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Information from Your Family Doctor
Managing Your Congestive Heart Failure
Am Fam Physician. 1998 Nov 1;58(7):1641-1642.See related article on congestive heart failure.
What is CHF?
Congestive heart failure, or CHF, is a type of heart disease. When the heart can't pump blood properly to the rest of the body, we call it CHF. This may be a temporary problem, or it may last a long time.
What causes CHF?
Heart attacks, rheumatic heart disease, heart muscle damage caused by alcohol or viruses, high blood pressure, heart valve abnormalities and certain medicines are the major causes of CHF.
How does my doctor know I have CHF?
Your doctor can tell if you have CHF by asking you some questions and giving you a physical exam. Some of the signs of CHF are: reduced ability to exercise, fatigue, breathing problems (especially when lying flat) and swelling of the legs. Your doctor may want you to have an echocar-diogram (say: eck-oh-car-dee-oh-gram). This is a special kind of picture. It can tell your doctor how well your heart is pumping and how serious your CHF is.
How is CHF treated?
Several medicines may be used to help prevent or treat the symptoms of CHF. The main medicines are digoxin, diuretics (for example, furosemide or hydrochlorothiazide), ACE inhibitors, vasodilators (for example, nitroglycerin) and beta blockers. These medicines all work in different ways to prevent and treat CHF, so your doctor might have you take more than one of them. Always talk about the side effects of medicines with your doctor. In addition to giving you medicine, your doctor may recommend that you eat a diet low in salt and limit the fluids you drink.
What is carvedilol?
Carvedilol is a medicine known as a beta blocker. It's useful in the treatment of CHF because it decreases the work your heart has to do. The brand name for carvedilol is Coreg.
Should all people with heart failure take carvedilol?
Carvedilol generally isn't used in people who have had severe heart failure, severe liver disease, some heart arrhythmias or asthma. People who had a bad reaction to carvedilol in the past shouldn't take it again.
How and when should I take carvedilol?
Always take carvedilol with food. Take it two hours after you have taken other blood pressure medicines. Never stop taking carvedilol without talking with your doctor first. Your doctor will start you on a low dosage of carvedilol and increase the dosage slowly every two weeks. This way your doctor can watch out for any side effects. In some people, symptoms of heart failure may get worse when they first start taking this medicine.
If I have side effects, should I call my doctor?
Yes. If you feel dizzy or faint when you stand up, call your doctor. You may need to have your dosage adjusted. Weigh yourself every day. If your weight goes up by more than 2 pounds or if you are getting short of breath more easily, call your doctor.
What if I have diabetes?
If you have diabetes and take carvedilol, it may be harder for you to tell when your blood sugar level is too low. Monitoring your blood sugar level more often will help you with this problem.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1998 by the American Academy of Family Physicians.
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