Help for Failing Hearts
Once diagnosed, heart failure is treatable.
"We use four drugs in combination to ease symptoms, slow the progression of disease, and extend the lives of 80% of heart failure patients," Packer says.
This drug cocktail includes Digoxin to increase the heart's pumping action; diuretics, or water pills, to help the body eliminate excess salt and water; ACE inhibitors to expand blood vessels, allow blood to flow more easily, and make the heart work more efficiently; and beta-blockers to improve the function of the heart's left ventricle. Beta-blockers also block a natural stress hormone capable of damaging the heart. Blocking this hormone gives the heart a chance to recover and helps prevent continued injury.
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.