Treatment Of Heart Failure
List Of Medications And Surgical Procedures

Treatment Of Heart Failure

Contents

• How Is Heart Failure Treated?
• What Medications Are Prescribed?
• For Women Only
• When Is Surgery Necessary?
• What Is A Ventricular Assist Device?
• What Is Cardiac Resynchronization?

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Congestive Heart Failure

How Is Heart Failure Treated?

While there is no cure for patients who receive a diagnosis of heart failure, various steps can be taken to help them live a relatively normal life. Most patients require a combination of drugs and medications to achieve the best results. Their doctor will start them on a low dose and gradually increase it to the optimal level over a period to time. They may also be recommended to take plenty of rest and to follow a diet with restricted salt intake (to reduce swelling, one of the symptoms of heart failure). In extreme cases, heart failure surgery and even a heart transplant may be required. Of course at this point, it should be mentioned that one of the best treatments for CHF, is prevention. That is, treating the underlying causes of heart failure, such as high blood pressure and coronary heart disease (CHD) before they turn into actual heart failure.

What Medications Are Prescribed?

Diuretics
Diuretics, also known as water pills, help you to urinate more often and rid your body of excess sodium and fluid (preventing edema) which is characteristic of CHF. By doing so they reduce blood volume and the workload of the heart. As some of these medication can cause the body to lose potassium you may also be prescribed a potassium supplement and told to eat foods rich in the nutrient including bananas, grapefruit, cantaloupe, apricots, sweet potatoes and prunes.
Digitalis
Also called digitoxin and digoxin, digitalis has been around since the 18th century. It helps to strengthen heart contractions and slow the heart rate leading to better circulation and less fluid retention. It is often prescribed in combination with diuretics. Possible side effects if taken in large dosages include dizziness, confusion, nausea, double vision and loss of appetite.
Vasodilators
This group of drugs helps to dilate the peripheral (arms and legs) arteries making it easier for blood to flow through. Among the newest type are ACE Inhibitors which were originally only prescribed for the treatment of high blood pressure but are now widely taken for CHF. They not only reduce symptoms but also increase life expectancy. ACE inhibitors include the drugs captopril (Capoten) and enalapril (Vasotec). People who cannot take ACE Inhibitors may be given ARBs (angiotensin receptor blockers) instead.
Other Drugs
Depending on the cause of heart failure, other medications may be prescribed. Calcium-channel blockers help to dilate veins and beta blockers slow the heart (but are only traditionally used in limited cases). If an irregular heartbeat (arrhythmia) is causing damage, arrhythmia treatments may be prescribed. Anticoagulant medications and aspirin treatment may be recommended for preventing blood clots.

For Women Only

It now appears that the drugs most commonly prescribed for heart failure, including digitalis, diuretics and vasodilators may not work for some women whose cause of heart failure is the heart's inability to fill with blood. Other drugs such as calcium channel blockers and beta blockers may actually be better options. Also, see: what is the prognosis for heart failure? as well as living with heart failure.

When Is Surgery Necessary?

Surgery is an option for patients who have severe heart failure that is not responding to medications. It is usually performed to stop further deterioration of the heart and hopefully to restore at least some pumping action. This may involve treating the underlying cause. For example, coronary angioplasty may be performed on those where heart failure is caused by coronary heart disease and the buildup of fatty deposit in their arteries called atherosclerosis. In severe instances a heart bypass surgery may be performed. If failure is due to valve disease, then a surgical implantation of an artificial heart valve may be performed. If a heart attack has damaged the left ventricle of the heart, reconstructive surgery on the ventricle can be done to remove scar tissue and reshape the muscle. Only in very few cases, and as a last resort, will a heart transplant be considered. Currently it is only offered to patients if their disease is likely to be fatal within 3 years. To have the best chance of success, patients need to be under the age of 65 and have no other health problems outside of their heart. If you are eligible your name will be added to a national donor list until such time a suitable heart becomes available. You will need to keep a pager at all times and keep a suitcase packed for hospital in the event that a donor heart is found.

What Is A Ventricular Assist Device?

A ventricular assist device (VAD) is a small mechanical device which can be fitted into the left ventricle of the heart. It helps the left side of a weakened heart to pump better. Initially they were used a temporary measure for patients waiting for a heart transplant, to buy time. Today however they are also fitted for long-term use - doctors sometimes refer to this as destination therapy. VADs are only fitted in severe cases (end stage heart failure) because they carry significant risks such as stroke, blood clotting and kidney failure. Small or thin people are not usually good candidates, nor are those with kidney failure, lung or liver disease or blood clotting disorders. Scientists are working on developing better VADs for the future.

What Is Cardiac Resynchronization?

Also called biventricular pacing, cardiac resynchronization is a relatively new treatment in the area of CHF. Many people with CHF have abnormalities in the heart's electrical system and this procedure involves inserting a particular type of pacemaker to correct the problem. It is called a cardiac resynchronization therapy device, or CRT pacemaker. However, if you are at risk of a particularly rapid heartbeat (persistent atrial fibrillation), you may be a better candidate for a pacemaker with a defibrillator. Or, talk to your doctor about buying a home defibrillator for cases of emergency.

Alternative Therapies: See chelation treatment and natural remedies for heart disease.

For more information related to women, see the following:

• Coronary Heart Disease in Women
• Chest Pain in Women

Back to Homepage: Womens Health Advice

WOMENS HEALTH ADVICE: ABOUT CONGESTIVE HEART FAILURE
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