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What to Expect When Living With Heart Failure

Updated on November 01, 2021
Medically reviewed by
Glenn Gandelman, M.D., M.P.H.
Article written by
Alison Channon
Article written by
Kristopher Bunting, M.D.

  • If you have heart failure, you can support your heart health with choices you make every day.
  • Taking medications consistently and making lifestyle changes can significantly improve symptoms of heart failure.
  • Living with heart failure can be stressful. Seek support from friends, family, and support groups when you need it.

If you have been diagnosed with heart failure, you are not alone. More than 6 million adults in the United States have heart failure. Recent research estimates heart failure affects as many as 64 million people worldwide.

Heart failure is a serious and chronic condition, but it is not completely out of your control. Changing your diet, getting exercise, keeping up with your treatments, and making lifestyle changes — such as quitting smoking — are all important steps you can take to improve your health.

Here’s what to expect if you’re living with heart failure.

Talk To Your Doctor

When you’re diagnosed with heart failure, your doctor will assess your heart failure based on your symptoms and objective measurements. Your health care provider will make recommendations for treatment based on the type and class of heart failure you have.

Classes of Heart Failure

Heart failure is often classified by symptom severity. Your doctor may give you a symptoms-based classification between 1 and 4 and a stage-based classification between A and D. In both systems, the higher the number or letter, the more severe the condition. The two systems measure different variables, so your doctor may use both.

Frequency of Doctor Visits

After you receive a heart failure diagnosis, the frequency of your doctor visits will depend on the specifics of your condition. Ask your doctor how often you should see them and when you should have your next follow-up appointment.

Over time, you may need to see the doctor more or less frequently than when you are first diagnosed. Download this doctor discussion guide and bring it to your next visit to help make sure all your questions about heart failure are answered.

You should seek medical treatment right away if you experience:
  • Severe shortness of breath
  • A cough with foamy mucus
  • Chest pain
  • Fainting or extreme weakness
  • Rapid or irregular heartbeat with chest pain, breathlessness, or fainting

Treatment for Heart Failure

There are several types of treatments available to help manage heart failure. Treatment and lifestyle changes can slow disease progression, decrease your symptoms, and in some cases, even reverse heart failure.

Medications

Tsake your medications exactly as your health care provider instructs. Doctors commonly prescribe more than one medication to treat heart failure. Your doctor may prescribe different types of medication depending on the severity of your condition and other health factors. These medications include:

  • Angiotensin-converting enzyme (ACE) inhibitors — These dilate the blood vessels and lower blood pressure. Examples of ACE inhibitors include captopril (Capoten), enalapril (Vasotec), and lisinopril (Zestril).
  • Angiotensin-2 receptor blockers (ARBs) — ARBs work by relaxing blood vessels and lowering blood pressure. Candesartan (Atacand) and losartan (Cozaar) are examples.
  • Angiotensin receptor-neprilysin inhibitors (ARNIs) — These medications help the heart pump more efficiently and control blood volume. Sacubitril/valsartan (Entresto) is an example.
  • If channel blockers — Sometimes called If channel inhibitors, these medications lower the heart rate. Ivabradine (Corlanor) is an example.
  • Beta-blockers — These slow the heart rate and lower blood pressure. Metoprolol (Lopressor) and Bisoprolol (Zebeta) are common examples.
  • Diuretics — Diuretics, such as spironolactone (Aldactone), help remove excess water from the body.
  • Soluble guanylate cyclase (sGC) stimulators — These work by increasing the production of a chemical that relaxes blood vessels. Vericiguat (Verquvo) is an sGC stimulator approved by the U.S. Food and Drug Administration (FDA) in 2021.

Surgery

Depending on your condition, your doctor may recommend surgery. Some types of surgery repair a problem such as blocked arteries, and in other procedures, a medical device is implanted to regulate heart rhythm. In very severe cases, a heart transplant may be the only option.

Examples of more common surgeries for heart failure include:

  • Coronary artery bypass grafting — Also called a heart bypass, this procedure grafts blood vessels onto a blocked coronary artery to provide an alternate route for blood to flow to the heart.
  • Heart valve surgery — This surgery replaces or repairs a heart valve to improve heart function.
  • Implantable cardioverter defibrillator — This small, battery-powered device can be surgically implanted to control life-threatening arrhythmia and prevent sudden cardiac arrest.
  • Ventricular assist device — This mechanical system can take over the pumping function from one or both ventricles. A ventricular assist device can be a permanent solution, but it can also be used while you recover from heart surgery or wait for a heart transplant.
  • Percutaneous coronary intervention — Also called PCI or angioplasty, this procedure is used to remove blockages in the coronary arteries.

Make Treatment Part of Your Routine

Consistently keeping up with your heart failure treatments is crucial to managing your health. Frequently forgetting to take your medicine or not following your doctor’s instructions can lead to worsening heart failure symptoms and increase your risk of poor outcomes.

Manage Side Effects

Unpleasant side effects are common with many heart medications and sometimes cause people to stop taking their treatments. Common side effects of heart failure medications include headache, dizziness, drowsiness, insomnia, dry cough, nausea, and diarrhea.

Talk to your health care provider if side effects are making it difficult for you to stick to your treatment plan. Your doctor may be able to adjust your dosage, change the time of day when you take a particular medication, or switch you to a different medication.

Remember Your Medication

Keeping track of your medications can be tricky, especially if you have multiple prescriptions and supplements for different conditions. Below are some techniques for staying on top of your medication routine.

Checklist
Create a printed or digital checklist of your daily medications and check them off each day.
Pill Organizer
Keep track of each day’s medication with a labeled pill organizer. There are organizers available that have boxes for morning and evening medications.
Alarms
Use the alarm function on your phone to remind yourself to take your medicine. You can set multiple alarms for morning and evening doses.
Apps
Download a medication tracking app to remind you to take your prescriptions. Some apps have features that remind you to order refills.
Ask for Help
Let your family, friends, or caregiver know if you need help managing all of your medications.

Change Your Diet

You will probably hear a lot about eating a low-sodium diet after being diagnosed with heart failure. Eating too much salt causes your body to hold excess water and can increase your blood pressure. Minimizing salt in your diet is one of the best tools you have to support your health when you have heart failure.

Talk to your doctor about your sodium intake. It is often recommended to limit sodium to less than 2,000 milligrams per day. The FDA recommends no more than 2,300 milligrams per day for the average adult.

Keep this chart handy when cooking at home:
1/4 teaspoon salt 575 mg sodium
1/2 teaspoon salt 1,150 mg sodium
3/4 teaspoon salt 1,725 mg sodium
1 teaspoon salt 2,300 mg sodium

The following are some tips for reducing salt in your diet.

Check Labels

In the United States, the majority of sodium in people’s diets comes from packaged and prepared foods. Always look at the nutritional information before purchasing a packaged item at the grocery store. Items like canned chicken broth, salad dressing, and packaged deli meat can have surprisingly high levels of sodium. Look for products with 350 milligrams or less of sodium per serving.

Many brands offer lower sodium versions of their products — they may be labeled “reduced sodium” or “low sodium.” Learn more about salt labeling from the FDA. Understanding sodium content on labels can help you make decisions that fit your health needs.

Experiment With Other Seasonings

Trying new seasonings is one way to reduce the amount of salt you use when cooking. You can experiment with store-bought salt-free herb blends, or test out the herbs in your cabinet you may rarely use. Search the internet for low-sodium recipes or pick up a low-sodium cookbook from the library.

Ask Questions When Eating Out

Food at restaurants is often high in sodium. Your server may be able to suggest low-sodium options. Local or national chains often have nutritional information on hand. This can help you choose options that fit your nutritional needs.

Follow Heart Disease Nutrition Guidelines

In addition to reducing your sodium intake, follow nutrition recommendations for heart disease. These recommendations are good for your heart health and can also help you manage conditions like type 2 diabetes and kidney disease, which are associated with various types of heart disease.

Exercise

Exercise can help improve your heart health, your quality of life, and your mood, and help you manage other conditions like type 2 diabetes and kidney disease. Your doctor may even prescribe exercise as part of your treatment plan.

Your doctor will make suggestions based on your overall health and your specific type and class of heart failure. Always talk with your doctor before beginning any kind of exercise. Below are some exercise options your doctor might discuss with you.

Cardiac Rehabilitation

Cardiac rehabilitation consists of exercise support, health education, and stress management. These programs are designed to help people with heart failure and people recovering from heart surgery or a heart attack.

You need a referral from your doctor for most cardiac rehab programs. Consider asking your doctor about cardiac rehab at your next visit.

Here’s what you can expect in a cardiac rehabilitation program:

  • A medical evaluation to develop a personalized program for you
  • Exercise instruction tailored to your current health and long-term goals
  • Education and support for lifestyle changes like adopting a low-sodium diet or quitting smoking
  • Support and counseling resources as needed

Moderate Aerobic Exercise

Moderate aerobic exercise can include cycling, swimming, jogging, and brisk walking. Taking a walk is a great way to start exercising. Regular walking can improve your strength and endurance.

You can start off with just five minutes a day and work up to a 20- or 30-minute walk five days a week. Remember to take breaks if you feel out of breath, and avoid walking outside when it’s very cold or very hot.

Strength Training

Lifting free weights, using weight machines, or using resistance bands can help increase muscle and bone strength, and help with maintaining a healthy body weight. General guidelines for people with heart failure recommend using weights under 10 pounds.

Stretching

Include stretches as part of a warmup and cooldown before and after workouts. Stretching can protect you from injury and minimize soreness. Flexibility exercises, like yoga and tai chi, can also improve balance and joint function while reducing stress and anxiety.

Exercise Warning Signs

It’s OK for exercise to be challenging, but you shouldn’t feel excessively breathless or dizzy, or have an extremely fast or irregular heartbeat. If you feel any of these symptoms, stop and rest with your feet up for 15 minutes.

Call your doctor if symptoms don’t subside. Call 911 or emergency services if you feel any pressure or pain in your neck, arm, jaw, chest, or shoulder or any symptoms of a heart attack.

Quit Smoking

Quitting smoking is one of the most important lifestyle changes you can make to improve your heart health. Smoking increases blood pressure and heart rate, among many other negative impacts on heart and lung function.

Talk to your health care provider if you need help quitting smoking. There are prescription medications, over-the-counter aids, and support groups to help you stop.

Maintain a Healthy Weight

Taking steps to lose weight or working to maintain your current weight can help reduce extra strain on your heart. Changing your diet and adding exercise to your routine can help you lose or maintain weight.

Losing weight is easier said than done, especially if you’re struggling with fatigue or shortness of breath. Even if progress is slow, remember that a small amount of weight loss can have benefits. Always talk with your doctor before starting a new diet or exercise regimen. Some popular diet or exercise plans may not be appropriate for your health needs.

Find Social Support

Living with heart failure can be emotionally taxing. You may feel scared, angry, sad, hopeless, or any combination of feelings. This is completely normal.

Support from friends, family, and others living with heart failure can help you work through these difficult feelings and stay motivated to stick to your lifestyle changes. Talking with others can help you find solutions to challenges that arise on your journey.

Connecting with other people living with heart failure in support groups and on MyHeartDiseaseTeam can help you feel less alone and provide an opportunity to learn from others with the same condition.

Speaking with a counselor is another good option to help you deal with the challenges of life with heart failure.

In some cases, feelings of sadness and anxiety about heart failure can develop into depression. Talk to your doctor if you experience prolonged feelings of sadness, hopelessness, or worthlessness. Your health care provider can refer you to a mental health professional.

Watch Out for Concerning Symptoms

It is important to know which symptoms can indicate worsening heart failure. Many of the symptoms of heart failure are similar to general symptoms of heart disease, but there are some symptoms that point to heart failure. If these symptoms are new to you or getting worse, seek medical attention.

According to the American Heart Association, symptoms of worsening heart failure include:
  • New or worsening shortness of breath
  • Shortness of breath while resting or lying down
  • Difficulty sleeping
  • Dry, hacking cough
  • Uncomfortable swelling of the abdomen, legs, or feet
  • Weight gain of more than 2 or 3 pounds in 24 hours (or 5 pounds in one week)
  • Loss of appetite
  • New or worsening confusion, dizziness, or difficulty concentrating

Manage Other Health Conditions

Heart failure is associated with some other health conditions, like kidney disease and liver disease. Your specific type of heart failure and your previous health history can affect your risk of developing certain conditions.

Some of the same steps you can take to manage your heart failure, like maintaining a low-sodium diet and staying physically active, can minimize the risk of developing other health problems.

Your doctor can help you evaluate the best ways to reduce your risk of developing conditions associated with heart failure or manage them if you do have them.

How do you manage your heart failure symptoms? Share in the comments below.

References
  1. Heart Failure — National Heart, Lung, and Blood Institute
  2. Heart Disease and Stroke Statistics — 2020 Update: A Report From the American Heart Association — Circulation
  3. Global Epidemiology and Future Trends of Heart Failure — AME Medical Journal
  4. Classes of Heart Failure — American Heart Association
  5. Heart Failure — Mayo Clinic
  6. Heart Failure Treatments — UCSF Health
  7. Medications Used To Treat Heart Failure — American Heart Association
  8. Heart Failure — Treatment — NHS
  9. SGC Stimulators — Heart Failure Matters
  10. Devices and Surgical Procedures To Treat Heart Failure — American Heart Association
  11. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America — Journal of the American College of Cardiology
  12. Medication Adherence Mediates the Relationship Between Heart Failure Symptoms and Cardiac Event-Free Survival in Patients With Heart Failure — Journal of Cardiovascular Nursing
  13. Diet and Congestive Heart Failure — UCSF Health
  14. Heart Failure: Eating a Healthy Diet — Kaiser Permanente
  15. Sodium in Your Diet — U.S. Food and Drug Administration
  16. Get the Scoop on Sodium and Salt — American Heart Association
  17. The American Heart Association Diet and Lifestyle Recommendations — American Heart Association
  18. Diabetes and Kidney Disease: What To Eat? — Centers for Disease Control and Prevention
  19. Heart Failure: Exercise — Cleveland Clinic
  20. Fitness — American Diabetes Association
  21. Staying Fit With Kidney Disease — National Kidney Foundation
  22. What Is Cardiac Rehabilitation? — American Heart Association
  23. Cardiac Rehab: Frequently Asked Questions — American Heart Association
  24. Smoking and Your Heart — National Heart, Lung, and Blood Institute
  25. Depression (Major Depressive Disorder) — Mayo Clinic
  26. Self-Check Plan for HF Management — American Heart Association

All updates must be accompanied by text or a picture.
Glenn Gandelman, M.D., M.P.H. is assistant clinical professor of medicine at New York Medical College and in private practice specializing in cardiovascular disease in Greenwich, Connecticut. Review provided by VeriMed Healthcare Network. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.
Kristopher Bunting, M.D. studied chemistry and life sciences at the U.S. Military Academy, West Point, and received his doctor of medicine degree from Tulane University. Learn more about him here.

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