The cause of the heart failure will guide the treatment plan. If the heart failure is caused by a valve disorder, then surgery may be done to fix the valve. If the heart failure is caused by a disease, such as anemia, then the underlying disease will be treated. Although there is no cure for heart failure due to damaged heart muscle, many forms of treatment have been used to treat symptoms very effectively.
Treatment of heart failure may include the following.
Controlling risk factors
These include:
- Quitting smoking
- Losing weight (if overweight) and increasing moderate exercise
- Restrict salt and fat from the diet
- Avoiding alcohol
- Proper rest
- Controlling blood sugar if diabetic
- Controlling blood pressure
- Limiting fluids
Medicine
Medicines include:
- Angiotensin converting enzyme (ACE) inhibitors. This medicine decreases the pressure inside the blood vessels and reduces the resistance against which the heart pumps. These also help remodel the heart, which can promote better pumping ability.
- Angiotensin receptor blockers (ARB). This is an alternative medicine to reduce workload on the heart if you can't tolerate ACE inhibitors. Some people develop a cough and need to discontinue ACE inhibitors. It helps to relax blood vessels, reduce stress on the heart, and helps your body get rid of salt and fluid.
- Angiotensin receptor-neprilysin inhibitors (ARNIs). This new medicine combines an ARB and a neprilysin inhibitor. It helps relax blood vessels, reduce stress on the heart, and helps your body get rid of salt and fluid.
- Sinus node I-f channel blocker. This is a newer medicine that may be used to reduce heart rate, which puts less stress on the heart.
- Diuretics. These reduce the amount of fluid in the body and are among the most important medicines in helping control fluid buildup in the body.
- Vasodilators. These widen (dilate) the blood vessels and reduce workload on the heart.
- Digitalis. This medicine helps the heart beat stronger with a more regular rhythm.
- Antiarrhythmics. These medicines help maintain normal heart rhythm and help prevent sudden cardiac death.
- Beta-blockers. These reduce the heart's tendency to beat faster and reduce workload by blocking specific receptors on heart cells. They can also promote better pumping over time.
- Aldosterone blockers. This medicine blocks the effects of the hormone aldosterone which causes sodium and water retention.
- Statins. These medicines lower the amount of bad cholesterol in your blood. While not used to treat heart failure, your doctor may prescribe a statin if you have high cholesterol or have had a past heart attack and are at risk for heart failure.
Other treatments
- Biventricular pacing/cardiac resynchronization therapy. A type of pacemaker that paces both pumping chambers of the heart at the same time to coordinate contractions and to improve the heart's function. Some people with heart failure are candidates for this therapy.
- Implantable cardioverter defibrillator. A device similar to a pacemaker that senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm. This can be a life saving device.
- Heart transplant. This is replacing the diseased heart with a healthy one from a donor.
- Ventricular assist devices (VADs). These are mechanical devices used to take over the pumping function for one or both of the heart's ventricles, or pumping chambers. A VAD may be needed when heart failure progresses to the point that medicines and other treatments no longer help.
Heart failure is a chronic health problem. It’s a gradual weakening of the heart. It’s when your heart can no longer pump the amount of blood your body needs to work properly. Heart failure can affect the right, left, or both ventricles of your heart.
If the right ventricle of your heart is failing, your heart may have trouble filling up with enough blood. If the left ventricle is weak, your heart may not empty completely when it pushes blood out to the rest of your body. In either case, a ventricular assist device (VAD) can support one or both of your ventricles. It can help your heart pump blood throughout your body.