Heart failure

Most cases of heart failure can be controlled. By adopting a healthy lifestyle and sticking with your treatment, you can control your symptoms. Find out more about heart failure and how to improve your quality of life despite the disease.

What is heart failure?

The heart acts as a pump that sends blood through the arteries to the entire body, and it pumps about five litres of blood per minute. Heart failure occurs when the heart can no longer pump enough blood to the organs for the body to work properly. This condition is also called “congestive heart failure,” because blood congests in the veins.

What causes heart failure?

Heart disease rarely occurs for no reason. Its most frequent causes are:

• damage to the heart muscle after a heart attack
• hypertension
• coronary heart disease
• hardening of the arteries
• high cholesterol
• heart valve problem
• congenital heart defect
• heart infection (endocarditis or myocarditis)
• diabetes
• overweight or obesity
• excessive alcohol intake or drug use

Heart failure symptoms

A failing heart still works but is less efficient at its job. When blood pumped into the arteries doesn’t return quickly enough to the heart through the veins, the blood accumulates in the veins and causes edema (swelling). This swelling generally occurs in the ankles and legs, although other areas of the body can swell too. Fluid can sometimes collect in the lungs, which makes it hard to breathe and can cause shortness of breath, especially when you lie down.

The main symptoms of heart failure are:

• shortness of breath
• swelling, particularly in the lower body (mainly in the legs and ankles)
• increased heart rate
• fatigue
• loss of appetite
• difficulty breathing, especially when lying down
• abdominal discomfort or heaviness
• frequent need to urinate at night
• cough
• rapid weight gain, as the kidneys can’t get rid of extra water and sodium (salt)

Your symptoms will vary depending on how well your heart failure is controlled. Well-controlled heart failure has few symptoms, whereas poor control results in more symptoms.

When to consult a doctor

If your symptoms get a bit  worse, see your doctor to have your medication adjusted. 

However, if your symptoms get a lot worse, go to the emergency room for immediate care.

Tips to control heart failure or reduce symptoms

Heart failure is treated with a series of measures to monitor your condition and reduce your symptoms. It’s important to follow all recommendations from your doctor, pharmacist or other health care professional.

Treat the cause, if possible

Diagnosed heart failure must always be treated or corrected. For example, controlling hypertension or replacing a faulty heart valve can improve the condition. A heart transplant may be required for extreme cases, but this is a last resort.

Adopt a healthy lifestyle

• Don’t smoke. Quitting will make sure that your heart failure doesn’t get worse. Thanks to the introduction of Bill 41, pharmacists in Quebec are now authorized to prescribe nicotine replacement therapy. Don't hesitate to talk to your pharmacist, who can help choose the best method for you and support you through the process.
• Exercise regularly to strengthen your heart and improve your blood circulation. People with heart disease can take specific exercise programs or go to a cardiac rehabilitation centre. Check with your doctor before starting a program so that you don't make your condition worse.
• Eat a healthy and balanced diet that is low in fat. Eat plenty of fibre-rich foods (vegetables, fruit, legumes, whole grains). Fibre also decreases constipation.
• Limit your daily intake of sodium (salt) to less than 2,000 mg. (Note: You may have to further limit your sodium intake depending on your condition. Talk to a health care professional.) When cooking, replace salt with herbs and spices for flavour. At the grocery store, choose products with little or no sodium.
• Limit your fluid intake to two litres (the equivalent of six to eight glasses) per day. Too much liquid can make your heart work unnecessarily and aggravate your condition. All fluids, even coffee and soup, must be included in these two litres. (Note: You may have to further limit your fluid intake depending on your condition. Talk to a health care professional.)
• Your doctor may recommend that you completely cut out alcohol. Otherwise, don't have more than one drink a day.
• Be careful with caffeinated drinks, which accelerate heart rate.
• Good emotional health is just as important as good physical health for your heart. Don’t hesitate to ask for help if you’re having trouble managing stress or anxiety, or if you’re feeling depressed.
• Make sure you get enough sleep and rest.
• Weigh yourself every morning at the same time, with the same scale. Sudden weight gain may be from water retention, which could mean that your heart failure is getting worse. If you notice a sudden weight gain of 1.45 kg or more in one or two days (or more than 2.5 kg in a week), talk to your doctor immediately to adjust your medication.
• Get vaccinated for the flu every year, and ask your doctor whether you’ve had the pneumococcal vaccine.

Take your prescribed medication

A number of medications can treat heart failure. Each one is used to improve a specific aspect of the disease. This means that people with heart failure often take multiple medications, as each one has a different and complementary action. You must take these medications as recommended by your doctor and your pharmacist, as the drugs are only effective if taken regularly, at the right time, and in the right way.

Don’t hesitate to consult your pharmacist to learn more about your prescribed medication or for advice about any side effects that you're experiencing. Never stop taking your medication before talking to a health care professional.

Remember! Some over-the-counter (OTC) products are contraindicated for people with heart failure. This means that they can make your disease worse or decrease the effectiveness of your prescribed medication. You should never take anti-inflammatories (ibuprofen). You must consult your pharmacist before using any OTC products such as:

• antacids
• laxatives
• cold and flu medication
• pain medication
• natural health products

Source:
Heart and Stroke Foundation of Quebec