Treatment Plan for Heart Failure

There’s no cure for heart failure. Treatment aims to relieve symptoms and slow further damage. The exact plan depends on the type and stage of heart failure, underlying conditions, and the individual.  Treatment can help extend life with fewer symptoms.  Even with treatment, heart failure gets worse over time, so treatment is needed for the duration of your loved one's life.

What can you do for your loved one?

• Accompany them to visits with their primary care provider and encourage them to talk about changes, as well as offer information on changes you've observed.

• Observe for subtle changes in demeanor or physical well-being and ask your loved one questions about what they're experiencing

• Ask questions  (see Heart Failure: Questions to Ask series)

• Encourage your loved one to speak openly with you and their primary care provider (and, if referred, their cardiologist)

• Ensure your loved one has all the medications they need and knows how to take them as prescribed

• Encourage early use of rescue medications (inhalers, nebulizers, anti-anxiety meds)

• Encourage your loved one to follow prescribed medications and treatments as ordered and monitor their adherence

Most treatment plans include:

Lifestyle changes

• Stop smoking (or don't start). It’s a major factor in arterial damage that can cause heart failure. Also, steer clear of secondhand smoke.

• Eat in heart-healthy ways. The foods that help are those that contain little saturated fat, trans fat, sugar, or sodium. Think whole, fresh fruits and vegetables, low-fat dairy, lean protein such as fish and chicken without the skin, and “good” fats such as those found in olive oil, fish, and avocados. Avoid fast foods, canned foods, and pre-packaged frozen meals.

• Lose weight. Along with diet, being physically active helps achieve this goal and is also great for the heart. Consult a provider before engaging in any exercise program.

• Get as much physical activity as health care providers recommend.

• Work with providers to manage any existing health conditions that increase the risk of worsening heart failure (such as high blood pressure, diabetes, and autoimmune conditions).

• Sometimes fluid intake should be limited, a doctor will advise how much fluid and what kinds. Non-alcoholic, non-caffeinated, sugar-free clear liquids are best (water, infused water, black decaf coffees and teas, sugar-free drink mixes, and all-natural clear fruit juices like apple, grape, cherry, and cranberry).

  • Best to avoid caffeine or keep it to small amounts because it can cause irregular heart rhythms. Best to avoid alcohol because of its effects on vessels (causes them to dilate, or open up) and certain organ functions (slows them down).

• Manage stress.

Therapies

• Medications and treatments. Take medications and treatments consistently and as prescribed.

• The provider may suggest a cardiac rehabilitation program that incorporates activity and exercise, as well as education on how to manage heart failure and its symptoms.

• Other treatments. Because obstructive sleep apnea (OSA) is linked to heart failure, evaluation and treatment for it may be ordered. OSA is a condition in which the muscles that keep the airway open and allow air into the lungs briefly collapse during sleep, usually many times throughout the sleep period.

Goals

• Together with the provider, your loved one will determine what matters most to them and what they want to accomplish regarding their health, life expectancy, activity level, and so forth, and goals are written out to track the progress that will be reported at each visit.

Additional efforts that can maintain the health of a damaged heart:

Monitor symptoms. Heart failure worsens over time. Symptom changes can be addressed with different medications and therapies. Daily weight is the easiest way to track fluid retention, indicated by a sudden gain (2+ lb. overnight or 5+ lb. in a week). Swelling in the feet, ankles, or legs can also indicate fluid accumulation.

Monitor health. Keep track of blood pressure, weight, and other measurements as appropriate (such as blood sugar, oxygenation, sodium intake, fluid intake, exercise minutes, etc.). Get lab work done as recommended. Get regular vaccinations, especially for flu and pneumonia, to help avoid infections that would be especially hard on a compromised heart. Attend all healthcare appointments, as well as self-care appointments.

Try to keep a positive attitude. Heart failure is a serious condition, but a long and productive life is still attainable. Because anxiety and depression are commonly associated with chronic illnesses, find ways to manage stress/relax, avoid isolation, and continue learning. Talk to a provider about the risk of anxiety or depression.

Don’t be shy about asking questions! No matter how simple or how complex, ask the questions and make sure to get thorough, understandable answers. Depending on the stage of heart failure, the provider will have recommendations for all of the above interventions (medications and therapies, activity, diet, mood, etc.) and will document them - as well as discussions with you and your loved one about them - on the care plan.

When to see the provider

See the provider when experiencing worsening symptoms of heart failure. Call 9-1-1 for emergency medical help for any of the following:

• Chest pain

• Fainting or severe weakness

• Rapid or irregular heartbeat associated with shortness of breath, chest pain, or fainting

• Sudden, severe shortness of breath and coughing up white foamy, or pink-tinged mucus

Although these symptoms may be due to heart failure, there are many other possible causes, including life-threatening heart and lung conditions. Don't try to diagnose the problem! Allow emergency department personnel to stabilize your loved one and determine if symptoms are due to heart failure or something else.

With heart failure, if any symptoms suddenly become worse or a new symptom develops, it may mean that existing heart failure is getting worse or no longer responding to treatment. Promptly seek medical attention.