CHF like a BNP test, MRI of the heart, EKG of the heart, cardiac angiograpy (heart cathetarization)

All of the information below is from the renowned Cleveland Clinic

How to decrease the likelihood of disease progression if you have heart failure

What to bring to your doctor visit:

  • Medication list
  • Daily weights
  • List of symptoms – what they are, when they occur, how long they last, and what relieves them
  • Test and lab results
  • Records from all doctor or emergency room visits
  • Questions

How to lessen symptoms of heart failure

    • Decrease sodium (salt) in your diet. Usually less than 2000mg/day of sodium.
      Sodium is found naturally in many foods we eat.
    • Weigh yourself each morning, in similar clothing, after urinating, but before eating, and on the same scale. Record your weight in a diary or calendar. If you gain two pounds in one day or five pounds in one week, call your doctor. Your doctor may want to adjust your medications. See Monitoring Your Health When You Have Heart Failure.
    • Learn what your “dry” or “ideal” weight is.
      This is your weight without extra water (fluid). Your goal is to keep your weight within four pounds of your dry weight.
    • Your doctor may also ask you to:
      • drink or eat less fluids
      • keep a record of the amount of fluids you drink or eat and your urine output. Remember, the more fluid you carry in your blood vessels, the harder the heart must work to pump excess fluid through the body. A 2000 mg sodium diet and limiting fluid intake to less than 2 liters per day will help decrease the workload of your heart and prevent symptoms from recurring.

Do NOT wait for your symptoms to become so severe that you need to seek emergency treatment. See When to Call the Doctor about Your Heart Failure Symptoms.

  • Take your medications as prescribed.
      • Medications are used to improve your heart’s ability to pump blood, decrease stress on your heart, decrease the progression of heart failure (ventricular remodeling) and prevent fluid retention.
      • Many heart failure medications are used to decrease the release of harmful hormones. These drugs will cause your blood vessels to dilate or relax (thereby lowering your blood pressure).
      • Common medications for heart failure
      • Other medications are used to treat any associated problems, such as controlling abnormal heart rhythms, hypertension and high cholesterol.
      • Medications you should avoid if you have heart failure

    If you are taking any of these medications, discuss this with your doctor

    • Keep a list of your medications and bring them to each of your doctor visits.
    • Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively.
  • Improve the heart’s function through:

How to improve your quality of life

  • Eat a healthy diet
  • Eat less than 2,000 milligrams (2 grams) of sodium each day.
  • Eat foods high in fiber and potassium.See potassium guidelines for heart failure.
  • Reach and maintain a healthy weight (you may need to fewer calories per day).
  • Limit foods high in fat, cholesterol and sugar.
  • Manage your fluids.
  • Weigh yourself daily. Keep your weight within four pounds (two pounds lower or higher) than your dry weight.
  • Limit fluid intake to 2 liters or less per day.
  • Exercise regularly
    A regular cardiovascular exercise program, prescribed by your doctor, will help improve symptoms, strength and your sense of well-being. It may also decrease heart failure progression. See Heart Failure Exercise Guidelines.
  • Avoid heavy exercise or activities
    Activities, such as pushing or pulling heavy objects, shoveling, or strenuous occupations, may worsen heart failure and its symptoms.
  • Prevent respiratory infections
    Ask your doctor about flu and pneumonia vaccines.
  • Take your medications as prescribed
    Do not stop taking them without first contacting your doctor.
  • Get emotional or psychological support – if you need it

Heart failure can be difficult for your whole family. If you have questions, ask your doctor or nurse. If you need emotional support, social workers, psychologists, clergy and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.

Heart Failure Management Program

You may benefit from a heart failure disease management program. As part of this program, doctors and nurses provide frequent contact with you (through office visits, telephone calls or home monitoring) to alleviate symptoms, prevent symptoms from recurring and decrease the need for emergency care or hospitalization. In this program, emphasis is placed on increasing your knowledge of heart failure and helping you self-manage your condition. Ask your doctor about Heart Failure Management Programs he or she may be affiliated with. At the Cleveland Clinic, call 216.444.4604.

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If you need more information:

Contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Cardiac rehabilitation

Your doctor or nurse may encourage you to participate in the hospital’s cardiac rehabilitation (rehab) program. A cardiac rehab program is designed to help you exercise safely and maintain a heart-healthy lifestyle. The program generally includes:

What type of exercise is best?

Exercise can be divided into three basic types:

1. Flexibility (and warm-up): Slow lengthening of the muscles. Stretching the arms and legs before and after exercising helps prepare the muscles for activity and helps prevent injury and muscle strain. Flexibility exercises include stretching, tai chi and yoga. These exercises allow you to have better balance, a better range of motion, and keep your joints flexible.

2. Cardiovascular or aerobic: Steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body’s ability to use oxygen.

Aerobic exercises include: walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing, and low-impact aerobics or water aerobics.

3. Strengthening: Repeated muscle contractions (tightening) until the muscle becomes tired.Strength Training involves lifting weights or using resistance (resistance tubing or bands, for example) to strengthen the skeletal muscles.

How often should I exercise?

In general, to achieve maximum benefits from exercise, you should gradually work up to an aerobic session that lasts 20 to 30 minutes, at least 5 times a week.


General exercise guidelines

  • Wait at least 90 minutes after eating a meal before aerobic exercise.
  • Gradually increase your activity level, especially if you have not been exercising regularly.
  • Warm up. Take time to include a 5- minute warm-up, including stretching exercises, before any aerobic activity.
  • Cool down. Include a 5-minute cool down after the activity. Stretching can be done while standing or sitting.
  • When drinking liquids during exercise, remember to follow your fluid restriction guidelines.
  • Schedule exercise into your daily routine. Plan to exercise at the same time every day (such as in the mornings when you have more energy). Add a variety of exercises so that you do not get bored.

Talk to a Nurse: Mon. – Fri., 8:30 a.m. – 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.


11 thoughts on “Congestive heart failure

  1. Reblogged this on Erika Kind and commented:
    I follow this blog for some weeks because it is so very insightful. Jon is a physical therapist and he posts frequently about muscle, bones, back, joint, organ, veins,… problems. He gives advice how to help yourself or how to recognize symptoms. I just commented that his blog is a reference book. Really, if you have something that bothers you about your health then check if Jon has written something. And if not then ask him!


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