The goal of heart failure treatment is to address the underlying causes of the condition in order to reduce symptoms and improve health.
After a diagnosis of heart failure (sometimes called congestive heart failure), the following drugs may be prescribed to help decrease symptoms, improve heart function, and in many cases prolong your life:
- Angiotensin-converting enzyme (ACE) inhibitors?widen blood vessels to lower blood pressure, improve blood flow, and reduce the workload on the heart.
- Angiotensin II receptor blockers, also known as ARBs, are an alternative to ACE inhibitors if they can't be tolerated.
- Beta-blockers?slow your heart rate and reduce blood pressure, as well as limit or reverse some damage caused by?systolic heart failure.
- Aldosterone antagonists are potassium-sparing diuretics that help the body get rid of excess water.
- Angiotensin receptor neprilysin inhibitors (ARNIs) are a combination drug consisting of a neprilysin inhibitor (sacubitril) and an ARB. Inhibition of neprilysin increases the levels of chemicals in the body that help the kidneys remove sodium, dilate blood vessels, and prevent negative remodeling of the heart.
- Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended as a fourth class of medication for people with heart failure with reduced ejection fraction. SGLT2 inhibitors lower blood sugar by preventing the kidneys from reabsorbing glucose back into the blood.
- Diuretics reduce the amount of fluid in the body.
- Statins, or cholesterol-lowering drugs, are often prescribed for the secondary and primary prevention of atherosclerotic cardiovascular disease.
- Anti-arrhythmia medication helps maintain normal heart rhythm and helps prevent sudden cardiac death. But because some anti-arrhythmics may actually cause heart failure, they must be taken with caution. (1,2)
Exercise and Eat Right
The following lifestyle habits can help relieve symptoms of heart failure and keep the condition from getting worse:
- Quit smoking.
- Avoid alcohol.
- Maintain a healthy weight.
- Participate in moderate exercise.
- Eat a heart-healthy diet low in saturated and trans fats and cholesterol.
- Get adequate rest and sleep.
- Control blood sugar, if you have diabetes.
- Control high blood pressure.
- Restrict salt in your diet.
- Limit fluids.
- Check your legs, ankles, and feet for swelling daily.
- Consider getting vaccinations.
- Reduce stress. (2)
Ask Your Doctor if Surgery Will Help
While surgery isn't often used to treat heart failure, it may be recommended if your condition can't be helped with medication or dietary and lifestyle changes, or if your doctor believes that is the only way to treat your condition — if you have a malformed heart valve or a blocked coronary artery, for example
In these cases, the following surgeries may be recommended:
Angioplasty?Also called percutaneous coronary intervention, this catheter-based procedure reopens blocked vessels.
During?angioplasty, a catheter with a small balloon-like device is threaded through a vein and opened once it reaches the clogged artery.
Then a small wire tube (called a stent) is placed into the artery to keep it open.
There is a slight risk of damage to the artery during this procedure, but angioplasty usually improves the condition.
Coronary Bypass Surgery Surgeons remove healthy blood vessels from another part of your body, such as a leg or the chest wall, and then attach the vessels to your diseased artery so the blood can flow around the blocked section.
Heart Transplant If you have severe end-stage heart failure that can't be helped by medication or dietary and lifestyle changes, your doctors may recommend a heart transplant.
During a heart transplant, the surgeon connects you to a heart-lung machine, which takes over the functions of the heart and lungs while the damaged heart is replaced with a healthy one taken from a donor.
Then the major blood vessels are reconnected and the new heart begins working.
According to the American Heart Association (AHA), about 90 percent of people live for more than a year after receiving a heart transplant.
But it can take several months to find a donor heart that is a good match. In fact, the AHA reports that only around 2,500 people receive a transplant each year. (1)
Heart Valve Replacement When heart valves are diseased or defective, extra strain is put on the heart, which can lead to heart failure. This may require surgical repair or replacement of the diseased or damaged heart valve. A variety of replacement valves can be used, including those made from metal and plastic and those made from human or animal tissue.
The surgery involves the patient being connected to a heart-lung machine while the bad valve is removed or replaced.
Implanted Devices The following devices can help improve heart function or protect from sudden cardiac arrest for some people with heart failure:
- Biventricular pacing, or cardiac resynchronization therapy, is a pacemaker that paces both sides of the left ventricle simultaneously, to coordinate contractions and to improve the heart's function.
- An implantable cardioverter defibrillator (ICD) is similar to a pacemaker in that it senses when the heart is beating too fast and delivers an electrical shock to slow down the rhythm.
- Ventricular assist devices (VAD) take over the pumping function for one or both of the heart's ventricles or pumping chambers. (2,3)
Additional reporting by Ashley Welch.