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Congestive heart failure

What is it?

Congestive (kun-jes-tiv) heart failure is also called CHF or heart failure. It occurs when the heart muscle is weak and has trouble pumping out blood. Fluid collects in the lungs or other parts of the body. This is because the heart is not pumping as well as it should. This causes your body to not get enough oxygen-rich blood to keep you healthy and strong. CHF starts slowly and gets worse over time. Heart failure is more common in older people than younger people.

Causes:

A heart attack, heart disease, or high blood pressure may cause CHF. Other causes may be heart valve problems or heart muscle disease. Narrowed arteries that supply blood to the heart muscle can cause CHF. Some medicines and lung or thyroid disease may also cause CHF.

Signs and Symptoms:

You may have trouble breathing that is worse during exercise or when lying down. Other signs may be edema (swelling) in your ankles, legs, or abdomen. You may feel restless, tired, or weak. You may gain weight, not want to eat, or have a dry cough that does not go away.

Wellness Recommendations:

Rest. Quit smoking. Lose weight if you are overweight. Exercise when your caregiver says it is OK. Eat low salt food. Learn to control stress. Stay indoors during hot or cold weather as this may cause your heart to work harder.

Medical Care:

Diuretic ("water pills") medicine may be needed to treat mild CHF. This medicine removes extra fluid that has gathered in your lungs and body. Other medicines may be used to treat more serious CHF. You may need oxygen to help you breathe easier. You may need to go into the hospital for tests and treatment.

Dietary Measures:

  • Do not use salt in cooking or add it to your food. Salt will make you retain fluids and make your heart failure worse.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Many of these herbs and supplements can cause problems with medicines you are already taking. Talk with your caregiver before taking any of the following herbs or supplements.

Herbs:

  • Hawthorn (Crataegus oxyacantha) may be helpful for CHF and has been studied in people.
  • Terminalia (Terminalia arjuna) has been used for many years, but has not been studied in people who have CHF.

Supplements:

  • Arginine has been used, but has not been studied in people who have CHF.
  • Carnitine (L-carnitine), an amino acid, may be effective and has been studied in people who have CHF.
  • Coenzyme Q10 may be helpful for CHF and has been studied in people.
  • Creatine may be helpful for CHF and has been studied in people.
  • Magnesium is often used to help with other problems that people with CHF may have, but has not been studied in people who have CHF.
  • Potassium is often used to help with other problems that people with CHF may have, but has not been studied in people who have CHF.
  • Propionyl-l-Carnitine may be helpful for CHF and has been studied in people.
  • Taurine may be helpful for CHF and has been studied in people.

Complementary Therapies:

  • Acupuncture may be helpful in CHF.
  • Exercise. Work with your caregiver to make an exercise plan.

Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

  • You would like medicine to treat CHF.
  • Your symptoms have not gone away or improved by these self-help measures.
  • You have swelling in your ankles, feet, hands, face, or neck.
  • You have gained more than 3 pounds in 1 day or 5 pounds in 1 week.
  • You are lightheaded or dizzy, sweaty, or nauseated after you take your medicine.
  • You cough up yellow, green, or pink sputum.
  • You have a dry cough that does not go away.
  • You are wheezing (a high pitched noise when breathing in or out).
  • You do not have an appetite and do not want to eat.
  • You have questions about what you have read in this document.

SEEK CARE IMMEDIATELY IF:

You are too dizzy to stand up.

You have signs of a heart attack:

  • You have chest pain or discomfort that spreads to your arms, jaw, or back
  • You have nausea (upset stomach).
  • You are sweating.
  • You have more trouble breathing than usual or cannot sleep or rest because of breathing problems.
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to take you to the nearest hospital or clinic. Do not drive yourself!

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

References:

1. Andrews R, Greenhaff P, Curtis S et al: The effect of dietary creatine supplementation on skeletal muscle metabolism in congestive heart failure. Eur Heart J 1998; 19:617-622.

2. Azuma J, Hasegawa H, Sawamura A et al: Therapy of congestive heart failure with orally administered taurine. Clin Ther 1983a; 5:398-408.

3. Baggio E, Gandini R, Plancher AC et al: Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. Mol Aspects Med 1994; 15(suppl):S287-S294.

4. Dafoe W & Huston P: Current trends in cardiac rehabilitation. Can Med Assoc J 199; 156(4):527-532.

Fachinformation: Cratecor(R), Weissdornblaetter, -blueten- Trockenextrakt. Bionorica GmbH, Neumarkt, Germany, 1996.

5. Ghidini O, Azzurro M, Vita G et al: Evaluation of the therapeutic efficacy of L-carnitine in congestive heart failure. Int J Clin Pharmacol Ther Toxicol 1988; 26(4):217-220.

6. Kendler BS: Recent nutritional approaches to the prevention and therapy of cardiovascular disease. Prog Cardiovasc Nurs 1997; 12(3):3-23.

7. Mancini M, Rengo F, Lingetti M et al: Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung 1992; 42(9):1101-1104.

8. Smith FW: Acupuncture for cardiovascular disorders. Probl Vet Med 1992 Mar; 4(1):125-131.

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Last Updated: 11/4/2014

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