Heart Failure Zones

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General Guidelines

What you need to know about your care at home.

Having heart failure can make you feel like you are on a tightrope or as if you own a fancy sports car. It takes careful attention to keep your body in balance and finely tuned.

The Heart Failure Zones handout will help you take care of yourself. It is important to know what you need to do every day to make sure you are in balance. Doing so will make you feel better, and you will be able to do the activities you enjoy.

Make sure you do the following EVERY DAY:

Monitor your weight

  • A change in your weight can be a sign that your heart failure is not controlled as well as it needs to be.
  • Weigh yourself every day. Know your dry weight. Dry weight is the weight of your body without extra fluid that builds up in your body because of heart failure.
  • Keep a record of your daily weight on a calendar or diary.
  • Call your heart failure doctor or nurse if, at any time, you weigh 4 pounds or more than your dry weight or 4 pounds or less than your dry weight.
  • At each appointment, ask what your current dry weight is. Write down your new dry weight so that you can compare your daily weight to your most recent dry weight.

Take your Medications

  • Take all of your medications every day.
  • Your heart failure medication plan is designed to keep your heart as healthy and strong as possible. Following the plan will help you feel better and live longer.
  • If you cannot remember to follow your medication schedule, tell your doctor or nurse. They may be able to change your schedule so that you are more likely to take your medications on time.
  • If your medications cause side effects, call your doctor or nurse.
  • Call your heart failure doctor or nurse if you have any questions about your medications (why you are taking it, how much you should take, how to know if it’s working, etc.).

Check for swelling

  • Swelling in your legs or stomach is a common sign that your body is overloaded with fluid. Call your doctor or nurse if you have any new or worsening swelling, even if you feel fine.

Eat a low-salt (sodium) diet

  • The most common low-sodium diet is a maximum of 2,000 mg of sodium per day.
  • Ask your doctor or nurse if you do not know your daily sodium limit.
  • Your daily sodium limit may be included in your hospital discharge paperwork.
  • Extra sodium in your body will cause fluid overload. This causes your heart to work harder. This can happen even if you feel fine. Try decreasing the amount of sodium in your diet to decrease excess fluid.

Exercise

  • Exercise is an important part of your treatment plan.
  • Check with your doctor or nurse before you start an exercise program.
  • Remember, exercise can cause shortness of breath, sweating and rapid heart rate. These are NORMAL effects and do not mean that your heart failure is getting worse.
  • If you become short of breath when exercising, stop and take a break. You can resume once your breathing has returned to normal.
  • Ask your doctor if cardiac rehabilitation would be good for you.

Green Zone – ALL CLEAR – This zone is your goal»

Your symptoms are absent or mild, and stable.

You do NOT have new or worsening:

  • Shortness of breath or fatigue.
  • Swelling of feet, ankles, legs or stomach.
  • Chest pain.

Your weight is stable (within 4 pounds of your dry weight).

Note: weight changes after you first leave the hospital are normal. They may be due to eating more or less food, exercising more or less, or taking in more or less fluids or sodium (salt). Every time you see your doctor or nurse, you should ask what your new target “dry weight” is.

Yellow Zone – CAUTION – This zone is a warning zone»

Call your heart failure doctor or nurse if you:

  • Gain or lose 4 or more pounds from your dry weight. Your daily weight is an early warning sign that your heart failure is getting worse, even before you feel symptoms.
    • An increase in your weight may be a sign that you have too much fluid in your body.
    • A decrease in your weight may be a sign that your “water pill” caused you to lose too much fluid, or that you are eating less. No matter the cause, your heart failure doctor or nurse should know about a change of 4 or more pounds from your dry weight.
  • Have new or worsening shortness of breath when you are involved in activities or at night when lying down. Shortness of breath is a sign that something has changed. You need medical attention before your heart is damaged any further.
    • If your breathing is getting worse when you are involved in activities, compared to what you are used to, your heart failure may be getting worse.
    • If you find that your are waking up during the night and need to sit up because you are short of breath, or if you need extra pillows to sleep comfortably, call your doctor or nurse the next day.
  • Notice swelling of your feet, ankles, legs or stomach. Swelling can be a sign that you are holding onto fluids. Even if you feel fine, if you notice new or worsened swelling, call your doctor or nurse.
  • Feel more tired than usual (or have a decrease in your energy level). You may feel like you need a nap to get through the day, or you may take longer naps.
  • Have dizziness that lasts for more than a minute.
    • It is common to become dizzy when you change positions, especially when you go from lying down to a sitting or standing position. To keep from getting dizzy:
      • Before standing, pump your feet back and forth and squeeze your hands 10 times to help move blood back toward your heart and decrease dizziness.
      • Stand up slowly.
      • If your dizziness lasts longer than a minute, your body is telling you that something has changed. It is important to call your doctor or nurse.
  • Feel uneasy and know something is not right. Trust the message your body is giving you – call your doctor or nurse.
  • Have a change in appetite (less hunger). Feeling full after eating smaller amounts of food than usual can be a sign of extra fluid in your abdomen.
  • Have a new or worsened cough. This can be a sign that there is too much fluid in your lungs. It may also be a side effect of one of your heart failure medications.

Red Zone – Emergency»

Go to the emergency room or call 911 if you:

  • Struggle to breathe or are short of breath while sitting still
  • Have new or worsening chest pain
  • Are confused or cannot think clearly

Keep your appointments

Follow-up visits with your heart failure doctors and nurses are very important to keep your heart in fine tune, even if you feel well. Your doctor needs to listen to your heart, check for early signs of heart failure and make sure your medications and diet are well-adjusted. The goals of follow-up care are to keep you feeling good, able to do the activities you enjoy, and keep you out of the hospital.

If you are unable to keep your follow-up appointment, it is important for you to call and reschedule your appointment.

Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.

Schedule an Appointment

Toll-free 800.659.7822

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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