According to George Groman, M.D., a cardiologist on staff at Howard County General Hospital, common causes of CHF can include a weak heart muscle damaged by a heart attack; leaking or narrowed valves; untreated high blood pressure; some cardiac arrhythmias; and, less often, diseases of the sac around the heart. These conditions can make the heart too weak to pump blood adequately. Another cause of CHF is diastolic dysfunction—when the heart is stiff and can’t sufficiently relax to fill with blood. This dysfunction becomes increasingly common with age and uncontrolled blood pressure as well as other causes.
Preventing Fluid Complications
If you have CHF, to reduce fluid buildup, Dr. Groman recommends you should:
- Limit salt intake. Use pepper or herbs and spices instead. Check with your doctor before using a salt substitute, which could cause a dangerous elevation of potassium.
- Be evaluated for sleep apnea if you snore.
- Use alcohol prudently—it can weaken the heart in some cases.
- Not use illicit drugs.
- Not smoke.
- Eat heart healthy—minimize saturated fat, trans fat and sugar.
- Maintain a healthy weight, and monitor your weight daily. If you see a progressive increase of three or more pounds in a week, call your cardiologist, who may adjust your diuretic dose.
- Take medications prescribed by your cardiologist.
Treating Fluid Buildup: New Hospital Service
“There can come a time when your small intestine becomes so waterlogged that your medications cannot be adequately absorbed,” says Dr. Groman. “This can result in further fluid buildup and may put you at risk for needing hospitalization and other types of intensive care.” To help patients avoid having to stay in the hospital, HCGH has begun an outpatient IV diuresis service to which your cardiologist can refer you. Appointments are offered weekdays in the hospital’s Infusion Center and last several hours to allow your nurse to record urinary output in response to the diuretic.
During treatment, nurses will speak with you about your diet and medications. All patients will receive a referral for a home care evaluation and remote, nursing-based patient monitoring. Lab work will be done (primarily to evaluate kidney function) and reviewed prior to you returning home.
“This collaborative effort between the patient’s physician, clinic nurses and home health has the potential to keep patients out of the hospital—and that is a very good thing,” notes Dr. Groman.