Congestive Heart Failure

ALTERNATIVE DOCTOR, LLC

Congestive Heart Failure

Congestive heart failure (CHF) occurs when the heart cannot pump out enough blood to meet the needs of the body. Any form of heart disease may lead to CHF, which results in a reduced ability to exercise and in severe cases can impair daily function. CHF is the most common cause of death for people over age 65.

Signs and Symptoms

	Shortness of breath
	Fatigue, exercise intolerance
	Rust-colored sputum
	Distended neck veins
	Cough—especially when waking
	Excessive nighttime urination
	Excessive protein in the urine
	Insomnia
	Nausea, vomiting
	Anorexia
	Anxiety
	Swelling in the extremities

What Causes It?

CHF can be the result of any type of heart disease or condition. The following factors make it more likely that you will get CHF.

	Smoking
	High-fat diet, excess body weight
	Alcohol abuse
	High sodium intake
	Influenza, pneumonia
	Noncompliance with prescribed medications or recommended diet

What to Expect at Your Provider's Office

Your health care provider will focus on identifying the cause and precipitating factors for CHF. Procedures include blood tests and electrocardiograms (ECG). Surgery may be needed if you have severe CHF.

Treatment Options

Treatment Plan

Treatment of CHF usually requires a combination of drugs. There are various mechanical devices that can also help. For example, pacemakers help the heart to beat at a steady rate, and intra-aortic balloons can provide increased blood flow to the heart. Oxygen relieves difficulty with breathing. Bed rest and reduced activity are important until your condition is stable. Surgery and heart transplant occur when other therapies for CHF fail.

Drug Therapies

Prescription

	Vasodilators—reduce narrowing of vessels; cornerstone of treatment; for example, angiotensin-converting enzyme (ACE) inhibitors; side effects include kidney failure, cough, hypotension
	Diuretics—for fluid control and sodium retention; limiting dietary fluid and sodium (less than 2 g a day) reduces need for diuretics; main types of diuretics include thiazide, loop diuretics, and potassium-sparing diuretics; mechanical removal of fluid also may occur
	Digitalis glycosides—increase the ability of the heart muscle to contract properly; prevent heart rhythm disturbances

Over the Counter

N/A

Complementary and Alternative Therapies

Nutrition and herbal medicine can play an important role in increasing the strength of the heart without also increasing its workload.

Nutrition

	Antioxidants: vitamin C (1,000 mg three times a day), vitamin E (400 IU per day), selenium (200 mcg per day)
	Coenzyme Q10 (30 to 50 mg twice a day): antioxidant, increases oxygenation of tissue, including heart muscle
	Essential fatty acids (1,500 mg twice a day): anti-inflammatory
	Diet: garlic, ginger and onions all have a beneficial effect on circulation. Increase fiber (especially water-soluble), fruits, vegetables, and vegetarian sources of protein. Increase potassium and decrease sodium in the diet.
	Homocysteine metabolism: Folic acid (800 mcg per day), B₆ (50 mg per day), B₁₂ (400 mg per day), betaine (200 to 1,000 mg per day)
	Magnesium (500 mg): mild vasodilation (dilates blood vessels)
	Taurine (500 mg twice a day): helps your heart work more efficiently
	Carnitine (750 to 1,500 mg twice a day): important in fatty acid metabolism, increases efficiency of cardiac function

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. of herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

	Hawthorn (Crataegus oxyacantha): increases blood vessel integrity; dose is 3 to 5 g. This dose is difficult to achieve in tea or tincture. Supplements or solid extract are used.
	Mistletoe (Viscum album): protects against high blood pressure and hardening of the arteries, historically for exhaustion and nervousness
	Linden (Tilia cordata): historically used to lower blood pressure
	Rosemary (Rosemariana officinalis): increases coronary artery blood flow, used to stimulate digestion and relieve nervous tension
	Mother wort (Leonorus cardiaca): regulates heart rhythm
	Dandelion (Taraxacum officinalis): potassium-sparing diuretic
	Indian tobacco (Lobelia inflata): helps reduce spasm, stimulates respiratory function, used in smoking cessation. May be toxic if used above recommended doses.
	Lily of the valley (Convallaria majalis): specific for cardiac insufficiency; exceeding recommended doses may lead to nausea, vomiting, headache, stupor. Use no more than 30 drops per day.
	Horsetail herb (Equisetum arvense): diuretic

Hawthorn should be included in any treatment. In addition, use a combination of four to six of the above herbs at 1 cup tea three times per day or 30 to 60 drops tincture three times per day.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Castor oil pack. Apply oil directly to chest, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes. For best results use three consecutive days.

Contrast hydrotherapy. Alternate hot and cold applications to the chest. Alternate three minutes hot with one minute cold and repeat three times. This is one set. Do two to three sets per day. For very sick patients, use cool and warm applications to decrease the contrast.

Acupuncture

May be helpful for increasing circulation and cardiac strength.

Massage

May help increase lymphatic drainage and reduce swelling.

Following Up

It is very important to prevent the heart disease from getting worse by getting plenty of exercise, eating a proper diet, and avoiding health risks.

Special Considerations

CHF is dangerous during pregnancy. The first two weeks after giving birth is particularly dangerous for women with CHF.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:218–219.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:120,142–144,162–163,171–172,197.

Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc. 1995;95:541–544.

Cecil RL, Plum F, Bennett JC, eds. Cecil Textbook of Medicine. 20th ed. Philadelphia, Pa: WB Saunders; 1996.

Gruenwald J, Brendler T, Jaenicke C et al, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998:779–781,932–923,1101–1103,1175–1176,1185–1187,1219–1221.

Murray MT. Encyclopedia of Nutritional Supplements. Rocklin, Calif: Prima Publishing; 1996:378–379.

Schmidt U, Kuhn U, Ploch M, Hubner WD. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomedicine. 1994;1:17-24.

Washington University School of Medicine, Department of Medicine. Washington Manual of Medical Therapeautics. 29th ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1998.

Werback MR. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing, Inc; 1987:40–78,136–139,227–240.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.