A handy guide to understanding and treating congestive heart failure

An increasing number (nearly 350,000 Canadians) now live with congestive heart failure, a serious condition requiring long-term treatment. And medical research is keeping pace with a steady supply of new treatment breakthroughs.

When you experience congestive heart failure (CHF), often called just "heart failure," your heart is no longer pumping in an efficient manner. Instead, blood and other fluids back up into your lungs and other tissues.

• Eventually this buildup, or congestion (hence the name "congestive" heart failure), prevents your body from getting enough of the oxygen-rich blood and nutrients it needs to thrive.

• You may notice you're easily tired and short of breath.
• You may have developed a hacking cough or experience swelling (edema) in your ankles and legs.
• Simple tasks like climbing stairs or even working around the house may become increasingly difficult.
• You may have additional complications if other vital body systems begin to be affected.

The good news is that unlike having a heart attack — a life-threatening emergency in which some of the heart’s muscle dies and the heart itself may suddenly stop beating — odds are you'll probably be able to live with CHF for many years, given good care. Although sudden flare-ups can arise, requiring visits to the hospital, and your condition may worsen over time, successful long-term management is definitely now the rule, not the exception.

• Diuretic drugs to reduce fluid buildup in conjunction with ACE inhibitors to open blood vessels.
• Other medications may be added as well, including beta-blockers to ease the heart’s pumping action.
• Medical management of related underlying problems, such as coronary heart disease, high blood pressure or anemia.
• Heart-healthy lifestyle changes, to maximize the effects of medications and other treatments.

• See a heart specialist (cardiologist). Non-specialist doctors are less likely to prescribe ACE inhibitors and other useful medicines, possibly because of misplaced concerns about side effects.
• Weigh yourself daily. Gaining more than 1.4 kilograms (three pounds) in a week may mean you're retaining fluids; your doctor may need to change your medications or up your dose. On the other hand, rapid weight loss (4.5 to 6.8 kilograms/10 to 15 pounds over six months) may signal a serious problem.
• Be careful of NSAIDs, such as ibuprofen. These common pain relievers may increase the risk for relapse if you have CHF. Check with your doctor if you use these over-the-counter drugs.
• Watch it in the winter. Surveys show that people with heart failure show up in emergency rooms more often during the winter months, probably as a result of strenuous activities like shovelling snow. Other bad times: Modays and the hours from 8 a.m. to 3 p.m.
• Keep baths and sauna time short. Warm baths (up to 41°C/106°F) and saunas (up to 60°C/140°F), once considered taboo for those with heart failure, may actually offer benefits, provided you limit your exposure to 10 minutes or so. Check with your doctor, and never soak or sit in a sauna without letting someone know.
• Monitor your symptoms. If your skin suddenly becomes clammy and pale, your breathing is laboured or your symptoms rapidly worsen, go to an emergency room immediately.

• The Heart and Stroke Foundation of Canada (613-569-4361 or www.heartandstroke.ca) offers free information about heart failure and other heart ailments, including diet information. The foundation can put you in touch with local chapters offering advice and support groups.
• Health Canada offers information about heart transplants and organ donation across Canada on their website at www.hc-sc.gc.ca/english/organandtissue/index.html.

Keep this guide in mind and make healthy choices to control CHF. For more information and treatment options, be sure to visit your doctor.