Heart Failure Treatment

If you have heart failure, you have a lot of choices for treatment. Your doctor may suggest you start with medication and lifestyle changes. If your condition gets worse, you can turn to centers that specialize in treating heart failure for more options, like surgery.

Medicines

It's important to keep up with your medications and take them the way your doctor tells you to. Common types of drugs that treat heart failure are:

  • Aldosterone antagonist
  • ACE inhibitors
  • ARBs (angiotensin II receptor blockers)
  • ARNIs (angiotensin receptor-neprilysin inhibitors)
  • Beta-blockers
  • Blood vessel dilators
  • Calcium channel blockers (unless you have systolic heart failure)
  • Digoxin
  • Diuretics
  • Heart pump medication
  • Potassium or magnesium
  • Selective sinus node inhibitors

 

Surgery and Medical Device Options

The goal of surgery is to make your heart work better.

Bypass surgery. Routes blood around a blocked artery.

Cardiac resynchronization therapy (CRT). When your heartbeat is off-kilter, it can make heart failure worse. This treatment uses a pacemaker that sends timed electrical impulses to both of your heart's lower chambers (the left and right ventricles) so they pump better and more in sync. Your doctor may call it a biventricular pacemaker. He could also pair it with an ICD (see below).

Heart transplant. This is done when heart failure is so severe that it doesn't respond to any other treatments.

Heart valve surgery. If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing it. A surgeon can repair or replace the valves.

Implantable cardioverter-defibrillator (ICD). This device is similar to a pacemaker. It's put under your skin in your chest. Wires lead through your veins and into your heart to keep track of your heart rhythm. If your heart starts to beat at a dangerous rhythm, or if it stops, the ICD tries to pace your heart or shock it back into normal rhythm. An ICD can also act as a pacemaker and speed your heart up if it's going too slow.

Infarct exclusion surgery (modified Dor or Dor procedure). When a heart attack happens in the left ventricle (the lower left chamber of your heart), a scar forms. The scarred area is thin and can bulge out with each beat, forming what's called an aneurysm. A heart surgeon can remove it.

Ventricular assist device. The doctor puts it into the abdomen or chest and attaches it to your heart to help it pump blood to the rest of your body. VADs are most often used in the heart's left ventricle, but they can also be used in the right ventricle or in both ventricles.

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How Can I Keep My Heart Failure From Getting Worse?

Monitor your symptoms. Check for changes in how much fluid builds up in your body by weighing yourself every day. Check for swelling, too.

See your doctor regularly. He'll make sure you're staying healthy and that your heart failure isn't getting worse. He'll ask to review your weight record and list of medications.

If you have questions, write them down and bring them with you to your appointment. Call your doctor if you have urgent concerns.

Tell all the doctors you see about your heart failure, the medications you take, and any restrictions you have. Also, tell your heart doctor about any new drugs prescribed by another doctor.

How Can I Prevent Further Damage?

  • If you smoke or chew tobacco, quit.
  • Keep to a healthy weight.
  • Control your blood pressure, cholesterol levels, and diabetes.
  • Exercise regularly.
  • Don't drink alcohol.

Your Heart Failure To-Do List

Eat a healthy diet. Limit the salt you eat to less than 1,500 milligrams each day. Eat foods high in fiber and potassium. Cut back on things high in saturated fat, cholesterol, and sugar. If you need to drop some weight, reduce the number of calories you eat.

Exercise regularly. A regular program that's OK'd by your doctor will improve your symptoms and strength and make you feel better. It may also slow your heart failure.

Don't overdo it. Plan out your activities and include rest periods during the day.

Prevent lung infections. Ask your doctor about flu and pneumonia vaccines.

Take your medications as prescribed. Don't stop taking them without first asking your doctor. Even if you have no symptoms, the drugs help your heart pump better.

Get emotional or psychological support, if you need it. Don't face things alone. Get the backing you need from social workers, psychologists, clergy, and support groups. Ask your doctor to point you in the right direction.

Be the Star of Your Team

It takes a team to manage heart failure, and you are the key player. Your heart doctor will prescribe your medications and manage other medical problems. Other team members, including nurses, dietitians, pharmacists, exercise specialists, and social workers, will also lend a hand. But it's up to you to take your medicine, change your diet, live a healthy lifestyle, keep your follow-up appointments, and be an active member of the team.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on 6/, 017

Sources

SOURCES: 

National Heart Lung and Blood Institute: "How Is Heart Failure Treated?" "Ventricular Assist Device."

American Heart Association: "Heart Failure Medications."

Mayo Clinic: "Heart Failure."

UpToDate: "Cardiac resynchronization therapy in heart failure: Indications," "General principles of the implantable cardioverter-defibrillator."

International Journal of Clinical Practice: “Ivabradine -- the first selective sinus node If channel inhibitor in the treatment of stable angina.”

Harvard Health Publishing: "Heart failure and potassium."

Clinical Calcium: "Magnesium in congestive heart failure."

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