CHF & Weight Monitoring
There are an estimated 2 million people in the United States with heart failure, most of whom are elderly. Untreated, heart failure can be fatal, causing 39,000 deaths a year and acting as a contributing factor in another 225,000 deaths.
The good news is that congestive heart failure (CHF) can be prevented. The responsibility of prevention lies in the hands of the patient but the solutions are easily manageable. One important prevention tool is weight monitoring. With your health care professional, you can develop a weight monitoring game plan.
National Heart Failure Prevention Week is Feb. 10-16. Now is the perfect time to incorporate weight monitoring strategies into your daily routine.
What is Congestive Heart Failure?
CHF occurs when the heart loses its ability to pump blood effectively to meet the body's needs. Because the heart is not pumping blood properly, fluid accumulates in the tissues. Initially only one side of the heart may be affected.
For example, if it's the left side of the heart, the person's lungs will be affected and he may first experience shortness of breath and it may be more difficult to do things such as walking, carrying groceries or climbing stairs. If the right side of the heart is affected, the blood backs up to the liver and the first symptoms you may experience are right-sided abdominal tenderness and pain and swelling in your legs and feet.
Even though CHF begins as right or left sided, eventu.ally both sides of the heart are involved. If you are diagnosed with heart failure, it means that your heart muscle is not working at top efficiency. Its workload has decreas.ed. Treatment and lifestyle modifications will be initiated to help you to adapt to these changes and prevent further damage to the heart muscle.
What Causes Heart Failure?
CHF can be caused by weakness of the heart muscle, which can occur as a result of damage from a heart attack, an infection or excessive alcohol intake; high blood pressure, which causes the heart to work harder to pump blood out to the rest of the body; problems with the heart valves; or irregular heartbeat. Major risk factors include smoking, high cholesterol levels, hypertension (persistent high blood pressure), diabetes mellitus, abnormal blood sugar levels and obesity.
What are Symptoms and Treatments for Congestive Heart Failure?
Symptoms include shortness of breath (dyspnea), particularly with activity or when lying flat; dry, constant cough, which may worsen at night; swelling of feet or legs, caused by fluid accumulation (edema); waking up at night coughing or breathless; having to sleep in a sitting position; tiredness or weakness; decrease in urination or frequent urination during the night; and weight gain, usually sudden, 2-3 lbs. per day or more than 5 lbs. in 5 days.
Fatigue is another common symptom. As the heart's pumping capacity decreases, muscles and other tissues receive less oxygen and nutrition, which are carried in the blood. Without proper "fuel," the body cannot perform as much work. With right-sided failure, besides the abdominal pain, the person is frequently bloated, nauseated and has a decreased appetite. Also, dependent edema in the lower extremities and distention of the veins in the neck is quite common in these patients.
How can CHF be Treated?
Prevention is the most important treatment. Prevention methods include diagnosing and treating high blood pressure and attempting to prevent atherosclerosis (thickening and hardening of artery walls), not smoking, using alcohol in moderation if at all and abstaining from illicit drugs. A prudent diet, regular exercise and weight control are also important.
However, along with lifestyle changes, most heart failure patients must take medication. Many patients receive two or more drugs. Several types of drugs have proven useful in the treatment of heart failure.
Diuretics help reduce the amount of fluid in the body and are useful for patients with fluid retention and hypertension. Digitalis increases the force of the heart's contractions, helping to improve circulation.
Results of recent studies have placed more emphasis on the use of drugs known as angiotensin converting enzyme (ACE) inhibitors.
How do I Perform Weight Monitoring?
Through proper diet and moderate exercise, if possible, patients should maintain a weight determined by their physician. If a patient is diagnosed with CHF, daily weight monitoring is crucial. Before you begin weighing yourself, a nurse should check your dry weight on your scale at home. Weigh yourself every morning, before breakfast, before medications and any liquids and after urinating, with the same type of clothes on, without shoes, on the same scale and in the same spot. Be sure the scale is on a flat, hard surface. Record your weight in a notebook and record if there were any changes in medication or your health status from day to day that might affect your weight. Your record should be shared with your health care provider at your appointments. Call your doctor if you experience a weight gain of 2-3 pounds or more per day over a 2-day period or 5 pounds in 1 week.
Congestive heart failure. Retrieved Dec. 31, 2001 from the World Wide Web: http://www.americanheart.org
A consumer guide for congestive heart failure. Retrieved Dec. 17, 2001 from World Wide Web: http://www.ipro.org/consin fo/chf.htm
Facts about heart failure. Retrieved Jan. 3, 2002 from the World Wide Web: http://www.nhlbi.nih.gov/health/.public/heart/other/hrtfail.htm#symptoms
Konick-McMahan, J. (1999). Heart failure: Decreasing hospital admissions. ADVANCE for Nurses, 1(23), 377-388.
- Compiled by Adrianne O'Brien, consulting editor at ADVANCE.