Q. Considerations for congestive cardiac failure?

- Subjects with congestive cardiac failure often tolerate small frequent meals better than larger infrequent meals as these are tiring to consume, can contribute to abdominal dissention and markedly increase oxygen consumption.

- Alternative seasonings and flavouring agents such as mild herbs and condiments may be used sparingly if sodium restriction is moderate to severe in order to ensure adequate food intake.

- The menu should be planned by keeping in mind the fluid allowance for the day.

- The patient should be advised to chew the food slowly. Sweating and chest discomfort are indicators of oxygen deficiency. Food ingestion should be stopped in such situations.

- Meals should be soft and well cooked. Raw' food should be completely avoided.

A liquid diet may be gradually progressed to a semi-soft, soft and a normal diet.

- If the patient is on ventilator, oral intake may not be feasible. In such situations; enteral parenteral tube feeding should be started.

The dietary management details discussed in the text above are usually recommended for congestive heart failure patients not suffering from liver or renal failure. Dialysis is the treatment of choice in case of renal failure. In such situations restrictions on sodium and fluid may be less rigid.