Ask the Doctors

Dear Doctor: My 80-year-old mother has been diagnosed with congestive heart failure. What is it, and is there anything she can do to keep it from getting worse?

Dear Reader: In congestive heart failure, the heart is no longer able to pump blood efficiently. This can be because of narrowing of the arteries that serve the heart, diabetes, high blood pressure, heart valve disease, congenital defects or damage to the heart muscle from a heart attack.

Although heart failure can't be cured, it can be managed with medication and lifestyle changes. To begin with, basic healthy-living guidelines are more important than ever. Maintain a healthy weight, get daily exercise and keep blood pressure under control.

In addition:

-- Be vigilant about medication: Your mother's cardiologist will have prescribed one or more drugs to manage the effects of her declining heart function. These may include a diuretic to deal with excess fluid, a beta-blocker to manage arrhythmias, an anticoagulant, statins to control cholesterol and medication to control heart rate.

-- Know your meds: You and your mother should learn the purpose of each drug that she takes. It's a good idea to post a detailed list of her daily drug regimen in a visible spot. Write down the name of each drug, the amount she must take and the time of each dose. Be sure to include potential side effects for each medication so if something goes wrong, that information is easily available.

-- Eat a heart-friendly diet: Get your mom to skip the processed foods. Instead, go for fresh fruit and vegetables, whole grains, beans and legumes. Protein should come from lean meats and fatty fish like salmon, which is loaded with omega-3 fatty acids. Stick to healthy fats like olive oil. Limit or quit caffeine, and steer clear of sugar and sugary drinks.

-- Be aware of salt: Sodium makes you retain fluid, so limiting salt is important for your mom. Most of the salt in our diets comes not from the shaker on the table, but from processed foods. Read labels and limit sodium to 2,000 milligrams per day.

-- Watch the fluids: We're talking about an important balancing act here. We need to take in enough fluids to stay hydrated, but for people with heart failure, too much can make it harder for the heart to pump. Your mother's cardiologist will have given her a target amount, likely in the range of 48 to 64 ounces per day. It's important that she stick to it. And don't forget that juice and soup count as liquids.

-- Get on the scale every day: A sudden weight gain of 2 pounds or more can indicate a serious problem. If that should happen, your mother should call her doctor immediately.

-- Look for other warning signs: dizziness, fainting, sudden shortness of breath, heart palpitations, increasing exhaustion, and abrupt swelling in the feet, legs or ankles. Any of these should be reported to her doctor right away. Even a change in her physical abilities -- a walk that had been easy and has now become laborious -- can indicate problems.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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