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posted: 5/19/2014 5:45 AM

Heart failure diagnosis does not mean death is imminent

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Q: I was just diagnosed with heart failure. So far, my symptoms have been mild. What can I do to make sure they don't get worse?

A: Heart failure is a condition that progressively weakens your heart's power to pump blood throughout your body. It may start out mild, but can worsen quickly.

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Many people think "heart failure" means sudden death. It surely is true that when the heart suddenly stops working at all and a person dies, the heart has failed in the worst possible way. But the term "heart failure" refers to a heart that still is pumping, but just not effectively enough.

When that happens, extra fluid in the blood is not eliminated as efficiently by the kidneys. Instead of being eliminated from the body in the urine, it builds up in the tissues. That creates swelling, usually most obvious in the lower legs and feet. It also creates breathlessness, since some fluid builds up in the lungs and makes it harder for the lungs to take oxygen into the body.

Fortunately, you can do several things to keep your heart failure in check.

I spoke with my colleague Dr. Eldrin Lewis, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. He recommended the following to ease symptoms and prevent them from getting worse:

• Take your medicines. Typically, medicines that accomplish three different purposes are prescribed: to help your body eliminate excess fluid and sodium; to relax your blood vessels; and to lower your heart's workload.

• Change your diet. Limit the amount of sodium you consume to 2,000 milligrams a day. Sodium makes you retain fluid. Don't add salt to your food and avoid processed foods, which contain a lot of sodium. Try not to drink more than two quarts of fluid per day.

• Listen to your body. Call your doctor right away if you notice new or worsening symptoms. These include heart palpitations, dizzy spells, fainting, worsening shortness of breath or rapid weight gain. A person can gain 3 to 10 pounds over just a few days from excess fluid.

• Pay attention to other medical conditions. Don't focus only on your heart failure and neglect other aspects of your health. For example, make sure to keep your blood pressure under tight control.

• Exercise and lose weight, if necessary. Regular aerobic exercise strengthens your heart and circulatory system so that blood circulates more efficiently. Exercise can also serve as an early warning system. If you've been able to walk a half-mile without trouble and you're suddenly short of breath, you'll know something is wrong.

With colleagues at Orca Health, I and my Harvard colleagues have published iBooks for the Apple iPad and iPhone on heart conditions, including heart failure. To learn more, visit AskDoctorK.com.

• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com.

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