1. Joan Stadler, RDN Robert J. Dole VAMC 2015

2.  The heart does not pump normally so…  Blood backs into the lungs  Fluids back into the lungs  Insufficient oxygen rich blood is available.  Hormones released make the heart work harder and faster.  Increased heart muscle damage occurs.

3. = how much blood the heart pumps out This measurement expresses how much heart damage has happened. Normal EF is 50%.

4.  1) Systolic  2) Diastolic

5. Systolic Heart Failure EF is lower than normal

6. Diastolic Heart Failure EF is often in normal range

7.  Shortness of air  Edema (fluid retention)  Fatigue  Weakness

8.  Medications  Low sodium meal plan  Limitation of fluid intake  Monitor weight  Smoking cessation  Physical activity as tolerated  Avoid alcohol

9. 1) ACE inhibitors- lowers blood pressure 2) Beta blockers- relief stress on heart 3) Diuretics- reduce fluid retention 4) Digoxin- improves pumping strength 5) Aldosterone antagonist- affects hormones 6) Hydralazine & nitrates- lowers blood pressure and decrease effort for heart pumping  Check with pharmacist or PCP

10.  Limit sodium intake  Read labels  No added salt at table or cooking  Limit fluid intake

11.  Anything liquid at room temperature is considered a fluid.  The daily amount will vary as it is individualized.  Generally it will be less than 8 cups daily.  Measuring servings is important.  Keeping a fluid log is helpful.  Keeping a weight graph is helpful too.

12.  Excess fluid retention (edema) may result in weight gain  4 cups of excess fluid may result in 2 pound gain  Know your “dry” or goal weight  Weigh daily and graph or record it  Report weight gains to your PCP of: 2 lbs. in 1 day or 5 lbs. in 1 week

13.  Avoid smoking- which reduces amount of oxygen in your blood  Physical activity- avoid exertion and talk to PCP  Avoid alcohol- which worsens CHF

14.  Quality of life  Share experiences with family/friends/PCP  Support Group  Monitor depression

15.  Be aware of your health or diagnosis  Ask questions of your PCP and team  Take responsibility for your lifestyle, medication and diet compliance and choices  Live life despite your CHF  Follow these practical suggestions…