So you’ve been diagnosed with heart failure (HF). What are you supposed to do now? For starters, don’t panic. “When you hear the words heart failure, it doesn’t mean your heart has stopped,” says Hal Skopicki, M.D., chief of cardiology and director of the Heart Failure and Cardiomyopathy Program at the Stony Brook University Heart Institute in Stony Brook, NY. “It means it has a challenge. The good news is we have developed a huge number of mediations and ways to manage HF that have resulted in an over 85 percent reduced risk of dying from HF.”
You'll likely have to make a bunch of changes in your life, but take them one step at time, starting with this advice.
#1: Take Your Medications as Directed
When you have HF, you should expect to take a wide variety of medications, including diuretics (water pills) to remove excess fluid that has accumulated, as well as ACE inhibitors to increase blood flow and beta blockers to slow your heart rate. “If your doctor finds out that your heart failure is related to uncontrolled high blood pressure, you’ll take medication for that as well,” says Robert Greenfield, M.D., a cardiologist and medical director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.
#2: Keep in Close Touch With Your Physician
Since HF is a chronic illness, your goal is to keep your physician in the loop on how you’re feeling and if your medications are working. For example, if you’re still having symptoms such as shortness of breath, fatigue or weakness, rapid heartbeat or swelling in your legs, ankles and feet, while on your medication, you may need to have your dosages adjusted. In the beginning, you can expect to see your doctor frequently, as often as once a week, precisely for this reason. Once your symptoms stabilize, fewer in-office visits will be required.
#3: Weigh Yourself Daily
“We call it the rule of twos: If your weight goes up more than two pounds in two days that means you’re retaining fluids,” says Dr. Osborne. “We want patients to report in to us if this happens so that we can make a quick course correction with diuretics. After all, you can put on 10 pounds in a couple of days that’s all water weight, and you won't be aware of it until you’re short of breath.”
Here's the reason it's so important to keep track: Fluid buildup (also called edema) can be particularly dangerous for people with HF. It can lead to a more serious form of the disease called congestive heart failure in which fluid begins to collect in the lungs, abdomen, and/or legs and feet. Emergency care is usually required.
#4: Quit Salt
While our bodies need just 220 mg of salt a day, the average American consumes approximately 6,000 mg per day. This is problematic for all of us, but especially for those with HF, says John A. Osborne, M.D., Ph.D., director of State of the Heart Cardiology in Dallas and a volunteer expert at the American Heart Association. “Salt acts as a water magnet and causes water to stay in the body,” he says. Exactly what you don't want to have happen if you have HF. “I try to get people to consume below 2,000 milligrams a day of sodium because it’s the enemy of the heart.”
The easiest way to quickly cut your salt intake is to dump processed foods from your diet, and focus on adding more fruits and veggies.
#5: Consider Cardiac Rehab
These medically supervised gyms that are often set up at your local hospital offer a safe space for HF patients to build exercise endurance and muscle. “HF patients are chronically ill so these gyms are great places for you to exercise, especially if you’re afraid of what you can and cannot do,” Dr. Osborne says. “Also, HF patients need a psychological boost so cardiac rehab not only helps patients feel better below the neck but above it, too.”
You do need a prescription for rehab, but it's often covered by insurance. So talk to your doc, confirm your coverage, and get ready to start getting stronger.