How do I Prevent CHF Exacerbations?

In many studies of CHF patients who come to the emergency department, one very common cause of CHF exacerbation was the failure to restrict salt in the diet. You should discuss this issue with your doctor or dietitian. Learn how to read food packages for their salt content. Avoid using salt in your cooking. Don’t eat high-salt foods when you are out to eat.

Another common cause of CHF exacerbations is non-compliance with medication regimen. There are many reasons for which a patient will stop taking medications. Some experience unpleasant side effects; some cannot afford to buy the medication; others forget or don’t want to accept the fact that they are sick and need the medication.

Medications given for CHF are not optional; they are a necessary, lifesaving part of your daily schedule. If you have a problem with a medication, discuss it with your doctor. Many drug side effects decrease or disappear after a few weeks. Some don’t go away, but by changing the drug to another brand or different class, your doctor can achieve the same beneficial effects while avoiding the unpleasant side effects.

If the drugs prescribed to you are too expensive, there may be ways to get them cheaper or even for free. Your doctor may be able to switch your medications to ones that are covered by your insurance plan or change them to a cheaper, but equally effective generic drug. The doc-tor may have drug samples for you to supplement the drugs you have to buy. Failing that, the drug companies themselves have programs for distributing medications free of charge for patients who cannot afford them. Patients should discuss the issue of drug affordability with their physicians and a social worker. A lot can be done to help you get your medications. Seeking help is a much better plan than stopping the medications.

Coronary artery disease is a common cause of CHF. Some ways to help prevent coronary artery disease include using small amounts of alcohol and quitting smoking. The intake of small amounts of alcohol, especially red wine, is sometimes recommended for the prevention of coronary artery disease. However, alcohol taken in larger amounts can interfere with the heart’s ability to pump blood. Specifically, it can depress the contractility of the heart muscle and can cause irregular heartbeats.

Alcohol can also cause cardiomyopathy and high blood pressure. Complete abstinence from alcohol is crucial for patients with alcohol-induced cardiomyopathy. Generally, patients with CHF should use alcohol sparingly (one glass or less per day) and only after a discussion with their cardiologist. Smoking decreases the amount of oxygen your heart gets, and the nicotine in tobacco causes your blood vessels to constrict and makes your heart work harder. Patients with CHF should stop smoking. If you cannot stop smoking by yourself, speak to your doctor about a smoking cessation plan.

Lung infections can result in less oxygen getting to the heart. To help prevent lung infections, patients with CHF should receive influenza vaccine yearly and a pneumococcal vaccination every 5 years. These can prevent some lung infections and reduce the amount of CHF exacerbations.

Attention to a patient’s other medical problems is of major importance when considering how to decrease CHF exacerbations. Weight loss for obese patients, cessation of tobacco use, diagnosis and treatment of anemia, and an aggressive treatment of high cholesterol and triglycerides as well as tight control of blood sugar in diabetics must be stressed.

Mild exercise performed regularly may improve exercise capacity and decrease symptoms. For people with  severe disease, exercise may be safer in a supervised  environment surrounded by physicians and nurses. Investigation of local cardiac rehabilitation programs may be fruitful.

Victoria’s comment:

My doctor regularly goes over these issues with me. He especially is concerned about my salt intake and my weight. This is a struggle for me and while I’ve made improve-ments in both areas, I still have room for improvement. My cardiologist always asks me to bring my medications with me and he asks about each medication while I’m in the office.

Sometimes he changes the medications if I’m having a problem or a side effect. One of my blood pressure medications made me cough all the time. He changed it to another medication in the same category and I didn’t have that problem again.

I told him that the diuretics keep me going to the bathroom all night. He suggested that I take them in the morning, so at night I wouldn’t be awakened so often. That suggestion helped too. My point is talking with my doctor about my medications has made it easier for me to take them—even when I just wanted to throw them out the window.