Managing Heart Failure

The good news: More patients with heart failure are living longer. Roughly 15 years ago, those suffering from heart failure would have been given medication and then asked to wait for a heart transplant while their condition deteriorated. Today, medical advances, new devices and treatments have revolutionized how heart failure is managed.

It is important for you, as a caregiver, to understand the ways in which your loved one can improve his or her chances for a longer, healthy life. Here, Cleveland Clinic heart failure expert Randall C. Starling, MD, MPH, Head of Heart Failure and Cardiac Transplant Medicine, offers seven important tips:

1. Stay connected. It’s essential for heart failure patients to maintain regular follow-up appointments with their doctor, even if they think their condition is under control. “Sustaining a relationship with healthcare providers helps increase the likelihood that they’ll remain on their treatment path and stay healthy,” Dr. Starling explains. Your loved one may visit the doctor only a few times a year, so encourage him or her to keep track of appointments and use a medical journal to chart any changes, if possible.

2. Mind the medication. For many heart failure patients, a combination of medications is key to managing their condition — or even reversing the symptoms, Dr. Starling says. “It’s important that your loved one know the names, doses and side effects of all his or her prescriptions,” he stresses. Offer to create a calendar with instructions on when to take medications and use a weekly pill dispenser. You also can offer to help refill prescriptions or drive your loved one to the pharmacy.

3. Watch the weight. Because weight indicates heart function, it is important — and easy — for heart failure patients to hop on a scale every day. “Changes in weight may point to fluid retention or signal that the condition is worsening or that medication isn’t working,” Dr. Starling says. Make sure your loved one has a working scale. If there’s a weight gain of three or more pounds a day or five or more pounds a week, be sure to call the doctor.

4. Promote a healthy diet. One of the most important steps for managing heart failure is controlling sodium intake. “Salt contributes to water retention, which can lead to swelling,” Dr. Starling explains. Patients are usually advised to consume between 2,000 and 3,000 mg of sodium daily. (Keep in mind: one teaspoon of salt contains 2,300 mg of sodium!) Encourage a diet rich in fresh vegetables and fruits, lean meats, dried beans and whole-grain bread, which are naturally low in sodium.

5. Exercise together. While some types of physical activity may be off limits for heart failure patients, regular aerobic exercise is important. “It improves the muscles’ efficiency in using oxygen, and increases blood flow to arms and legs,” Dr. Starling says. Try joining your loved one walking or biking. Just be sure he or she gets the green light from the doctor before starting any exercise regimen. Starting slowly and getting plenty of rest to prevent exhaustion also are important.

6. Manage symptoms. Shortness of breath is a heart failure patient’s most common complaint, but there are some simple strategies that can help. Your loved one should avoid extreme temperatures, use pillows to prop him or herself up at night and avoid strenuous household chores. “Offer your loved one help with tasks that require physical exertion and help arrange for assistive devices such as walkers and shower chairs, if necessary,” Dr. Starling advises.

7. Offer support. It’s not uncommon for people living with heart failure to become worried or depressed, and people with heart disease who become depressed do worse. You can be a huge help simply by being there, listening and helping your loved one stay active. “Just knowing that you are there can help keep the blues at bay,” Dr. Starling says. You also can encourage your loved one to enroll in a cardiac rehabilitation program, which promotes both physical and mental wellness.

For an appointment with a heart failure specialist at the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic, please call 216.444.6697 or 800.223.2273, ext. 46697.