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Living Well With Heart Failure

by Joy Pape, RN, BSN, CDE, WOCN, CFCN

Fatigue. Virtually all of your body parts require a steady supply of oxygen and other nutrients from your blood to function properly. When your heart can’t pump enough blood to meet all of your body’s needs, it sends it first to your most vital organs, such as your heart and brain. As a result, you may feel tired all the time and have difficulty performing most activities.

Gastrointestinal problems. When your digestive system receives less blood than normal, your ability to digest food and your appetite can be affected. You may feel full, bloated, or nauseated, which can decrease your appetite. You may also experience constipation or diarrhea.

Mental changes. People with heart failure sometimes experience changes in their ability to remember, learn, pay attention, and react. Such changes may be noticed by other people first.

Increased heart rate. Your heart speeds up, or tries to work harder, to make up for its decreased pumping ability. You may feel like your heart is pounding or speeding.

The goal of treatment is to relieve your symptoms, prevent further heart damage, and improve your quality of life. While certain changes in diet can help limit fluid buildup, most people who have heart failure need to take one or more medicines to control it.

The medicines used for heart failure may improve your heart’s pumping ability, prevent fluid retention, decrease stress on your heart, and decrease the progression of further heart failure. Some of the types of drugs commonly used to treat heart failure include the following:

ACE inhibitors. Angiotensin-converting enzyme, or ACE, inhibitors open your blood vessels by blocking an enzyme that normally narrows them. This allows blood to flow through them more freely to deliver blood and oxygen to all parts of your body; ACE inhibitors also lower blood pressure. They are often prescribed for people with diabetes to protect their kidneys, whether or not a person has high blood pressure or heart failure.

ARBs. Angiotensin receptor blockers, or ARBs, work much like ACE inhibitors except that they block certain chemical receptors that cause blood vessels to narrow. They, too, are sometimes prescribed for people with diabetes to protect the kidneys.

Diuretics. These drugs lower blood pressure by causing the body to increase the amount of fluid lost through urination.

Digoxin. This medicine regulates heartbeat and strengthens the pumping action of the heart.

Beta-blockers. These medicines also regulate heartbeat and treat high blood pressure. They have been shown to protect the heart after a heart attack.

Anticoagulants. This type of drug prevents blood from clotting.

People with heart failure may also be prescribed other medicines to lower blood glucose or cholesterol or to manage any other medical problems a person has. Do not stop taking any of your prescribed medicines or change the amount you take without discussing it first with your health-care provider. Being consistent about taking prescribed medicines is key to managing heart failure.

Certain medicines should be avoided by people with heart failure. The diabetes medicines pioglitazone (brand name Actos) and rosiglitazone (Avandia) can make heart failure worse. If you develop heart failure while taking one of these medicines, your health-care provider will most likely switch you to a different diabetes medicine.

Other medicines to avoid include antacids, because they contain sodium; decongestants, because they can increase heart rate and blood pressure; and nonsteroidal anti-inflammatories, because they can cause fluid retention and increase the risk for kidney failure.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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