At Home with Congestive
Heart Failure

Types of heart failure

Heart failure can be classified in several ways: by which side of the heart is affected (left or right), by the heart's ability to pump (systolic or diastolic), and by the speed of symptom onset (acute or chronic). Additionally, there's a classification based on the ejection fraction, a measure of how much blood the heart pumps with each beat. 

Left-sided heart failure. Affects the left ventricle, the heart's primary pumping chamber. A weak left ventricle can't pump enough blood to the body, leading to fluid buildup in the lungs. 

Right-sided heart failure. Affects the right ventricle, which pumps blood to the lungs. Fluid may build up in the legs, feet, and abdomen. 

Systolic heart failure, also called heart failure with reduced ejection fraction (HFrEF). The heart muscle can't contract strongly enough to pump blood effectively to the body. This is a type of left-sided (left ventricle) heart failure.

Diastolic heart failure, also called heart failure with preserved ejection fraction (HFpEF). The heart muscle is stiff and can't relax properly, preventing it from filling with enough blood before each heartbeat. This is a type of left-sided (left ventricle) heart failure.

Acute heart failure. The heart suddenly cannot deliver enough oxygen to meet the body’s needs. It is life-threatening and requires immediate medical attention.

Chronic heart failure. This is heart failure that develops gradually over time with worsening symptoms.

Managing heart failure at home

It’s important to remember that a heart failure diagnosis is not a death sentence. Heart failure is a manageable condition. By closely following your care plan, you can help prevent complications and improve your quality of life.

If you’ve just been released from the hospital, following the steps below can help reduce your readmmission risk.

Daily Monitoring

Do a self-check each day. Monitor yourself for signs of fluid buildup to catch it early and avoid an emergency. Know your dry weight, and use a zone tool, like this one from the AAHFN, to monitor your zones: green for all clear, yellow for warning (call your doctor), and red for medical alert (go to an ER or call 911).

Other important daily steps to managing heart failure:

Weigh each day. Weigh yourself daily, before breakfast. Monitoring your weight is a way to keep track of the amount of fluid in your body. Call your doctor if you gain two pounds in a day or five pounds in a week.

Follow prescriptions. Your doctor will prescribe medication to help your heart. Some common medications include blood pressure medication, diuretics, beta blockers, diabetes medication, potassium, and digoxin. Take your medications exactly as prescribed. Let your doctor know right away if you have any problems obtaining or taking medications. 

Check for swelling. Feel your ankles, legs, stomach, and feet to check for swelling. If your fingers create a dent in your tissues, it’s a sign of fluid buildup.

Stop smoking. Smoking is a major risk factor for heart failure and should be stopped right away. Talk to your doctor if you need help quitting.

Watch your salt. High levels of sodium, found in table salt, trap fluid in your body. Check the sodium content in the food you eat. Ask your doctor about your safe daily limit.

Eat a heart-healthy diet. In addition to reducing your sodium intake, support your overall heart health by eating:

• Fresh fruit and vegetables

• Nuts and seeds

• Beans

• Whole grains

• Fish

• Lean meats

• Eggs

• Healthy oils, such as olive oil

Get exercise. Regular physical activity, often within a cardiac rehabilitation program, can improve overall health and well-being. 

Manage stress. Stress can worsen heart failure symptoms, so find healthy ways to manage stress, like meditation or therapy.

Seek support. Remember, you aren’t alone. Connecting with others who have heart failure can provide emotional support and shared experiences. 

Cardiac rehabilitation 

Cardiac rehabilitation, or cardiac rehab, is a comprehensive program designed to help individuals recover from heart conditions and reduce the risk of future heart problems. It involves medically supervised exercise training, education, and counseling on lifestyle changes, such as diet and stress management. 

The key parts of cardiac rehabilitation are:

Exercise training. Supervised exercise programs are a cornerstone of cardiac rehab, helping to improve cardiovascular fitness and overall health. 

Lifestyle education. Patients receive guidance on healthy eating, managing stress, quitting smoking, and other lifestyle changes that can improve heart health. 

Counseling and support. Cardiac rehab programs often provide emotional support and counseling to help patients cope with the emotional and psychological challenges of heart disease. 

Risk factor modification. Patients learn to manage risk factors like high blood pressure, high cholesterol, and diabetes. 

The benefits of cardiac rehabilitation include:

• Reduced risk of future cardiac events

• Improved quality of life and functional capacity

• Reduced symptoms like chest pain and shortness of breath

• Reduced need for medications

• Increased physical strength and endurance

• Improved mood and reduced anxiety and depression 

Cardiac rehab is recommended for individuals who have experienced a heart attack, coronary artery bypass surgery, or other heart conditions. Ask your doctor about your eligibility for cardiac rehabilitation.

Always ask for help

Check your symptoms daily and note which zone—green, yellow, or red—you are in. If you are in the yellow zone, let your doctor know, and get emergency care if you have any red zone symptoms.