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Care During Chemotherapy and Beyond

Congestive Heart Failure



What is congestive heart failure?

Heart failure doesn't mean that your heart has stopped working, or has "failed." Heart failure means that the heart is not pumping blood through your body as well as it should.

Heart failure is also called "congestive heart failure," if fluid starts to accumulate in the body. This is because the heart is not pumping the blood very well, and fluid may "back up" into your lungs.

To diagnose congestive heart failure, your doctor or healthcare provider may order a chest x-ray, an ECG, an echocardiogram, and some blood tests. He or she may also order a urine test.

There are many causes of heart failure. These may include:

  • Long-standing high blood pressure
  • Heart valve problems
  • Irregular or abnormal heart beats
  • Coronary artery disease (when your blood vessels to the heart are narrowed)
  • When the heart muscle itself is damaged, due to medications, age, or a previous heart attack (cardiomyopathy)

What are some symptoms of congestive heart failure to look for?

  • You may be overly tired, or very weak. It may be hard for you to do any kind of your normal activities.
  • You may have symptoms of coughing spells or a long-term (chronic) cough.
  • You may experience shortness of breath, either at rest or while performing any type of activity. This may include walking to the door, or climbing stairs.
  • You may have trouble lying flat in bed, and you may have to sleep on 2 or more pillows. Your shortness of breath may cause you to wake up in the middle of the night.
  • Your legs may be swollen, especially in your feet and ankles.
  • You may gain "water" weight easily, or feel bloated.
  • You may experience palpitations.
  • Some people may chest pain, which may range from excruciating, to a mild discomfort. The severity of pain does not indicate how severe the damage to the heart muscle may be.

Things you can do about congestive heart failure:

  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • If you have a family history of heart disease, stroke, high blood cholesterol, or high blood pressure, in a first or second-degree relative, you may be at risk for certain problems. Notify your healthcare provider if you have any of these diseases in your family.
  • You may be told to reduce the amount of salt you are eating in a day. Many times, it may be restricted to about 2 grams of sodium per day to help alleviate symptoms of congestive heart failure. You should discuss this with your healthcare provider how you can specifically use your diet to control your symptoms of heart failure.
  • You should try to exercise, as tolerated, to maintain your optimal level of functioning and alleviate symptoms of heart failure. Discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise only under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help you to feel better, and will promote the flow of oxygen in your lungs and blood.
  • Sleeping at night with your head of the bed elevated may make it easier to breathe. You may do this by sleeping on extra pillows.
  • Use relaxation techniques to decrease the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and try to concentrate on things that have relaxed you in the past. Such techniques can lessen symptoms of heart failure.
  • You should restrict the amount of alcohol you take in, or avoid it all together. Alcohol may adversely interact with many medications.
  • If you are ordered a medication to treat your heart failure, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.
  • If you miss a dose of your medication, discuss with your healthcare provider what you should do.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs that may be prescribed by your doctor:

There are many types of medications that may be used to treat heart failure and congestive heart failure. These may include:

  • ACE inhibitors - These drugs work by opening, or dilating, your arteries. They will lower your blood pressure, and improve blood flow to your kidneys, and through out your body, thereby easing symptoms of heart failure. Your healthcare provider may also prescribe these medications if you have diabetes or protein in your urine, to protect your kidneys. Some examples of this medication may include: enalapril maleate (Vasotec ®), lisinopril (Zestril®), and fosinopril sodium (Monopril®)
  • Aspirin - Depending on your overall health status, and the type and severity of your heart failure, your healthcare provider may prescribe aspirin as a "blood thinner." Aspirin works by preventing platelets in your blood from forming blood clots (anti-platelet).
  • Beta-blockers - can be used to slow down your heart rate, and improve blood flow through your body, thereby lessening the symptoms of heart failure. You may take this drug if you have been diagnosed with irregular heartbeats, or high blood pressure. Some examples of this medication may include: Metoprolol (Lopressor®), propranolol (Inderal®), and atenolol (Tenormin®).
  • Diuretics - may be known as "water pills" as they work to prevent heart failure and congestive heart failure by making you urinate out extra fluid. Some examples of this medication may include furosemide (Lasix®), and hydrochlorthiazide. You may receive this medication alone or in combination with other medications.
  • Digoxin - Also called digitalis, this medication works by slowing down the heart rate, and making it beat more effectively. This will pump blood through out the body better. It is also called Lanoxin®
  • Do not stop any of these medications abruptly, as serious side effects may occur

When to call your doctor or health care provider:

Call your doctor with the following symptoms:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection), if you are undergoing chemotherapy.
  • Excessive shortness of breath, chest pain, jaw pain or discomfort
  • Feeling your heart beat rapidly (palpitations)
  • Any new rashes on your skin, especially if you have recently changed any medications
  • Any unusual swelling in your feet and legs
  • Weight gain of greater than 3 to 5 pounds in 1 to 2 days.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.