Help for Failing Hearts
Though 80% of people with heart failure should be taking beta-blockers, Packer says that only 15-20% are currently taking them.
Heart bypass surgery also can improve heart function in some people by re-routing blood flow around blockages. In addition, doctors can replace leaky valves in people whose heart failure is caused by a heart valve defect.
"If you are the right candidate, heart transplantation surgery may also be an option," says Elias Iliadis, MD, co-director of the interventional fellowship program at Geisinger Medical Center in Danville, Pa.
And many new drugs, devices, and surgical techniques are being developed, Packer tells WebMD.
A new class of drugs called endothelian antagonists blocks a specific stress hormone called endothelian, which can damage the heart. Another group of drugs called vasopeptidase inhibitors inhibit other hormones that can wreak havoc on the heart muscle.
Also in development are implantable devices that look like gun holsters. These devices keep the heart pumping at a normal pace, Iliadis explains.
But Packer warns against becoming too exited about these new, experimental options. "We really need to be very careful about becoming too optimistic or pessimistic about each of these," he says.
Nonetheless, heart failure treatment has clearly come a long way.
At one point in time, doctors just treated heart failure with diuretics to get rid of the excess salt and fluid, explains Kris Vijay, MD, the director of heart failure program and the director of clinical research at Arizona Heart Institute in Phoenix.
"Then over time, we realized that fluid accumulation is secondary to failure [of the heart pump], so we added agents that help the heart pump better. [But] as we did this, we realized patients were still getting worse and slowly dying," Vijay tells WebMD.
"Then we discovered that in addition to pump failure, all sorts of hormones are being released in the bodies of people with heart failure that continue to attack the heart muscle, weakening it and causing deterioration," he tells WebMD.
So more studies investigated whether blocking these hormones would slow disease progression. Enter beta-blockers and ACE inhibitors. Both block specific, heart-damaging hormones, or "little devils," as Vijay calls them.
Now that physicians better understand "some of the underlying mechanisms that occur with heart failure, [we] are targeting those mechanisms, and we are winning the game to some extent," he says.
Patients can help by recognizing the symptoms and getting the right care.
But some experts fear one of the hindrances to getting proper care may be the name -- heart failure.
"We struggle with [the name] all the time," says Packer.
"From a patient perception, the name heart failure sounds morbid so a lot of education is needed in terms of patient awareness, especially since a positive outlook can have a significant role in making quality of life better," Vijay says.