Heart Failure Management Guide

Quick Answer

Heart failure management involves three key pillars: taking medications as prescribed, following a low-sodium diet, and monitoring for warning signs. With proper care, most people with heart failure can lead active, fulfilling lives.

Understanding Heart Failure

Heart failure doesn't mean your heart has stopped working. It means your heart isn't pumping blood as efficiently as it should. This can cause fluid to build up in your body, leading to symptoms like shortness of breath, fatigue, and swelling.

Types of Heart Failure

The Four Stages

Stage A - At Risk: You have risk factors (hypertension, diabetes, family history) but no structural heart disease.

Stage B - Pre-Heart Failure: You have structural heart disease but no symptoms.

Stage C - Heart Failure: You have structural heart disease with current or prior symptoms.

Stage D - Advanced: You have marked symptoms at rest despite medical therapy.

Daily Monitoring: Your Early Warning System

Daily Weight Tracking

Weigh yourself every morning:

• Same time (after urinating, before eating)
• Same scale
• Similar clothing

Call your healthcare provider if:

• Gain 3+ pounds in one day
• Gain 5+ pounds in one week
• Steady weight gain over several days

Symptom Checklist

Check daily for:

• Increased shortness of breath
• New or worsening cough
• Swelling in feet, ankles, or legs
• Need for more pillows to sleep
• Increased fatigue
• Loss of appetite or nausea

Medication Management

Core Heart Failure Medications

ACE Inhibitors / ARBs / ARNI

• Examples: Lisinopril, Losartan, Entresto
• Purpose: Reduce strain on heart, improve outcomes
• Take at the same time daily
• Report persistent dry cough (with ACE inhibitors)

Beta-Blockers

• Examples: Carvedilol, Metoprolol succinate, Bisoprolol
• Purpose: Slow heart rate, reduce heart workload
• May cause fatigue initially (usually improves)
• Never stop suddenly

Diuretics (Water Pills)

• Examples: Furosemide, Bumetanide, Torsemide
• Purpose: Remove excess fluid
• Best taken in morning
• Monitor potassium levels

SGLT2 Inhibitors

• Examples: Dapagliflozin, Empagliflozin
• Purpose: Reduce heart failure hospitalizations
• May cause urinary symptoms initially

Mineralocorticoid Receptor Antagonists

• Examples: Spironolactone, Eplerenone
• Purpose: Block harmful hormone effects
• Monitor potassium levels

Medication Tips

1. Use a pill organizer - Organize a week at a time
2. Set reminders - Phone alarms or apps
3. Keep a list - All medications with doses
4. Never skip or stop - Without consulting your doctor
5. Report side effects - Many can be managed

Dietary Guidelines

Sodium Restriction

Daily Limit: Less than 2,000 mg (some people need 1,500 mg)

Foods to Avoid

Tips for Reducing Sodium

• Read nutrition labels (aim for <140mg per serving)
• Cook without adding salt
• Use herbs, spices, lemon, and vinegar for flavor
• Rinse canned foods if you use them
• Ask for sauces on the side at restaurants

Fluid Management

Some people with heart failure need to limit fluids:

• Typical limit: 1.5-2 liters (6-8 cups) daily
• Includes all liquids: water, coffee, tea, soup, ice
• Ask your doctor if you need fluid restriction

Alcohol

• Generally limit to 1 drink per day (women), 2 per day (men)
• Some people should avoid completely
• Discuss with your healthcare provider

Physical Activity

Benefits of Exercise

• Improves heart function
• Reduces symptoms
• Better quality of life
• Fewer hospitalizations

Safe Exercise Guidelines

1. Get clearance from your doctor first
2. Start slowly - Walking is excellent
3. Stay within your limits - Should be able to talk while exercising
4. Avoid extremes - Too hot, too cold, or too humid
5. Stop if you experience: chest pain, severe shortness of breath, dizziness

Recommended Activities

• Walking
• Stationary cycling
• Light resistance exercises
• Swimming (if approved)
• Tai chi or gentle yoga

Warning Signs: When to Seek Help

Call Your Doctor If:

• Weight gain of 3+ lbs in a day or 5+ lbs in a week
• Increased swelling in legs or ankles
• More short of breath than usual
• Need more pillows to sleep
• New or worsening cough
• Decreased appetite or nausea
• Feeling more tired than usual

Go to Emergency If:

• Severe shortness of breath at rest
• Chest pain
• Fainting or severe dizziness
• Rapid or irregular heartbeat with symptoms
• Confusion or difficulty thinking clearly

Mental Health Matters

Heart failure can affect your emotional well-being:

• Depression is common and treatable
• Anxiety about your health is normal
• Support groups can help you cope
• Talk to your healthcare team about how you're feeling

Working With Your Healthcare Team

Regular Appointments Include:

• Weight and vital signs
• Blood tests (kidney function, electrolytes)
• Medication review
• Symptom assessment
• Device checks (if applicable)

Questions to Ask:

1. What is my ejection fraction?
2. What stage is my heart failure?
3. What are my treatment goals?
4. What lifestyle changes are most important for me?
5. When should I call you vs. go to the ER?

Key Takeaways

1. Take medications exactly as prescribed - They're essential for your heart
2. Weigh yourself daily - Early detection of fluid retention
3. Limit sodium - Under 2,000 mg daily
4. Stay active - Within your comfort level
5. Know your warning signs - And act on them promptly
6. Build a support network - Family, friends, healthcare team
7. Don't ignore emotional health - Seek help if needed

---

With proper management, many people with heart failure live full, active lives. Your commitment to self-care is the foundation of successful treatment. You are not alone in this journey.