Your health is important. Please follow up with your doctor as recommended.

1.  What is CHF?
 Nutrition
 Medications
 CHF Zone Review
 Question and Answer Session

3.  Congestive Heart Failure (CHF) happens when
blood backs up, or congests, into the liver,
abdomen or lungs.
 This typically happens when the heart muscle
is damaged, weakened, stiffened and/or
enlarged.
 One may also notice swelling of their legs or
ankles or possibly even the whole body if left
untreated.

4.  Coronary Artery Disease
 High Blood Pressure
 Faulty heart valves
 Damaged heart muscle
 History of heart attack
 Congenital heart defects
 Smoking
 Poor diet
 Lack of exercise

5.  For anyone still smoking, NCH offers smoking
cessation information and assistance.
 Please let one of us or your nurse know if you
are interested in assistance to quit.
 Florida Quit Line 1-800-U-Can-Now
Staffed 24/7

6.  Fatigue
 Shortness of Breath
 Swelling
 Sudden Weight Gain
 Cough
 Palpitations

7.  Stop Smoking
 Reduce sodium intake
◦ No prepackaged frozen meals or canned products
 Preventative medical care
 Take your medications as directed
 Maintain a healthy weight
 Monitor your weight daily
 Report any significant changes to your doctor
immediately
◦ Weight gain >5 pounds in a week
◦ Weight loss > 8 pounds in a week

8.  Prior to starting any activity or exercise
program please consult with your doctor.
 Exercise regularly following your doctors
guidelines.
 Ask your doctor about a Cardiac
Rehabilitation Program.

9.  Moderate physical activity can actually help
the heart grow stronger.
 Plan activities with two to three 20-30 minute
rest periods every day.
 Short walks are a good way to begin your
exercise program.
 Try to avoid activities in extreme hot or cold
temperatures.
 Look for activities you enjoy doing such as
bicycling, fishing, gardening, or swimming.

10.  If you experience any of the following
symptoms during your activity, stop and rest.
◦ Shortness of Breath
◦ Cough
◦ Chest discomfort
◦ Pain
◦ Dizziness
◦ Fast heart beat
◦ Extreme weakness
 If after rest the symptoms do not go away,
call your doctor or go to the emergency
room.

11. Do not exercise beyond your
outlined recommendations.
Remember, that more is not
always better and something
is better than nothing!!

12. Helping to live healthier

13.  Fluid restrictions are sometimes used by
doctors to help prevent an overload of fluid in
the body.
 If you become fluid overloaded you may
experience shortness of breath, increased
swelling and/or weight gain.

14.  Eat allowed fruits and vegetables ice cold
between meals.
 Chew on ice cubes (but remember they count
as part of your fluid balance!).
 Use small cups/glasses for beverages.
 Freeze allowed beverages in ice cube trays.
 Drink in sips instead of gulps. NO straws.
 Measure your daily fluid allotment and store
it in a container in the refrigerator.

15.  Remember that 2 cups of retained fluid is
equal to about 1lb of fluid weight gain.
 Keep your home well humidified.
 Try lemon wedges, sour hard candies, or
chewing gum to stimulate saliva and moisten
a dry mouth.
 Rinse your mouth with non-alcohol
mouthwash.
 Again, do not use a straw.

16.  Changing your diet is not easy.
 It may take several weeks before your adjust
to the new tastes and flavors of your meals.
 Most people with CHF should follow a low
sodium diet.
 Following a low sodium diet will help keep
water from building up in your body and may
help prevent you from having to take some
medications.

17.  A low sodium diet is considered 2300 mg of
sodium per day, but your doctor may
recommend 2000 mg of sodium per day due
to your CHF.
 How much is 2000 mg of sodium?
◦ ¼ teaspoon = 600 mg of sodium
◦ ½ teaspoon = 1200 mg of sodium
◦ ¾ teaspoon = 1800 mg of sodium
◦ 1 teaspoon = 2400 mg of sodium

18.  Page 15 in your packet gives you a list of
sodium content in some common foods.
 Pages18-19 give you some helpful hints on
spices and dining out.
 Pages 20-21 give you a starting reference list
of foods allowed or to avoid.

19.  No single meal should have more than 600
mg of sodium.
 Stop adding salt to food.
 Take the salt shaker off the table.
 Do not add salt when cooking.
 Pick foods naturally lower in salt such as
fresh fruits, vegetables, meat, chicken and
fish, dried beans, rice, canned products
labeled as “No Salt Added”

20.  Avoid prepackaged frozen meals, canned
foods, and pickled foods whenever possible.
 If you use a canned food, get the “No salt
added” products instead of the „Low Sodium”
 Use dry beans rather than canned beans. Salt
is often used in the canning process to
ensure long shelf life.
 Avoid commercial spice mixtures (the first
ingredient is often salt).

21.  Garlic. It is beneficial to your heart and
immune system as well as tasty and full of
flavor.
 Herbs and spices will add flavor and are
loaded with health boosting nutrients.
 Crush herbs in your hand before adding to
food to release added flavor.
 Peppers add spice and flavor to meals.
Remove the pepper seeds for a milder taste.
 Mozzarella or Swiss cheese are the lowest in
sodium.

22.  Reading labels is the best way to find out how
much sodium something has in it. It may
seem challenging at first, but many people
find it fun after they become accustomed to
it.
 Lets learn about a food label and what
information they can give us.
 Please refer to your booklet on page 17-18
for detailed information.

23. Nutrition Facts
Serving Size 1 cup (228g)
1. Start here with Serving Size
Servings per Container 2
2. Check Calories
Amount per Serving
Calories 250 Calories from Fat 110
% Daily Value*
Total Fat 12g 18%
3. Limit these Nutrients
Saturated Fat 3g 15%
Trans Fat 3g
Cholesterol 30mg 10%
Sodium 470 mg 20%
Total Carbohydrates 31g 10%
Dietary Fiber 0g 0%
Sugars 5g
Protein 5g
Vitamin A 4% 4. Get enough of these Nutrients
Vitamin C 2%
Calcium 20%
Iron 4% 5. Footnote
*Percent Daily Values are based on a 2000 calorie diet. Your Daily Values may be
higher or lower depending on your calorie needs.
Calories 2,000 2,500 6. Quick guide to % Daily Values
Total Fat Less than 65g 80g
Sat Fat Less than 20g 26g a. 5% or less is LOW
Cholesterol Less than 300mg 300 mg b. 20% or more is HIGH
Sodium Less than 2400 mg 2400mg
Total Carbohydrates 300g 375g
Dietary Fiber 25g 30g

24. Always take as instructed by your physician

25.  Beta blockers
 Digoxin
 Diuretics
 Angiotensin-converting
enzyme (ACE inhibitors)
 Angiotensin II (A-II) receptor
blockers

26.  Beta Blockers slow the heart
rate, lower blood pressure and
lessen the risk of some
abnormal heart rhythms
 Examples: Propanolol,
Metoprolol, Coreg, Atenolol,
Sotalol

27.  Frequently prescribed medications to treat
HTN and a primary CHF medication
 Can be taken at any time of day, with or
without food
 Taking with food slows absorption and
minimizes side effects
 Often prescribed with other medications

28.  Side Effects:
◦ Low heart rate
 Take your pulse everyday and get medication
parameters from your doctor
◦ Dizziness/Hypotension
 Be careful when standing up from a seated position
◦ Fatigue/Lethargy
◦ Sudden weight gain
◦ Impotence
◦ Vomiting/Diarrhea

29.  Digoxin increases the
strength of heart
contractions and tends
to slow your heart beat
 Examples: Lanoxin

30.  Can be taken with or without food but high
fiber diets may decrease absorption
 Take at least two hours before or after high
fiber or antacids
 Consult with your MD before taking any
herbal or over the counter medications
 Take your pulse everyday and get parameters
from your MD

31.  Side Effects:
◦ Fatigue
◦ Slowed Heart Beat
◦ Headache
◦ Vomiting/Diarrhea
◦ Toxicity
 Blurred vision, light flashes, or yellow-green visual
halos around objects
 REPORT TO MD IMMEDIATELY

32.  Diuretics prevent fluid from collecting in your
body and decrease fluid in your lungs, making
breathing easier
 Examples: Lasix, Bumex, Hydrochlorothiazide

33.  Take in the morning
 If taking twice per day, then take in the
morning and afternoon
 May need potassium or magnesium
supplements
 Use sunblock to prevent photosensitivity
 Follow a low sodium diet
 Have your BP and kidney function checked
regularly by your MD

34.  Side Effects:
◦ Electrolyte imbalance
◦ Orthostatic Hypotension
◦ Dehydration
 Dark, concentrated, smelly urine
 Extreme thirst
◦ Toxicity
 Ringing in the ears
 Abdominal pain
 Fever
 REPORT THESE IMMEDIATELY

35.  ACE inhibitors lower blood
pressure, improve blood flow
and decrease your hearts
workload
 Examples: Captopril, Enalapril,
Lisinopril, Ramipril

36.  Take on an empty stomach, one hour before
meals
 Do not use salt substitutes
 Choose foods low in salt and potassium
 NSAIDS may cause body to retain salt and
water and decrease the effectiveness of your
ACE

37.  Side Effects:
◦ Nausea/Vomiting/Diarrhea
◦ Dizziness/Hypotension
◦ Skin Rash
◦ Cough
 Most common
 If persists or severe, contact MD
◦ Toxicity
 High Potassium
 Swelling in face, neck or tongue (ANGIOEDEMA)
 REPORT TO MD IMMEDIATELY

38.  Reduces high blood pressure,
making it easier for the heart to
pump blood, improving heart
failure. These drugs provide
the same benefits of the ACE
Inhibitors without the potential
side effect of persistent cough
 Examples: Avapro, Diovan,
Micardis, Cozaar

39.  Take on a full or empty stomach
 Take at least two hours before or after an
antacid
 It may take a few weeks to feel full benefit of
medication
 Have kidney function and blood pressure
monitored by your MD

40.  Side Effects:
◦ Hypotension/Dizziness
◦ Headache
◦ Nausea/Vomiting/Diarrhea
◦ Elevated Potassium Level
◦ Confusion

42.  These are quick glance reviews to give you an
idea of how well controlled your CHF is today.
 Everyday goals
◦ Weigh yourself every morning before breakfast.
◦ Take your medication as prescribed.
◦ Check for swelling in your feet, ankles, legs and
stomach.
◦ Eat a low salt diet.
◦ Balance activities and rest periods.

43.  Congratulations! Your symptoms are
under control.
 No shortness of breath.
 No weight gain more than 2 pounds.
 No swelling in your feet, ankles, legs or
stomach.
 No chest pain.
 No decrease in your ability to maintain a
normal activity level.

44.  Call your doctor‟s office if:
◦ Short of breath.
◦ Swelling in your feet, ankles, legs and stomach.
◦ Feeling tired, no energy.
◦ New or increasing cough.
◦ Dizziness.
◦ Chest pain.
◦ Feeling uneasy.
◦ It becomes harder to breath lying down or you must
sleep in a chair.
◦ Weight gain of 3 pounds in a day or 5 pounds in a
week.

45.  Go to the emergency room or call 911 if you
have any of these symptoms:
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 Struggling to breath or unrelieved shortness
of breath while sitting still.
 Weight gain or loss of 5 pounds in 2 days.
 Unrelieved chest pain.
 Confusion.