Elderly Woman with Chronic Heart Failure Advised to Follow Low-Sodium Diet
In this article, we will explore the case of an 80-year-old woman diagnosed with chronic heart failure. Her symptoms included chest tightness, shortness of breath, and leg swelling, which worsened over the course of a week. After being admitted to the hospital, she underwent a comprehensive treatment plan involving diuretics, anticoagulants, vasodilators, and cardiac support medications. The patient showed significant improvement upon discharge, with reduced symptoms and no signs of swelling. This article is intended for informational and educational purposes only, with patient details modified to ensure privacy.
Patient Overview
Age: 80 years old
Gender: Female
Condition: Chronic Heart Failure
Hospital: Third Xiangya Hospital, Central South University
Visit Date: June 2021
Treatment: Intravenous medications (Nitroglycerin, Furosemide, Digoxin), oral medications (Rivaroxaban, Spironolactone, Sacubitril/Valsartan, Atorvastatin)
Duration of Treatment: 8 days
Outcome: Symptoms improved, chest tightness and leg swelling subsided
Initial Consultation and Diagnosis
The patient had a long-standing history of heart-related issues, including coronary artery disease and ischemic cardiomyopathy. Five years prior to her visit, she began experiencing intermittent chest tightness and shortness of breath, which were managed with prior treatments. However, a week before seeking care at our facility, her symptoms worsened significantly. She reported difficulty breathing during physical activity and while lying flat at night, accompanied by leg swelling. Upon examination, she presented with an enlarged heart, rapid heart rate, and irregular rhythm. An ECG confirmed atrial fibrillation with rapid ventricular response, along with ST segment and T wave abnormalities. Based on her clinical presentation and history, she was diagnosed with chronic heart failure and admitted for treatment.
Treatment Plan and Progress
Following admission, the patient underwent further diagnostic evaluations to assess heart function and overall health. As surgery was not indicated, a conservative pharmacological approach was recommended. She was started on intravenous medications including nitroglycerin for vasodilation, furosemide to reduce fluid buildup, and digoxin to support cardiac function. Oral medications included rivaroxaban for anticoagulation, spironolactone as a potassium-sparing diuretic, sacubitril/valsartan to improve heart function, and atorvastatin to manage cholesterol. After eight days of treatment, the patient showed marked improvement and was discharged with instructions to follow up in one month. Once stabilized, she was advised to schedule checkups every three to six months.
Post-Treatment Recovery
Before treatment, the patient experienced significant discomfort, including shortness of breath and leg swelling. Following her hospital stay, these symptoms were largely resolved. On physical examination, her lungs were clear, heart rhythm was stable, and there were no signs of fluid retention or heart murmurs. The patient was in good general condition and was cleared for discharge. She has not yet returned for follow-up evaluation.
Key Lifestyle Recommendations
While it is encouraging to see patients improve, maintaining long-term stability requires ongoing care and lifestyle adjustments. Here are some essential recommendations for managing chronic heart failure:
1. Prioritize Rest and Light Exercise
Patients with chronic heart failure should avoid strenuous activities that place excessive strain on the heart. However, light aerobic exercise such as tai chi can promote cardiovascular health and support recovery when done safely.
2. Adopt a Low-Sodium Diet and Monitor Fluid Intake
A low-sodium diet is crucial for preventing fluid retention, which can increase the workload on the heart. Patients should also monitor their fluid intake and maintain a stable weight to avoid complications like edema and worsening heart function.
Clinical Insights and Final Thoughts
Chronic heart failure is a progressive condition that typically cannot be cured. However, through a combination of medical therapy and lifestyle changes, patients can experience meaningful symptom relief and improved quality of life. In this case, timely diagnosis and appropriate treatment played a key role in the patient's recovery. It is equally important for patients to remain proactive about follow-up care, including regular monitoring of heart function to detect any signs of deterioration early. By staying informed and committed to heart-healthy habits, individuals with chronic heart failure can better manage their condition and extend their life expectancy.