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Heart failure - fluids and diuretics

HF - fluids and diuretics; CHF - ICD discharge; Cardiomyopathy - ICD discharge

Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes fluid to build up in your body. Limiting how much you drink and how much salt (sodium) you take in can help prevent these symptoms.

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What to Expect at Home

When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you drink too many fluids, you may get symptoms such as swelling, weight gain, and shortness of breath. Limiting how much you drink and how much salt (sodium) you take in can help prevent these symptoms.

Your family members can help you take care of yourself. They can keep an eye on how much you drink. They can make sure you are taking your medicines the right way. And they can learn to recognize your symptoms early.

Your health care provider may ask you to lower the amount of fluids you drink:

Tips to Limit Fluids

Remember, some foods, such as soups, puddings, gelatin, ice cream, popsicles and others contain fluids. When you eat chunky soups, use a fork if you can, and leave the broth behind.

Use a small cup at home for your liquids at meals, and drink just 1 cupful (240 mL). After drinking 1 cup (240 mL) of fluid at a restaurant, turn your cup over to let your server know you DO NOT want more. Find ways to keep from getting too thirsty:

If you have trouble keeping track of it, write down how much you are drinking during the day.

Eating too much salt can make you thirsty, which can make you drink too much. Extra salt also makes more fluid stay in your body. Many foods contain "hidden salt," including prepared, canned and frozen foods. Learn how to eat a low-salt diet.

Diuretics

Diuretics help your body get rid of extra fluid. They are often called "water pills." There are many brands of diuretics. Some are taken 1 time a day. Others are taken 2 times a day. The three common types are:

There are also diuretics that contain a combination of two of the drugs above.

When you are taking diuretics, you will need to have regular checkups so that your provider can check your potassium levels and monitor how your kidneys are working.

Diuretics make you urinate more often. Try not to take them at night before you go to bed. Take them at the same time every day.

Common side effects of diuretics are:

Be sure to take your diuretic the way you have been told.

Weighing Yourself Regularly

You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body.

Weigh yourself every morning on the same scale when you get up -- before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it.

Call your provider if your weight goes up by more than 2 to 3 pounds (1 to 1.5 kilograms, kg) in a day or 5 pounds (2 kg) in a week. Also call your provider if you lose a lot of weight.

When to Call the Doctor

Call your provider if:

Related Information

Heart failure - overview
High blood cholesterol levels
High blood pressure - adults
Coronary heart disease
Low-salt diet
Heart failure - home monitoring
Aspirin and heart disease
Cholesterol and lifestyle
Controlling your high blood pressure
Fast food tips
Heart failure - discharge
Heart failure - what to ask your doctor

References

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 2423992 www.ncbi.nlm.nih.gov/pubmed/24239922.

Mann DL. Management of patients with heart failure with reduced ejection fraction. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 25.

Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/ AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017;136(6):e137-e161. PMID: 28455343 www.ncbi.nlm.nih.gov/pubmed/28455343.

Zile MR, Litwin SE. Heart failure with a preserved ejection fraction. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 26.

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Review Date: 7/25/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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