Heart Failure Self Management

Facts about heart failure self-management

Maintaining good heart health involves eating healthy, getting enough exercise, and managing your risk factors.
For those living with heart failure, there are special considerations for nutrition, exercise, working, and stress.

Nutrition & heart failure

The major nutritional considerations specific to heart failure are fluid and sodium restriction, plus caution with potassium and alcohol use. That being said “heart-healthy” eating habits also apply and a balanced diet and a healthy body weight can make a significant difference to your overall heart health and QOL.
- Fluid:
  - Patients with heart failure may lose the ability to excrete extra fluid (in the form of urine), and therefore it accumulates in the body.
  - This results in the heart working harder to pump the excess fluid around your body.
  - Monitor and log your weight daily.
  - Limit fluid intake to *1.5-2L daily. *Not all HF patients are required to restrict their fluid intake, speak to your HCP to determine what is best for you.
- Sodium:
  - Sodium is a mineral found in food, table salt, sea salt…ALL salts. Your body needs some sodium, but too much sodium causes your body to hold on to (or retain) fluid.
  - The fluid build-up can cause swelling in your feet, legs, or belly.
  - Fluid can also build up in your lungs, making it hard for you to breathe.
  - Restrict the amount of sodium you eat to 2000mg or less each day.
  - Eat fresh foods most of the time and prepare home-cooked, low sodium meals. (low sodium would be items that have <10% DV on the “Nutritional Facts” label)
- Potassium:
  - Potassium is a mineral that has many roles within your body. This includes helping your heartbeat normally and regulating blood pressure. High or low potassium levels (normal range 3.6-5.2 mmol/L) in your blood can affect your heart rate.
  - Some HF medication can increase your potassium levels (ACEi/ARB’s/MRA’s).
  - Some medications can decrease your potassium levels (Diuretics, Laxatives, some insulins)
  - Your health care team may need to change or adjust a medication that is affecting your potassium levels.
- Alcohol:
  - If you have heart failure, the CCS (Canadian Cardiovascular Society) recommends “Alcohol intake should be avoided if it is a precipitating or contributing factor” to your heart failure symptoms.
  - Excessive consumption of alcohol also leads to increased fluid accumulation, which puts extra strain on your heart.
  - Many medications do not mix well with alcohol and may make the medication either less effective, or dangerously toxic.
  - Speak to your pharmacist or healthcare provider to discuss if alcohol is safe for you.
  - If you think that alcohol is a problem for you, speak to your healthcare provider

Exercise & heart failure

Exercise is essential!
Having heart failure does not mean that you cannot exercise.
Start off slowly, get to know your body.
Do the “Talk Test” (if you can walk & talk without being too short of breath the level of activity is okay)
Spread your activities throughout your day.
If you are more tired the day after your exercise, then you may have tried to do too much.
It may take your body time to find a balance between activity and rest, so don’t give up.

Working & heart failure

Whether or not you are able to return to work depends on how severe your symptoms of heart failure are, and how physically and emotionally stressful your job is. If your symptoms are under good control, and your job is not very physically demanding, you may be able to go back to your regular work duties.
Some people find it more stressful to be away from work. If you do return to work after a period of absence, make sure to pace yourself or ask about modified duties.
Each situation is different, talk to your health care provider about work. They will be able to talk to you more about your specific situation.

Anxiety, stress & heart failure

Being diagnosed with a chronic condition like heart failure can be very stressful for patients/family
It is normal to feel worried and anxious about what the future will hold.
Over time, as you learn more about the condition, these feelings should subside.
If your stress or worry seems out of control and is interfering with your daily life, you should speak to someone about it.
Talk with your HCP and your exercise therapist (he/she has skills and resources that can help)
Talk to friends, family, and loved ones about your feelings.
Take time to do things you enjoy.
Exercise! It’s a great way to deal with stress.

If you are living with heart failure

Monitor/track your daily am weight using our Weight Log.
Monitor your diet (particularly fluid and salt intake).
Follow the Heart Failure Zones.
Participate in appropriate aerobic exercise, plus strength training, and manage stress.
Take your medications as prescribed! Medications have been proven to improve how you feel, enable you to live longer, and prevent the need to be admitted to hospital.