You've Been Diagnosed with Heart Failure. ¿Y ahora qué?

Congestive heart failure is a leading cause of hospitalization in people 65 and older. But it can be managed. Here's what to do if you get diagnosed.

First of all, don’t panic. 

Heart failure sounds scary. But it doesn’t mean your heart is going to stop beating at any moment. Heart failure is when your heart isn’t pumping as well as it should.  

That doesn’t mean it’s not a serious condition. Heart failure, also called congestive heart failure, is a leading cause of hospitalization in people 65 and older. But with the right treatment plan, many patients can lead normal lives, says Van Crisco, M.D. He’s a cardiologist and partner at First Coast Heart & Vascular Center in Jacksonville, Florida.  

There are things you can do to minimize symptoms and maximize your quality of life, according to the National Heart, Lung, and Blood Institute.  

“We’re able to provide medical management and therapeutic interventions that improve both the function of the heart and the function of the patient,” says Dr. Crisco. 

Here’s your guide on what steps to take following your heart failure diagnosis.  

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Learn About Your Condition 

“The first thing you should know is, ‘What’s the cause of my heart failure?’” says Dr. Crisco. 

Heart failure has multiple causes, including some that may be reversible. Knowing the cause of your heart failure can help you get the best treatment, avoid triggers that worsen your symptoms, and keep you out of the hospital.

Some common causes of heart failure include: 

• Coronary artery disease 
• High blood pressure 
• A previous heart attack 

Understanding your disease and how to manage it may also improve your sense of control and confidence in living with heart failure. 

Keep Up With Medications 

The medication schedule set by your doctor can sometimes be a bit complicated. That's because heart failure treatment often includes several different medications taken simultaneously. Certain medications work better when used in combination rather than alone.

But even if you feel overwhelmed, it’s important to stick to your medication schedule. These medicines can improve your heart’s ability to work properly and prolong your life. 

Here are some of the medications your doctor may prescribe: 

• Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors relax your blood vessels, making it easier for your heart to pump blood through your body. 
• Angiotensin II receptor blockers. This medication helps lower your blood pressure, making it easier for your heart to pump. 
• Angiotensin-receptor neprilysin inhibitors (ARNIs). These work by widening your blood vessels, taking pressure off your heart. 
• If-channel blockers. This medicine helps slow your heart rate. When your heart beats slower, it can pump more blood with each contraction. 
• Beta-blockers. Beta-blockers block hormones, like adrenaline, to slow your heart rate. 

• Aldosterone antagonists. This medicine helps your kidneys produce more urine to flush out salt and water from your body, easing pressure on your heart. 
• Hydralazine and isosorbide dinitrate (for Black patients). This drug relaxes your blood vessels, allowing your heart to beat more easily. 
• Diuretics, or water pills. Diuretics help your body remove excess fluids and sodium through urination. This takes pressure off your heart, allowing it to beat easier. 

Recommended reading:
12 Clever Ways to Remember Your Medications
5 preguntas que debe hacerle a su farmacéutico​​​​​​​.  

Assemble Your Support Team  

"It takes a team to manage heart failure patients," says Dr. Crisco. Don't be afraid to ask for help from family members, friends, and community members who support you. They can act as your advocate and attend medical appointments with you.

Your doctor and their office staff are crucial members of your care team. Make sure you know who to contact in the office in case you have any questions or need to schedule a visit.

And get in the habit of writing down any questions you have about your condition. This will help remind you to discuss those concerns with your doctor.

Track Your Signs and Symptoms 

Throughout your treatment, your doctor will check specific indicators that may reflect changes in your heart condition. This includes things like: 

• Weight 
• Blood pressure 
• Heart rate 
• Signs of fluid overload (like swelling) 
• Fatigue and tiredness levels 

Once you have a baseline, you can track these things at home between appointments. Keep an eye out for signs and symptoms that might suggest a change in your heart function.

A sign is something you can see, like noticing an indentation in your ankle when removing a sock. That may be a sign of fluid retention.

A symptom is something you feel, like shortness of breath, which may be related to fluid in the lungs.  

Other signs and symptoms of heart failure include: 

• Persistent coughing or wheezing 
• Lack of appetite 
• Nausea 
• Confusion 

Regularly tracking these signs and symptoms (in a notebook or notes app) helps you manage your health while reducing your chances of ending up in the emergency room. 

Get Moving 

After learning you have heart failure, it's normal to worry about putting too much pressure on your heart through exercise. But starting or continuing a regular exercise program helps keep heart failure from getting worse. It can even help minimize existing symptoms.

"You want to maintain muscle mass and bone density," says Dr. Crisco. Since heart failure patients often overlap with fall-risk and hip fracture patients, for example, "we want to make sure that you're prepared for any other health condition that comes at you."

Remember: Exercise doesn't need to be strenuous to be beneficial. Your doctor may refer you to a cardiac rehabilitation program to learn how long and intense you should exercise, plus which specific workouts are right for you.

With the greenlight from your doctor, SilverSneakers group fitness classes are another good option. Classes are designed specifically for older adults. And the instructors are trained to help members modify movements to fit their individual fitness needs.  

It's important to listen to your body, adds Dr. Crisco. It's OK to push yourself, but stop if you feel short of breath, he says.

See our sources:
Heart failure overview: American Heart Association
Living with heart failure: American Heart Association
Heart failure facts: National Heart, Blood and Lung Institute
Causes of heart failure: American Heart Association
Medications that treat heart failure: American Heart Association
Heart failure signs and symptoms: American Heart Association 

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