[What patients with cardiac insufficiency should know and why?]

The diagnosis of cardiac failure carries practical and psychological consequences which may require the patient to change his way of life. In addition to compliance to therapy which is the basis of clinical stability, the patient must understand a number of realities: violent physical exercise may be forbidden but regular daily physical exercise is to be recommended (with intermittent rest periods) as it increases the patient's comfort, although a beneficial effect on the prognosis has not yet been demonstrated. In addition, a reduced salt intake should be recommended although strict restrictions are no longer necessary with the ready availability of diuretics; the patient should also be taught to titrate his diuretic therapy with respect to alimentary intake and daily weight changes. Finally, instructions should be given about intercurrent conditions (infection, paroxysmal arrhythmias, hypertensive crises) which may decompensate stable patients and lead to a relapse of congestive heart failure. The patient and his family must know how and whom to contact immediately in case of an emergency.