What You Need to Know About Fluid Restriction in Congestive Heart Failure

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If you have congestive heart failure, your doctor may restrict your fluid intake.
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Congestive heart failure (CHF) means your heart can longer pump blood effectively, which may result in the buildup of fluid in your body. There's no cure for CHF, but there are steps you can take to minimize the strain on your heart. These include dietary modifications and fluid intake restrictions.

Complications of Heart Failure

Heart failure can be caused by a variety of heart problems. When the heart stops functioning efficiently, blood begins to back up in different parts of the body, and fluid may build up in the lungs, liver, arms and legs, according to the U.S. National Library of Medicine.

Fluid in the area surrounding the heart, called pericardial effusion, can be caused by CHF as well as other health conditions that damage or weaken heart muscles, including infection, inflammatory disorders, kidney failure, cancer and others, notes the National Center of Biotechnology Information.

"Trauma, complication of a heart attack or dissection of a major artery, the aorta, may also cause pericardial effusion," explains Muddassir Mehmood, MD, a cardiologist at the University of Tennessee Medical Center, Knoxville, Tennessee.

A small amount of fluid around the heart does not necessarily pose a huge risk and may not require treatment, Cedars-Sinai says, but when too much fluid builds up, the heart cannot expand properly. This results in not enough oxygen-rich blood being pushed out to the body. This condition, called cardiac tamponade, can be caused by CHF, reports the U.S. National Library of Medicine. It is a medical emergency that requires immediate treatment.

Is Fluid Intake Restriction Necessary?

As fluid builds up in your body, symptoms such as swelling, shortness of breath, fatigue, coughing and congestion (fluid in the lungs) can occur, reports the Heart Rhythm Society. Restricting how much fluid and sodium you consume may help minimize these symptoms, according to the U.S. National Library of Medicine.

When heart function is not optimal and congestion occurs, a temporary fluid restriction may be prescribed, explains Dr. Mehmood. "However, fluid restriction is a moving target and not everyone with CHF needs fluid restriction," he cautions.

The extent of a fluid restriction will depend upon a variety of factors, so it is critical that any type of restriction is carried out under a doctor's supervision. Some people with congestion may be advised to limit fluid intake to 6 to 9 cups of fluid a day, while others with low sodium levels (due to the congestion) may be advised to adhere to even stricter fluid restrictions, Dr. Mehmood explains.

Work with your physician to determine the appropriate amount of fluid intake to meet your needs.

Other Dietary Decisions to Consider

A heart-healthy diet is a key component of any CHF treatment plan. "In general, consuming a diet with an emphasis on vegetables, fruits, nuts, whole grains and fish; eliminating trans-fat; minimizing refined carbohydrates and processed meats; and replacing saturated fats with mono and polyunsaturated fats is advised," Dr. Mehmood says.

Read more: The 14 Best Foods for Your Heart

In addition, limit sodium. The Heart Failure Society of America recommends a low-sodium diet to help control symptoms of heart failure, including minimizing fluid build-up. Cutting table salt from your diet is a good first step.

Learning to read labels for sodium content and educating yourself about amounts of sodium found naturally in foods are additional steps to help you reach the recommended intake of 2,000 to 3,000 milligrams daily for people diagnosed with heart failure, and less than 2,000 milligrams a day for those with moderate to severe symptoms, the Heart Failure Society advises.

Also, limit or avoid alcohol. The American College of Cardiology reports that alcohol abuse increases the risk for congestive heart failure to the same degree as other risk factors, including high blood pressure, smoking, obesity and diabetes.

And while some reports say light to moderate consumption of certain types of alcohol are beneficial for heart health, this does not hold true when it comes to heart failure, says the American Heart Association. Drinking alcohol increases the risk for heart failure. "Heavy alcohol intake may lead to congestive heart failure by damaging the heart muscle," explains Dr. Mehmood.

If you want to increase your intake of flavonoids, the components of red wine with antioxidant properties, he recommends including non-alcoholic sources such as grapes or blueberries in your heart-healthy diet.

Read more: 10 Heart-Healthy Foods That Aren't

Is This an Emergency?

To reduce the risk of spreading COVID-19 infections, it is best to call your doctor before leaving the house if you are experiencing a high fever, shortness of breath or another, more serious symptom.
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