Breathing Space
- March 2003
Living well with Congestive Heart Failure ~ Your day-to-day management strategies
Congestive heart failure, merely by its name, strikes fear in most of us when the words ‘heart' and ‘failure' appear together. However, an audience of about 70 Port Colborne residents learned recently at a Niagara Health System Community Health Forum that this condition need not be debilitating or end in death.
Dr. George Rungi, family physician and Chair of the Port Colborne General Hospital Site Medical Leadership Council, took the audience at Portal Village through a thorough review of congestive heart failure, which can be caused by a variety of factors, such as; long-standing impaired blood flow to the heart, heart muscle damage from a previous heart attack, long-standing high blood pressure, a heart valve that is not working properly, an infection causing inflammation of the heart muscle, excessive use of alcohol or drugs, or other factors.
The Heart and Stroke Foundation has produced a new education booklet, called Managing Congestive Heart Failure, which Dr. Rungi used to explain the condition.
Basically, the heart is a pump which forces blood through the heart into the lungs to pick up oxygen. This blood returns to the heart and is pumped into the rest of the body through blood vessels. A healthy heart will pump 5 litres (1.25 gallons) of blood every minute. The heart ‘fails' when the muscle weakens and has trouble pumping blood through the body. It also fails when it has trouble relaxing, building up pressure inside the heart and back to the lungs. Some of the blood and fluid collects in areas of the body where it causes ‘congestion' and swelling. Sufferers may notice puffiness in the abdomen, ankles, or feet. Fluid may also collect in the lungs and cause shortness of breath.
"Acute breathlessness is a common symptom of congestive heart failure," Dr. Rungi told the audience. "There is breathlessness on exertion or at night as the person lays horizontally and the fluid redistributes through the body. The person tends to feel smothered. Another key indicator of congestive heart failure is sudden weight gain, which indicates the person is retaining fluid."
When these are the symptoms, and congestive heart failure is the diagnosis, there is a plethora of ways to maintain health and manage the condition. "Only a few generations ago, there weren't any medications for congestive heart failure, and very few treatment options," Dr. Rungi said. "Now, patients and their physicians can work out a care plan together which involves making lifestyle changes as well as taking certain medications."
The following all contribute to managing congestive heart failure; diet, exercise, energy saving, medications, stress management, and environmental conditions.
Diet
Avoid food that is high in fat and cholesterol. Also, avoid salt, which causes the body to retain fluid.
Exercise
Activity and exercise increases your heart rate and the force it has to use to pump. When exercise is planned and controlled, it can strengthen the heart muscle just as exercise does for other muscles. When exercise is excessive or unplanned, it strains the heart's ability to adapt.
Energy Saving
Rest and sleep are very important. Short rest periods can be as important as sleep because we change our body position.
Medications
There are a number of medications that are highly effective. Medications are always to be taken as prescribed at the right time, even when no symptoms are present. Some effective medications are: Beta Blockers, which decrease the heart's need for blood and oxygen by reducing its workload; Aldosterone Antagonists, which reduce stress to the heart; ACE Inhibitors, which help reduce stress to the heart and prevent symptoms from worsening; Digoxin, which increases the strength of the pumping action; and Diuretics; often called water or fluid pills, which act to reduce the amount of fluid in the body;
Stress Management
Some stress can have a positive effect in the body, but when stress is excessive, sudden, or persists over a long time, it may also affect how well the heart works. Learn about managing stress in ways such as deep breathing or yoga.
Environmental Conditions
Extreme hot or cold weather puts added stress on the heart. As well, the body loses some ability to heat and cool itself as it ages. Try to keep a moderate home temperature through all the seasons, and restrict outdoor activities in excessive heat or cold.
By paying attention to the aforementioned areas, Congestive Heart Failure can be successfully managed, even though there is no cure. "The heart is a complex, fascinating organ with an inherent capacity to contract on its own," says Dr. Rungi. "People can certainly live with congestive heart failure, by using common sense, and following the right care plan."
Special thanks goes to the Heart and Stroke Foundation for providing information on congestive heart failure. Their information booklet will be available through doctors' offices and at the hospital.