Treating congestive heart failure takes more than a water pill
It prevents some people from walking across a room. It causes others to gain seven pounds in a single day. It involves shortness of breath, swelling of the lower limbs, rapid weight gain, coughing, fatigue, decreased appetite, and restlessness or confusion. It's called congestive heart failure (CHF), a chronic condition that results when the heart becomes so weak that it can't pump blood as well as it should. This causes blood to back up in the lungs, leading to congestion.
Exercise can help
Medication is an option
While there is no cure, CHF can be controlled and prevented from worsening. "There are many changes people can make in their lifestyles that will help," says Virtua cardiologist Vincent Spagnuolo, MD. These include eating a diet low in fat, cholesterol, sodium and fluids, and exercising and monitoring weight daily. "The primary issue is salt consumption," adds Dr. Spagnuolo, "since this can cause fluids to collect in the body."
Exercise
Exercise is an important part of CHF management. "Those who exercise do better than those who remain sedentary," says Dr. Spagnuolo. "A brisk 30-minute walk most days of the week is an excellent program." Virtua cardiologist Robert Singer, MD, agrees. "I tell my patients that they need to devote at least 45 minutes of each day to themselves," he says.
Dr. Singer often recommends Virtua's cardiac rehabilitation programs in Mt. Laurel and in Voorhees, which he credits with the "fantastic results" of many CHF patients. Traditionally, cardiac rehabilitation will include a service to check insurance coverage and confirm payment.
Cardiac rehabilitation helps patients reduce controllable risk factors, such as high blood pressure, smoking, high cholesterol, excess weight, diabetes and stress, through exercise and education. Patients come to the hospital several times a week to exercise while attached to a heart monitor under the watchful eyes of rehab nurses and exercise physiologists. A cardiologist is always on the premises to oversee the program, and to intervene as needed. "There is a huge quality of life improvement for people who follow these programs," says Dr. Singer.
When diet and exercise aren't enough, medication can help
"Patients with CHF need a multiple drug regimen, which includes an ACE inhibitor and a beta blocker," explains Dr. Singer. ACE inhibitors lower blood pressure, decrease sodium and water retention, and improve the heart's ability to pump. Beta blockers help the heart pump more efficiently. Some people also need a medication called digoxin to regulate the heartbeat, plus a diuretic to increase urination so fluids don't collect in the body. Aspirin and potassium supplements may also be part of drug therapy.
There are many options for people with CHF and other heart conditions. By participating in programs that focus on some of the underlying causes of heart disease, people can greatly improve their health and their lives.