Understanding Heart Failure -- Diagnosis and Treatment
What Are the Treatments for Heart Failure?
Treatment of heart failure focuses on slowing or reversing its progression. The earlier treatment starts, the better the outcome.
After a diagnosis, your doctor will recommend a series of lifestyle changes. You may be asked to reach and maintain a healthy weight, increase your activity level (as recommended by your doctor), restrict salt intake, restrict fluid intake, and avoid alcohol. If you smoke or chew tobacco, you'll be advised to stop. You will need to work with your doctor to find the right balance of rest and activity -- mobility is important to keep blood circulating. You will also need to weigh yourself daily and record your weight to detect fluid retention.
Your doctor will also prescribe several medications to manage your heart failure or the underlying problem that caused the heart failure. Drugs used to treat heart failure, often in combination, include:
Diuretics or water pills to help the body eliminate excess salt and water. Examples include Aldactazide, Aldactone, Bumex, Demadex, Diuril, Dyazide, Hydrodiuril, Lasix, Lozol, Maxide, and Zaroxolyn.
ACE inhibitors, which have a multitude of beneficial effects in patients with heart failure, including serving as vasodilators -- they expand blood vessels and increase blood flow, thus helping the heart pump more efficiently. ACE inhibitors are important heart failure drugs since they have been shown to significantly prolong life and improve the quality of life for most people with heart failure. ACE inhibitors include: Accupril, Altace, Captopril, Mavik, Monopril, Prinivil, Vasotec, and Zestril.
Angiotensin receptor blockers work in similar ways as ACE inhibitors. They are prescribed when patients develop side effects to ACE inhibitors, such as cough or high potassium levels.
Beta-blockers can improve the heart's ability to relax, and decrease the production of harmful hormones produced by the body in response to heart failure. Beta-blockers used to treat heart failure include carvedilol (Coreg) and metoprolol.
Digoxin, sold under the brand name Lanoxin, may improve heart pumping function and control certain heart rhythm problems. Digoxin is an older medication and not used as frequently as in the past, because many of the newer agents appear to have more profound effects on symptom control and overall outcome. Nevertheless, it may still be a reasonable add-on for those patients in whom symptoms don't improve with diuretics and ACE inhibitors.
Potassium supplements replace the potassium that may be lost because of increased urination from diuretics.
Some of these drugs may cause unwanted side effects. Always discuss problems you may be experiencing with your doctor before stopping or decreasing the dose of any prescribed medications.
In some cases, when drugs don't improve heart function enough or cannot be tolerated, surgery or other intervention is necessary. Doctors recommend surgery for several major reasons: to correct certain problems that cause heart failure (such as coronary-artery bypass graft surgery), to repair or replace valves, to implant devices (such as an intra-aortic balloon pump, specialized pacemakers, ICDs, or ventricular-assist devices) to help the heart pump, or to transplant a new heart. Heart transplants are used to treat severe CHF.