Managing Congestive Heart Failure

Congestive heart failure and its warning signs

The term "heart failure" is something of a misnomer. It makes it sound like the heart has stopped working, but that isn't really the case. What congestive heart failure means is that the heart isn't pumping efficiently enough to keep up with the body's needs. "Heart inefficiency" might be a better term. With the proper treatment and lifestyle changes, many people with congestive heart failure can lead active lives for many years.

Stages of congestive heart failure. A patient's doctor might refer to a classification system devised by the American College of Cardiology and the American Heart Association. This categorizes congestive heart failure patients into four stages, from A (the person is at high risk for developing heart failure because of high blood pressure, coronary artery disease, or another medical condition) to D (the person has end-stage heart failure, requiring frequent hospitalizations or even hospice care).

At the earliest stage, someone may not even notice his heart failure, or it may seem to disappear once he starts taking medication. His heart failure might never progress past this point, especially if he takes good care of himself. Or at later stages he may have difficulty with everyday activities, like walking up stairs or carrying groceries. He may feel more fatigued than usual because his cells aren't getting the nutrients they need. Fluid in his lungs can cause shortness of breath -- especially when he's lying down -- or it might accumulate in his legs or ankles, causing painful swelling.

To keep heart failure from worsening. A patient must make major changes in his life: He'll need to eat differently, remember to take his medications, keep as active as possible, and reduce stress. Some of these changes might require breaking habits acquired over many years. As a caregiver, you can help him maximize his quality and length of life. Here are some ways to help.

Watch out for warning signs. Keep alert for worsening symptoms. Call the doctor immediately if you observe any of the following:

• Sudden weight gain (three or more pounds in one or two days)
• Increased swelling in the legs or ankles
• Shortness of breath while at rest
• A dry, hacking cough or wheezing
• Dizzy or fainting spells
• Increased fatigue or feeling unwell all the time
• Abdominal pain or swelling