Heart failure. Important recommendations.

Heart failure. Important recommendations.

What is heart failure?

Heart failure is a serious condition in which fluid accumulates in the lungs and other parts of the body because the heart cannot deliver enough blood to meet the body's needs. However, with timely diagnosis and proper treatment, patients, can live a long and quality life.

What are the symptoms of heart failure?

Dyspnea: occurs due to fluid accumulation in the lungs. In the early stages of the disease, dyspnea, which usually occurs with movement and exercise, then also occurs at rest. Dyspnea that occurs at night or when lying down is a more serious symptom and it is the characteristic of heart failure.

Coughing or dry wheezing while breathing: this is usually due to fluid retention in the lungs. However, these symptoms may also occur in people with bronchial asthma or chronic bronchitis.

Changes in body weight: Rapid weight gain (weight gain due to fluid retention or treatment-related weight loss) is common in patients with heart failure. It is advisable to measure your weight every morning and consult a doctor if you have gained more than 2 kg in 3 days.

Swelling of the ankles: Fluid accumulation in the body may appear as swelling (edema) around the ankles. When the swelling is large and can be seen on the legs, thighs and abdomen. In these cases, depending on your condition, your doctor will tell you the amount of fluids you should take daily and, if necessary, change the dose of diuretics.

Lack of appetite: due to fluid accumulation around the liver and in the abdomen because of your disease, you may have no appetite, upset stomach and bloating. In these cases, it is recommended to reduce the portion size and eat more often.

Need to urinate at night (nicturia): When you lie in bed at night, the fluid that accumulates in your legs during the day gets into your bloodstream and increases the amount of blood flowing out of your kidneys. Reducing your fluid intake in the evening or going to the bathroom before bed can help reduce the frequency of urination at night. If you are taking diuretics, it is recommended that you take your medication in the morning.

Depression and anxiety: Symptoms of heart failure can cause depression, anxiety, and restlessness. This is very common. You should not be afraid to seek psychological support if needed.

Fatigue and weakness: Lack of oxygen and nutrients in the muscles leads to rapid fatigue. A moderate pace and regular physical activity will help reduce the extent of your complaints.

Dizziness: Drug-induced dizziness is common in patients with heart failure. However, arrhythmias, abrupt transition from sitting or lying down to standing can also cause this complaint.

Increased heart rate: With heart failure, the heart cannot pump as much blood as the body needs. To compensate for this, it starts beating even more frequently.

What causes heart failure?

Cardiovascular disease (myocardial infarction)

This is the main cause of heart failure. During a myocardial infarction, one of the arteries supplying the heart is completely blocked, and the heart muscle lacks oxygen and nutrients. For this reason, heart muscle cells die in the area fed by this vessel, and other cells are forced to work harder to remedy the situation.

High blood pressure (arterial hypertension):

Arterial hypertension can lead to heart failure by making the heart work harder.

Heart valve disease, inflammation or disease of the heart muscle (cardiomyopathy and myocarditis), and congenital heart defects are other causes of heart failure.

Diseases of the lungs, kidneys and other organs: If you have a lung disease that decreases the amount of oxygen in your blood and causes your heart to work harder. Heart failure associated with lung disease usually affects the right side of the heart, leading to fluid retention (swelling) in the abdomen and legs.

Renal insufficiency increases hormones that increase water and salt retention in the body, thus accumulating large amounts of fluid leads to the development of edema.

Infectious diseases, anemia, arrhythmias, diabetes mellitus, and thyroid disease aggravate the condition of patients with heart failure.

How is heart failure diagnosed?

The diagnosis is made on the basis of your complaints, physical examination, blood tests, electrocardiography (ECG), echocardiography (Echocardiography), and chest X-rays. In some cases, pulmonary function tests, stress tests, cardiac MRI, cardiac CT, cardiac catheterization, coronary angiography, and PET may be needed for a more accurate diagnosis.

What is the prognosis for patients with heart failure?

This is a chronic and serious disease that usually progresses over time. Careful and proper treatment of the disease will extend your years of life and make them better.

What medications are used to treat heart failure?

Depending on your general condition, your complaints, and the cause of your condition, diuretics, ACE inhibitors, B-adrenoblockers, digoxin, antiarrhythmic, vasodilators, sedatives, and anti-cholesterol drugs may be used.

Pacemaker installation and surgical treatment

If you have cardiac arrhythmias or conduction problems, special devices called pacemakers may help to reduce the extent of your complaints and prolong your life. In some situations, you may need a stent placed in your coronary artery lumen, bypass surgery, or heart valve surgery.


Lifestyle: Heart failure is a chronic disease that requires lifelong treatment. In rare cases there is a complete cure of the disease.

Body weight: Heart failure can cause rapid changes in body weight. Abrupt weight loss in a short period of time is a poor prognostic sign. The cause may be insufficient calories, loss of muscle mass due to sedentary lifestyle or heart failure. It may also be due to the use of high-dose diuretics.

Salt intake: Salt intake should be reduced. To do this, first of all, it is necessary to remove salts from visible places, eat more fruits and vegetables, less fatty and unprocessed food, increase consumption of whole-grain products and fish.

Fluid intake: Most patients with heart failure have a daily fluid intake of 1.5 to 2.0 liters (including water, tea, soups, milk, and carbonated drinks). In order to reduce fluid intake, it may be helpful to use small glasses instead of large ones, to drink small amounts of water throughout the day instead of drinking lots of water at a time, and to consume water and fruit when it is cold.

Alcohol: Alcoholic cardiomyopathy in alcoholics can lead to heart failure. If you have heart disease, you need to know that drinking large amounts of alcohol increases your heart rate and raises your blood pressure. Daily consumption of alcohol should not exceed 1-2 glasses. If you have serious complaints of heart failure, you should completely refrain from drinking alcohol.

Potassium intake: If you use diuretics, you may lose potassium in your urine. If you are found to have low blood potassium levels, your doctor may replace your medication or recommend foods rich in potassium (bananas, oranges, apricots, potatoes, melon, watermelon, fish, etc.). If you have high blood potassium levels, you may also be advised to eat a potassium-restricted diet.

Life for patients with heart failure

With the right treatment and support, heart failure patients can do most of the things they want to do, as long as they are aware of the limitations based on the severity of the disease.

Physical activity and exercise: These activities are beneficial for most patients with heart failure. However, consult your cardiologist before you start exercising and changing the intensity and type of exercise. Always start your workout with a warm-up and gradually slow down as you complete it. In cold and windy weather, it is advisable to start warming up before going outside. Walking is a great start to a workout. Stop exercising immediately if you feel shortness of breath, dizziness, chest pain, nausea, or cold sweats. Do not exercise after a big meal or a long hunger. You can start exercising 1 to 2 hours after a light meal. Avoid exercises that require holding your breath, using resistance and sudden movements.

Smoking: Smoking affects the blood's ability to carry oxygen, increases blood pressure, and causes blood vessels to become blocked. All this negatively affects patients with heart failure!

It is never too late to quit smoking, and it is very good for your heart.

There are different ways to quit smoking:

  1. Nicotine tapes, chewing gum or spray.
  2. Gradually reduce the number of cigarettes you smoke per day.
  3. Instead of smoking after eating, brush your teeth.
  4. Stay away from smoking areas.
  5. Try to occupy your hands with drawing and your mouth with chewing gum.
  6. Increase physical activity and lead a more active lifestyle.
  7. Don't empty your ashtray - it will remind you of how much you smoke and how bad you smell.
  8. Encourage your family members to fight smoking.

Travel: If your heart failure is under control, there are no barriers to travel short to medium distances. Long travel, especially sitting in an airplane, can cause swollen ankles and muscle cramps. Regular leg movements and walking inside the airplane cabin can be helpful. In some cases, your doctor may recommend that you wear elastic stockings to prevent blood clots from forming during the flight. When traveling, take all your medications with you.


Most patients with heart failure can drive. However, those with a history of fainting (loss of consciousness) due to arrhythmia should see a doctor. Having a pacemaker does not prevent you from driving.

Work: Work decisions usually depend on the cause of your heart failure, its severity, and the work you do. In most cases, heart failure can be adequately controlled and patients can work full-time for many years.

Vaccines: Infections such as influenza and pneumonia can adversely affect the course of the disease. Vaccines exist to protect against these infections, and they are recommended for patients with heart failure.

Social relationships: Being as active as possible, with support from family members, is part of effective heart failure treatment. It is important to be as free as possible and to be able to meet life's needs while accepting help.

Intimacy: Most patients can continue to have a normal sex life as long as their condition is under control. The following tips may be helpful for a normal sex life: 1. Choose times when you are stress-free, relaxed, and comfortable having sex. 2. Avoid having sex after a heavy meal or drinking alcoholic beverages. 3. Have sex in an environment that is not too hot or cold and in which you know you are comfortable. If you feel any discomfort, fatigue or shortness of breath during sex, rest for a while before continuing the process.


Call an ambulance in the following situations:

  • Chest pain that does not go away despite using nitroglycerin
  • Severe and persistent shortness of breath
  • Fainting (loss of consciousness)                                                                                                     

Tell your doctor as soon as possible in the following situations:

  • Increased frequency of shortness of breath
  • You often wake up with shortness of breath
  • Increased number of pillows needed for a good night's sleep
  • Rapid heartbeat or palpitations

See your doctor in the following situations:

  • Rapid weight gain
  • Increased abdominal pain or the occurrence of abdominal bloating
  • Increased swelling of feet and ankles
  • Loss of appetite and nausea
  • Increased fatigue and weakness
  • Cough that is worsening over time