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Heart failure - discharge

Congestive heart failure - discharge; CHF - discharge; HF - discharge

Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. When symptoms become severe, a hospital stay may be necessary. This articles discusses what you need to do to take care of yourself when you leave the hospital.

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When you Were in the Hospital

You were in the hospital to have your heart failure treated. Heart failure occurs when the muscles of your heart are weak or have trouble relaxing, or both.

Your heart is a pump that moves fluids through your body. As with any pump, if the flow out of the pump is not enough, fluids do not move well and they get stuck in places they should not be. In your body, this means that fluid collects in your lungs, abdomen, and legs.

While you were in the hospital:

What to Expect at Home

Your energy will slowly return. You may need help taking care of yourself when you first get home. You may feel sad or depressed. All of these things are normal.

Checking Yourself at Home

Weigh yourself every morning on the same scale when you get up -- before you eat but after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it.

Throughout the day, ask yourself:

If you are having new (or different) symptoms, ask yourself:

Diet and Fluids

Your health care provider may ask you to limit how much you drink.

You will need to eat less salt. Salt can make you thirsty, and being thirsty can cause you to drink too much fluid. Extra salt also makes fluid stay in your body. Lots of foods that DO NOT taste salty, or that you DO NOT add salt to, still contain a lot of salt.

You may need to take a diuretic, or water pill.

DO NOT drink alcohol. Alcohol makes it harder for your heart muscles to work. Ask your provider what to do on special occasions where alcohol and foods you are trying to avoid will be served.

If you smoke, stop. Ask for help quitting if you need it. DO NOT let anybody smoke in your home.

Learn more about what you should eat to make your heart and blood vessels healthier.

Try to stay away from things that are stressful for you. If you feel stressed all the time, or if you are very sad, talk with your provider who can refer you to a counselor.

Taking Your Heart Drugs

Have your entire drug prescriptions filled before you go home. It is very important that you take your drugs the way your provider told you to. DO NOT take any other drugs or herbs without asking your provider about them first.

Take your drugs with water. DO NOT take them with grapefruit juice, since it may change how your body absorbs certain medicines. Ask your provider or pharmacist if this will be a problem for you.

The drugs below are given to many people who have heart failure. Sometimes there is a reason they may not be safe to take, though. These drugs may help protect your heart. Talk with your provider if you are not already on any of these drugs:

Talk to your provider before changing the way you take your medicines. Never just stop taking these drugs for your heart, or any drugs you may be taking for Diabetes, high blood pressure, or other medical conditions you have.

If you are taking a blood thinner, such as warfarin (Coumadin), you will need to have extra blood tests to make sure your dose is correct.

Activity

Your provider may refer you to cardiac rehabilitation program. There, you will learn how to slowly increase your exercise and how to take care of your heart disease. Make sure you avoid heavy lifting.

Make sure you know the warning signs of heart failure and of a heart attack. Know what to do when you have chest pain, or angina.

Always ask your provider before starting sexual activity again. DO NOT take sildenafil (Viagra), or vardenafil (Levitra), tadalafil (Cialis), or any herbal remedy for erection problems without checking first.

Make sure your home is set up to be safe and easy for you for you to move around in and avoid falls.

If you are unable to walk around very much, ask your provider for exercises you can do while you are sitting.

Follow-up

Make sure you get a flu shot every year. You may also need a pneumonia shot. Ask your provider about this.

Your provider may call you to see how you are doing and to make sure you are checking your weight and taking your medicines.

You will need follow-up appointments at your provider's office.

You will likely need to have certain lab tests to check your sodium and potassium levels and monitor how your kidneys are working.

When to Call the Doctor

Call your provider if:

Related Information

Ventricular assist device
Cardiac ablation procedures
Heart pacemaker
Implantable cardioverter-defibrillator
Heart failure - overview
Atherosclerosis
High blood pressure - adults
Angina
Coronary heart disease
Tips on how to quit smoking
ACE inhibitors
Angina - when you have chest pain
How to read food labels
Implantable cardioverter defibrillator - discharge
Low-salt diet
Heart failure - fluids and diuretics
Heart failure - home monitoring
Aspirin and heart disease
Being active when you have heart disease
Butter, margarine, and cooking oils
Cholesterol and lifestyle
Antiplatelet drugs - P2Y12 inhibitors
Controlling your high blood pressure
Dietary fats explained
Fast food tips
Heart disease - risk factors
Mediterranean diet
Heart failure - what to ask your doctor
High blood pressure - what to ask your doctor
Taking warfarin (Coumadin, Jantoven) - what to ask your doctor
Taking warfarin (Coumadin)

References

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 2423992 www.ncbi.nlm.nih.gov/pubmed/24239922.

Mann DL. Management of heart failure patients with reduced ejection fraction. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 25.

Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/ AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017;136(6):e137-e161. PMID: 28455343 www.ncbi.nlm.nih.gov/pubmed/28455343.

Zile MR, Litwin SE. Heart failure with a preserved ejection fraction. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 26.

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Review Date: 7/25/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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