Congestive Heart Failure Clinic

Congestive Heart Failure means that your heart is not pumping as strongly as it once was. When your heart pump is weak, fluids can back up into your lungs, abdomen and legs. This can cause you to become short of breath, tired, bloated and swollen.

The measurement of how well your heart is pumping is called the ejection fraction (EF). It tells the amount of blood the left ventricle pumps out in on beat. Normal Ejection Fraction is >50%.
There are two different kinds of heart failure:
  1. Systolic heart failure– weakened pumping action of the left ventricle. The EF is low.
  2. Diastolic heart failure – your heart is not relaxing adequately. (Your heart is pumping normally). The heart walls are stiff and do not easily relax. This causes problems with your heart filling normally with blood.
Common causes of Heart Failure:
Coronary artery disease/heart attack, high blood pressure, heart valve disease, viral infections,  excessive alcohol use, severe lung disease. Sometimes the cause is unknown.
Common symptoms of Heart Failure:
  • Shortness of breath
  • Weight gain
  • Swelling of lower legs
  • Swelling in the abdomen
  • Dry cough
  • Fatigue/weakness
  • Loss of appetite
Things you can do:
  • Take your medications as prescribed.
  •  Maintain a log of your weight. Weigh every morning (place scale on hard surface, not carpet). Record wt. Call the office with wt. gain of > 2 lbs. overnight or 5 lbs. in one week.
  • Low sodium diet   – 2000mg sodium daily. Use seasoning blends instead – Mrs. Dash. Do not use salt substitutes. They contain potassium and this can become problematic in combination with your medications.
  • Fluid restriction – drink with meals and pills only. When thirsty, take a small drink of water. Do NOT push fluids. Try hard candy, popsicles, frozen grapes to moisten your mouth.
  • Aerobic exercise can help strengthen your heart, maintain muscle mass and strength, increase your energy level, reduce stress. Discuss your specific situation with your health care provider.
  • Limit alcohol. Alcohol has been shown to decrease the heart’s ability to contract. No more than one drink (one glass of beer or wine, or one mixed drink or cocktail with no more than one ounce of liquor) – 2-3 times per week.
Tips for taking some of the prescribed medications for Heart Failure:
  • Take diuretics (water pills) on an empty stomach – one hour before eating or two hours after eating.
  • Take coreg (carvedilol) with food.
  • Take ACE inhibitor/ARB (Common names are lisinopril, diovan, benicar. There are others – please ask your health care provider at your appointment) separate from coreg(carvedilol). For example, at lunch or bedtime.
Middletown Cardiovascular Associates, Inc. (MCA) Heart Failure Clinic
The Heart Failure clinic is a nurse practitioner clinic that specializes in the care of Heart Failure. The purpose is to provide close follow-up. The goal is to help you manage your Heart Failure and recognize signs/symptoms of concern at an early stage. The visits include education regarding specifics of your pathophysiology , medications, diet and exercise.