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Heart Failure Treatment

Benjamin McDonald , edited by Ann Witt, MD

Treatments for heart failure vary based on the severity of the disease process. Surgical and medical procedures as well as the following lifestyle changes may be recommended:

  • Quit Smoking. In addition to increasing your risk for developing cancer, smoking raises your blood pressure and increases your body's need for oxygen. It also increases your chance of heart disease.

  • Lose Weight. If you are overweight, your doctor will recommend that you lose enough weight to return to a more average weight for your frame. Losing weight eases strain on the heart,while also improving diabetes, blood pressure and cholesterol control.

  • Limit Sodium: Sodium encourages your body to hold onto fluid. Typically, in heart failure your body has too much fluid and by limiting sodium you can help limit the fluid retained.

  • Limit Fluids

  • Limit Alcohol

  • Exercise has been shown to improve quality of life and decrease death from heart failure.

  • Check your weight regularly. A sudden increase in your weight may suggest that you are retaining more fluid and that you are experiencing a worsening of your heart failure that may require medication adjustment.

In addition to lifestyle changes, medications are an important part of the treatment of heart failure. In addition to controlling your blood pressure and diabetes, your physician may place you on medications specifically for your heart failure. While not an exhaustive list, the more commonly used classes of medications are noted below.

Diuretics (e.g, Lasix) help remove extra fluid from the body, allowing the heart to function more efficiently. Losing weight when first starting a diuretic supports the diagnosis of heart failure since the weight loss is most likely from extra fluid.

Beta-Blockers (e.g, Carvedilol, Metoprolol) work by slowing your heart rate and improving the relaxation of the heart, allowing it to better fill with blood between pumps. These medications have been shown to decrease the likelihood of dying from heart failure as well as the number of hospitalizations necessary to treat this condition. Typically, beta-blockers are started when a patient's heart failure is stable. Initially, a patient is started on a low dose that is slowly adjusted.

Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors; e.g., Lisinopril, Captopril) or Angiotension Receptors Blockers (ARB's): Like beta blockers, these medications have also been shown to decrease symptoms, and decrease the rate of hospitalization and death for patients with heart failure. While ACE inhibitors have been studied more extensively, ARB's appear to offer similar benefits to ACE inhibitors and are usually used when a patient cannot tolerate an ACE inhibitor.

Digoxin is a medication often used to control irregular heart beats. This medication can also be used to improve the symptoms of heart failure.

If your heart failure is not controlled through medications, your doctor may recommend surgery. Some of the common surgical procedures to treat heart failure include:

Coronary Artery Bypass: You are a candidate for this procedure if your heart failure is caused by blockages in your coronary arteries. See our description above for more details about this surgery.

Heart Valve Replacement/Repair: Heart valve replacement or repair procedures employ various techniques to strengthen the affected valves so that they can work more efficiently. The procedure chosen depends on the cause of heart valve damage.

Heart Transplant: As a last resort (after all other treatment options have been exhausted) you may be placed on the waiting list for a heart transplant. A good candidate for heart transplant is someone who is generally very healthy apart from his or her heart condition. When an organ is transplanted, the body' s immune system rejects the new organ as a foreign body. For this reason, transplant recipients generally have to take immunosuppressive (decreasing the response of the immune system) drugs for the rest of their lives. While these drugs help fight rejection of the new heart, they also weaken the body's defenses against viral and bacterial infections. Almost 90% of transplant patients survive the first year post-surgery, and approximately 70% survive the first 5 years.

Left Ventricle Assist Device (LVAD): This procedure is basically a way to stabilize an individual who is waiting for a heart transplant or to help a person for whom transplant is not an option. The LVAD assists the heart in pumping the blood through the body.