How to Survive and Thrive with Heart Failure

How heart failure happens

Heart failure is not a disease, but rather a condition caused by other diseases or risk factors. In the most common type of heart failure, the left ventricle—the heart’s main pumping cham-ber—becomes too weak to contract well. In the other type, which is particularly common in women, it becomes too stiff to refill after emptying. Either way, the heart is unable to meet the body’s needs for oxygenated blood.

Symptoms generally include fatigue or shortness of breath with exertion, fluid retention, heart palpitations, difficulty breathing when lying down, and awakening gasping for air. As heart failure progresses, these symptoms begin to occur more frequently with less exertion, or even at rest.

Heart failure is sometimes diagnosed before symptoms appear, usually when a patient with high blood pres-sure, diabetes, or previous heart attack is being closely monitored by a physician. When heart failure is identified early, fewer medications are needed to help the heart do its job.

Managing heart failure

Once heart failure has been diagnosed, medications are used to slow disease progression and prevent the need for hospitalization. These medications typically include a diuretic (“water pill”) or aldosterone blocker to reverse fluid retention, an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) to improve blood flow, and/or a beta-blocker to lower blood pressure and heart rate. The combination prescribed depends on the underlying cause of the heart failure and its severity.

For some patients, treating the underlying cause with bypass surgery or valve surgery is necessary to prevent further deterioration. Some patients benefit from a biventricular pacemaker, which synchronizes their heartbeat to help their heart contract properly.

Leading a healthier life

Leading a healthy lifestyle is regarded as critical to slowing the progression of heart disease and improving quality of life. Certain lifestyle adjustments can go a long way to help maintain or even improve your level of independence and enjoyment of normal activities.

✔ Lower your sodium intake. Your doctor will determine how much sodium is safe for you to consume, but, generally, you can expect to cut your intake by one-half to two-thirds. Because canned, bottled, and prepared foods tend to have high sodium levels, most people find the best way to eat less sodium is to buy fresh food and prepare it at home.

✔ Limit fluids. Because heart failure causes the body to retain fluid as well as salt, you’ll want to restrict your fluid intake to eight cups a day, including water, beverages, ice, citrus fruit, soup, ice cream, applesauce, and any other food that melts or is soupy. Weigh yourself daily to detect weight gain that may be a sign you are retaining fluid.

✔ Get regular exercise. While exercising with a weak heart may sound frightening, exercise actually strengthens the heart muscle, helps blood circulate, and improves sleep and quality of life. Exercise also will keep your bones and muscles strong and help you manage your weight. Your doctor will tell you how much exercise—and what kind—is best for you.

✔ Rest up. Don’t push yourself. Rest when you feel tired. Don’t be afraid to catnap, but avoid napping too long, or you may find it hard to sleep for seven to eight hours a night.

“Preventing or minimizing symptoms and staying out of the hospital is an ongoing process. It takes patient dedication and doctor-patient teamwork to maximize quality, as well as length, of life,” says Dr. Gelbman. “Now that people are living longer, heart failure is becoming increasingly common. Fortunate-ly, the way we manage this condition is continuing to improve.”

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