How Is Heart Failure Treated?
Early diagnosis and treatment can help people with
heart failure live longer, more active lives. How heart failure is treated will
depend on your type and stage of heart failure (how severe it is).
The goals of treatment for all stages of heart
failure are to:
For people with any stage of heart failure,
treatment will include lifestyle measures, medicines, and ongoing care. People
who have more severe heart failure also may need medical procedures and
surgery.
Lifestyle Measures
You can take simple steps to help yourself feel
better and control heart failure. The sooner you start these measures, the
better off you're likely to be.
Follow a Healthy Eating Plan
A diet low in salt, fat, saturated fat,
trans fat, and cholesterol can help you prevent or control heart
failure. Salt can cause extra fluid to build up in your body, making heart
failure worse. Fat and saturated fat can increase your blood cholesterol
levels. Trans fat raises your LDL ("bad") cholesterol and lowers your
HDL ("good") cholesterol. High blood cholesterol can cause heart disease, which
in turn can cause heart failure.
A balanced diet with varied nutrients can help your
heart work better. Getting enough potassium is key for people with heart
failure. Some heart failure medicines deplete the potassium in your body. This
can put people with heart failure in danger. Lack of potassium can cause very
rapid heart rhythms that lead to sudden death.
Potassium is found in foods like bananas,
strawberries, raisins, beets, and greens. Talk to your health care team about
getting the correct amount of potassium.
If you have heart failure, you shouldn't drink
alcohol. If you have severe heart failure, your doctor may advise you to limit
the amount of fluids that you drink.
Examples of healthy eating plans are the National
Heart, Lung, and Blood Institute's
Therapeutic
Lifestyle Changes (TLC) diet and the
Dietary
Approaches to Stop Hypertension (DASH) eating plan.
The TLC diet is low in saturated fat and
cholesterol to help lower blood cholesterol. The DASH eating plan contains less
salt/sodium, sweets, added sugars, fats, and red meat than the typical American
diet. Fruits, vegetables, fat-free or low-fat diary products, whole grains,
fish, poultry, beans, seeds, and nuts are the focus of the plan.
Adopt Healthy Habits
Taking steps to control risk factors for CAD, high
blood pressure, and diabetes also will help control heart failure.
- Lose weight if you're
overweight
or obese. Work with your health care team to lose weight safely.
- Do physical activity as your doctor directs to
become more fit and stay as active as possible.
- Quit smoking and avoid using illegal drugs. Avoid
exposure to secondhand smoke. Smoking and drugs can worsen heart failure and
harm your health.
- Get enough rest.
Medicines
Your doctor will base your medicine treatment on the
type of heart failure you have, how severe it is, and your response to certain
medicines. The following are the main medicines for treating heart failure.
- Diuretics (water or fluid pills) help reduce
fluid buildup in your lungs and swelling in your feet and ankles.
- ACE inhibitors lower blood pressure and reduce
strain on your heart. They also may reduce the risk of a future
heart
attack.
- Aldosterone antagonists trigger the body to get
rid of salt and water through urine, which lowers the volume of blood that the
heart must pump.
- Angiotensin receptor blockers relax your blood
vessels and lower blood pressure, so the heart doesn't have to work as hard.
- Beta blockers slow your heart rate and lower your
blood pressure to decrease the workload on your heart.
- Isosorbide dinitrate/hydralazine hydrochloride
helps relax your blood vessels, so your heart doesn't work as hard to pump
blood. The Food and Drug Administration approved this medicine for use in
African Americans after studies showed it worked well for this group.
- Digoxin makes the heart beat stronger and pump
more blood.
Many people with severe heart failure must be
treated in the hospital from time to time. In the hospital, you may receive new
or special medicines, but you will keep taking your other medicines too. Some
people with very severe heart failure are given intravenous (IV) medicines,
which are injected into veins in their arms.
Your doctor also will order extra oxygen if you take
medicine but still have trouble breathing. The extra oxygen can be given in the
hospital and at home.
Ongoing Care
It's important to watch for signs that heart failure
is getting worse. Weigh yourself each day. Let your doctor know right away if
you have a sudden weight gain or weight loss. Either one can signal a need to
adjust your treatment. If your doctor advises you to limit your intake of
fluids, carefully watch how much you drink during the day.
It's also important to get medical care for other
related conditions. If you have diabetes and/or high blood pressure, work with
your health care team to control your condition(s). Have your blood sugar level
and blood pressure checked. Your doctor will tell you how often to come in for
tests and how often to take measurements at home.
Medical Procedures and Surgery
As heart failure worsens, lifestyle changes and
medicines may no longer control heart failure symptoms. You may need a medical
procedure or surgery.
If you have heart damage and severe heart failure
symptoms, you may need:
- Cardiac resynchronization therapy. In heart
failure, the right and left sides of the heart may no longer contract at the
same time. This disrupts the heart's pumping. To correct this problem, doctors
may implant a type of
pacemaker
near your heart. This device helps both sides of the heart contract at the same
time, which may decrease heart failure symptoms.
- An
implantable
cardioverter defibrillator (ICD). Some people with heart failure have very
rapid, irregular heartbeats. Without treatment, the problem can cause
sudden
cardiac arrest. Doctors implant ICDs to solve this problem. ICDs are
similar to pacemakers. The device checks your heart rate and corrects heart
rhythms that are too fast.
People who have heart failure symptoms at rest
despite other treatments may need:
- A mechanical heart pump, such as a left
ventricular assist device. This device helps pump blood from the heart to the
rest of the body. People may use pumps until they have surgery or as a
long-term treatment.
- Heart
transplant. When all other treatments fail to control symptoms, some people
who have heart failure receive healthy hearts from deceased donors.
- Experimental treatments. Studies are under way
to see whether
open-heart
surgery or
angioplasty
(a procedure used to unblock heart arteries and improve blood flow) can reduce
heart failure symptoms.
Ongoing Research
Researchers continue to learn more about heart
failure and how to treat it. As a result, treatments are getting better.
People with heart failure often can be treated in a
research study. You get top care from heart failure experts and the chance to
help advance heart failure knowledge and care.
You also may want to take part in a heart failure
registry, which tracks the course of disease and treatment in large numbers of
people. These data help research move forward. You may help yourself and others
by taking part. Talk to your health care team to learn more. |