Heart Failure Treatment

Just a few decades ago, heart failure treatment options were pretty limited and the outlook for anyone with heart failure was gloomy.

Researchers and medical professionals have made huge strides in recent years, but heart failure is still a chronic disease that often requires lifelong treatment once it begins.  

Doctors can sometimes correct a heart problem by repairing a valve or other surgical procedures. For most people though, controlling or limiting heart failure must be done with a combination of the right medications and possibly a device that helps the heart work properly.

Lifestyle changes can help too. If you eat a more heart-healthy diet, get some exercise, and stay away from substances that hurt heart function, like too much alcohol and illegal drugs, you can stretch your heart's longevity.

Medications for heart failure

There are a number of medications doctors often prescribe when you have heart failure.

ACE inhibitors ACE stands for Angiotensin-converting enzyme. These drugs widen blood vessels, which lowers high blood pressure and lightens the workload the heart has to carry. Better known ACE inhibitors include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten). Not everyone can tolerate ACE inhibitors however.

ARBs ARB stands for Angiotensin II receptor blockers. These are an alternative for those who have problems with ACE inhibitors. Losartan (Cozaar) and valsartan (Diovan) are among the more commonly prescribed.

Beta blockers Beta blockers slow down your heart rate and lower blood pressure. Examples include carvedilol (Coreg), metoprolol (Lopressor) and bisoprolol (Zebeta).

Digitalis, or Digoxin (Lanoxin). This medication strengthens your heart muscle contractions and slows down the heartbeat.

Diuretics These decrease the amount of fluid in your lungs, making it easier for you to breathe. But they also make your body lose potassium and magnesium, so you doctor will probably prescribe supplements to go with the. Examples include bumetanide (Bumex) and furosemide (Lasix).

Diuretics are also commonly known as "water pills."

Very often, you need more than one medication for heart failure treatment. Typically, these include

• nitrates for chest pain (angina),
• statins to lower cholesterol, or
• blood-thinning medications to help reduce the chance of blood clots.

Your doctor may also recommend supplemental oxygen. If you heart failure is serious, you may need supplemental oxygen treatment for a long time.

Treating heart failure with surgery and devices

Sometimes surgery and medical devices are needed to correct the underlying cause of heart failure. These may include the following.

Coronary bypass surgery Most people have become familiar with how this heart failure treatment procedure works. When arteries in the heart become blocked, a surgeon will replace bypass the blockage. This improves the blood supply to the heart and is likely to prevent a future heart attack.

Heart valve repair or replacement This involves repairing a faulty heart valve or replacing it with an artificial or "prosthetic" valve.

Implantable cardioverter-defibrillators This is also known as an ICD. It is a small battery-powered electrical device that's implanted under the skin near the heart. Wires actually connect it to the heart so that it can monitor the heartbeat. When it detects an irregular heart rate, it sends an electrical impulse to the heart that shocks it back into a normal rhythm.

Biventricular pacing or cardiac resynchronization therapy Also called CRT. Heart failure often causes the muscles of the heart to beat in an uncoordinated way. Biventricular pacing uses a "pacemaker" device that sends electrical impulses to the lower chambers of the heart to make sure the heart pumps efficiently.

The heart pump Also called left ventricular assist devices, or LVADs. These are mechanical devices that help a weakened heart pump. LVADs are implanted into the abdomen or chest, and are now used sometimes instead of a heart transplant.

Heart transplant In some cases, the degree of heart failure is so severe that there's only one alternative. Heart transplants give a second chance to someone whose heart has deteriorated to the degree that prospects for longevity are low. A suitable donor heart must be found, so sometimes heart transplant candidates must wait tensely for months or even years to get one.

Happily, thanks to advances in heart failure treatment in the last decade, some transplant candidates improve enough during drug/device therapy that they can be taken off the heart transplant list.

Also see heart failure symptoms.