[2003] Contraception and pregnancy 1.6.11 In women of childbearing potential who have heart failure, contraception and pregnancy should be discussed. If pregnancy is being considered or occurs, specialist advice should be sought. Subsequently, specialist care should be shared between the cardiologist and obstetrician. [2003] Depression See NICE's guideline on depression in adults with a chronic physical health problem. Lifestyle advice Salt and fluid restriction 1.6.12 Do not routinely advise people with heart failure to restrict their sodium or fluid consumption. Ask about salt and fluid consumption and, if needed, advise as follows: restricting fluids for people with dilutional hyponatraemia reducing intake for people with high levels of salt and/or fluid consumption. Continue to review the need to restrict salt or fluid. [2018] 1.6.13 Advise people with heart failure to avoid salt substitutes that contain Smoking and alcohol See NICE's guidance on smoking and tobacco and alcohol. Air travel 1.6.14 Air travel will be possible for the majority of people with heart failure, 20 of depending on their clinical condition at the time of travel. [2003] Driving 1.6.15 Large Goods Vehicle and Passenger Carrying Vehicle licence: physicians should be up to date with the latest Driver and Vehicle Licensing Agency (DVLA) guidelines. Check the DVLA website for regular updates. [2003] 1.7 Monitoring treatment for all types of heart failure See the section on treating heart failure with reduced ejection fraction for specific recommendations on monitoring treatment for heart failure with reduced ejection fraction. Clinical review 1.7.1 All people with chronic heart failure need monitoring. This monitoring should include: a clinical assessment of functional capacity, fluid status, cardiac rhythm (minimum of examining the pulse), cognitive status and nutritional status a review of medication, including need for changes and possible side effects an assessment of renal function. Note: This is a minimum. 