Restriction of physical activities to reduce myocardial work and oxygen consumption. However, care should be taken to prevent deep vein thrombosis.
- Oxygen administration in dyspnoeic, hypoxic patient.
- Once patient is stabilized, cardiac rehabilitation and appropriate aerobic exercise may improve functional capacity.
- Weight loss in obese patients. This will reduce systemic vascular resistance and myocardial oxygen demand.
- Dietary salt restriction (2-2.5 g sodium or 5-6 g salt per day) should be advised.
- Fluid and water restriction to 1 to 1.5 L/24 h in patients with advanced heart failure is important in the presence of hyponatremia and volume overload. Very severe fluid restriction may lead to pre-renal azotemia.
- Discontinuation of negative inotropic agents, if any (beta blockers, diltiazem, verapamil, disopyramide, flecainide) and agents that cause fluid retention (NSAID).
- Dialysis or ultra-filtration in patients with severe heart failure and renal dysfunction.