Learning About Your Health

Congestive Heart Failure (CHF): Caring for Yourself at Home

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What is Congestive Heart Failure (CHF)?

Congestive Heart Failure (CHF) is a condition in which your heart is not pumping as well as it should. CHF can cause symptoms such as shortness of breath, generalized weakness, and swelling in the ankles, feet, and abdomen. Coronary artery disease, heart attack, high blood pressure, and heart valve disease are common causes of CHF.

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Caring for Yourself at Home – Living Well with CHF

People with CHF can live better and longer if they learn to follow these seven essential lifestyle practices:

  1. Be knowledgeable about your diagnosis and treatment.


  2. Eat a healthy, low-sodium diet.


  3. Follow the medication plan as prescribed.


  4. Know what signs and symptoms to monitor and when to report them:

    • New or increased shortness of breath or cough.

    • Weight gain of more than 3 pounds a day or 5 pounds a week.

    • Increased swelling of ankles, feet or abdomen.

    • Persistent nausea or inability to eat.

    • Feeling of rapid heartbeats or palpitations.

    • Dizziness not related to change in body position.

    • Tightness, discomfort, or pain in the chest, jaw, or arm.
  5. Stay active and exercise within the limits of your illness.


  6. Modify risk factors such as smoking, obesity, high blood pressure, and cholesterol.


  7. Learn to cope with stress.

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Special Instructions on How to Take Your Medications

  • Take your medications at the same time each day.


  • Use a medication organizer to keep track of your medication schedule.


  • Do not stop taking any medications unless your doctors tell you to do so.


  • Tell your doctor if you have any side effects from your medications, such as a headache, dizziness, upset stomach, or cough.


  • Do not skip a pill. If you do miss a pill, do not take two pills the next time.

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Making a Follow-up Appointment

People with congestive heart failure usually see their doctor 2-4 weeks after going home from the hospital. Bring all pill bottles or a list of medications to each appointment to share with your health care provider.

Recognizing Danger Signals at Home

Call your doctor before your next appointment if you develop any of the following symptoms:

  • New or increased shortness of breath or cough.

  • Weight gain of more than 3 pounds a day or 5 pounds a week.

  • Increased swelling in ankles, feet, and abdomen.

  • Persistent nausea or inability to eat.

  • Feeling of rapid heartbeats or palpitations.

  • Dizziness not related to change in body position.

  • Tightness, discomfort, or pain in your chest, jaw, or arm.

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Planning Your Activity Once You At Home

  • You can continue your normal daily activities if you are not short of breath or feeling very tired.


  • Talk to your doctor about when you can go back to work.

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Keeping to an Exercise Program

Exercise Regularly: Exercise helps improve heart muscle function following a heart attack. It also helps you maintain a healthy weight and control risk factors such as diabetes, high cholesterol, and high blood pressure. You are encouraged to exercise regularly. Regular exercise can reduce your symptoms.

Follow These Guidelines

  • Rest after meals. Wait at least 1 hour after you eat to walk or do any strenuous activities.

  • Space your activities to avoid getting too tired.

  • Exercise (walk or cycle) at a calm, easy pace.

  • Pace yourself so you can easily hold a conversation while you exercise.

  • Exercise when you are rested.
NOTE: If you become short of breath, dizzy, develop pain or chest tightness – stop and rest. If symptoms persist – Call 911.

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More Tips on Your Diet

  • Do not add salt to your food during cooking or at the table.


  • Avoid foods with salt: Extra salt makes the body hold on to water which, in turn, can make congestive heart failure worse.


  • Buy no-salt foods: Read labels on packages, jars, and cans of food. Salt is sodium chloride. Canned, frozen dinners and prepared foods often contain lots of salt.


  • Fluid Restriction: Some patients must limit their fluid intake to no more than 6-8 cups of fluid intake each day. Check with your doctor for specific instructions.


  • Eat slowly: Do not overeat. Do not exercise right after eating.


  • Weigh yourself at the same time each day with the same amount of clothing. Use the Daily Weight Record (PDF 46KB) to keep a log of your weight.

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Maintain a Healthy Weight

Being more than 10 percent overweight increases your risk of heart disease. Measure your waist circumference: Your waist circumference (waist-line measurement) serves as an important value in determining if you are overweight. The recommended waist circumference for men and women is as follows:

  • Women: Less than 35 inches.

  • Men: Less than 40 inches.

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Eat a Heart-Healthy Diet

Read labels on packages, jars, and cans of food:

  • Salt is sodium chloride. Canned foods, frozen dinners, pickled vegetables, and processed foods often contain lots of sodium chloride.

  • Most luncheon meats (cured meats) such as ham, smoked turkey, salami, and bologna are high in sodium chloride and other sodium-containing preservatives.
Low cholesterol, low sodium:
  • Most doctors recommend that you do not have more than 2-3 grams (2,000-3,000 mg) of sodium chloride each day.

  • If you have high blood pressure or diabetes check with your doctor for special diet instructions.
Limit high-cholesterol foods:
  • Limit high-cholesterol foods such as egg yolks, whole milk, cheese, organ and fatty meats, and processed foods.

  • Recommended cholesterol (lipid) lab values for people with heart disease:

    • Total cholesterol should be less than 200.

    • LDL (low-density lipoprotein) cholesterol, sometimes called "bad cholesterol" should be less than 100.

    • HDL (high-density lipoprotein) cholesterol, "good cholesterol," should be greater than 40.

    • Triglycerides (fat carried by cholesterol) should be less than 150.
Avoid/reduce saturated fats:
Avoid butter, coconut, palm, and partially hydrogenated oils, and fatty meats which are high in saturated fats. Choose canola, olive, safflower, sunflower or peanut oils in small amounts.

Minimize intake of trans fats:
Trans fats are found in processed foods with hydrogenated or partially hydrogenated oil (boxed crackers, cookies, and cakes).

Eat more fiber and carbohydrates:
Eat at least 5 serving per day of a variety of vegetables and fruits. Other good food choices include: pasta (plain), grains, dried beans, potatoes, and brown rice.

Add folic acid and B vitamins to your diet:
Adequate folic acid intake in your diet may reduce the amount of homocysteine in your blood. Homocysteine is an amino acid that builds and maintains tissues. Too much homocysteine may promote atherosclerosis. Folic acid can be found in green, leafy vegetables, citrus fruits, legumes, peanuts and cereal grains.

Consume alcohol in moderation:
Consult your doctor to evaluate the benefits and risks of alcohol consumption for you.

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Live a Heart-Healthy Lifestyle

Obtain Regular Medical Checkups:
Conditions such as high cholesterol, high blood pressure, and diabetes, may be present without any symptoms in the early stages.

Stop Smoking:
Smoking is harmful to the health of your heart. Smoking increases your heart rate and blood pressure, contributes to atherosclerosis (build-up of plaque in your blood vessels), and decreases oxygen to your heart. Cigarette smoking is a major risk factor for another heart attack.

Smoking is an addiction. Nicotine releases a chemical to your brain which gives you a feeling of pleasure. Your doctors and nurses realize that smoking is not an easy habit to quit, and we want to support you.

Here are some tips on how to quit smoking:

  • Make the decision to quit smoking while you are in the hospital. Inform your doctor and nurse.

  • Ask your doctor to prescribe a treatment plan to help you stop smoking. Your doctor may order medications to help with nicotine withdrawal and smoking cessation. These include nicotine replacement therapy (patch or gum), a smoking avoidance medication, or an antidepressant medication.

  • Ask your doctor if these medications are appropriate for you during your hospitalization and after you go home.

  • Inform your doctor or nurse when you are experiencing symptoms of nicotine withdrawal such as anxiety, cravings, irritability, restlessness, depression, and insomnia.

  • There are resources to help you quit. Call 1-800-NO-BUTTS, or ask your nurse or doctor for information about how you can quit smoking.
Other Risk Factors:
  • Being overweight makes your heart work harder. Ask for help in losing weight.

  • Having high blood pressure or high cholesterol levels damages your artery walls and increases your chances of coronary artery disease.
Managing Stress – Actions to cope with stress can include learning to use:
  • relaxation

  • deep breathing

  • visualization techniques

  • socializing with friends

  • listening to music

  • adopting a wellness lifestyle

  • seeking professional support when needed

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More Ways to Learn

  • Watch the Patient Video Education Channel in your hospital room. Anyone can use the video channel by following these instructions:

    • Tune to channel 60 on the television set, and follow the on-screen directions.

    • Pacific Campus patients dial extension 78888; California Campus patients dial extension 21000; and Davies Campus patients dial extension 33600.

    • Order videotape for viewing according to category or title by listening to information given over the telephone.
      Please watch videotapes #28 "Congestive Heart Failure" and #49 "How to Beat Cigarettes."
  • Ask about our Cardiac Rehabilitation Program at California Pacific Medical Center. This is a comprehensive program for cardiac patients and their families. A multidisciplinary team of health care professionals create a supportive environment, motivating participants to achieve a healthy lifestyle. The program includes supervised exercise three times per week, group education, and risk factor counseling. For more information call (415) 600-3361.


  • Call 1-800-NO-BUTTS for more information about smoking cessation.


  • Visit Our Community Health Resource Center at 2100 Webster Street, San Francisco (415) 923-3155. Services include classes and written information on a wide variety of health topics.


  • Visit these Web sites:

  • Interactive Tools

    • Determine your readiness to quit smoking.

    • Measure how smoking affects your chance of having a heart attack in the next 10 years.

Produced by the Center for Patient and Community Education in association with Department of Outcomes Management at California Pacific Medical Center. Last updated: 8/05.

© 2002 – 2010 California Pacific Medical Center.

Funded by: A generous donation from the Mr.and Mrs. Arthur A. Ciocca Foundation.

Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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