Heart1 - Heart Failure Information Center

Current Treatments for Heart Failure

Heart failure is a debilitating condition that affects not only a patient's quality of life, but also life expectancy. Heart failure treatments are designed to reduce fatigue, shortness of breath and tissue swelling. They can also enhance a patient's energy level and ability to exercise. In fact, many treatments can help slow the condition's progression, enabling people with heart failure to live longer and more comfortably. Everyone's situation is different - certain treatments that fit one patient may not be right for another. Patients and their families should talk with a physician about the most appropriate medical or surgical treatments.

Lifestyle Modifications

All patients with heart failure are recommended to undergo lifestyle modifications such as dietary changes - including reduction of sodium in the diet - and avoidance of alcohol. Mild heart failure sufferers are also encouraged to pursue a gradual course of gentle exercise under a doctor's supervision to help alleviate symptoms and build stamina.

Drug Treatments

Most patients with heart failure are prescribed medications to help improve heart function. These medications very greatly, and forms of treatment depend upon the individual and stage of heart failure. Medications that are considered standard treatments for heart failure include the following:

Vasodilators, particularly ACE inhibitors (angiotensin-converting enzyme inhibitors), are considered a cornerstone of heart failure drug therapy. Vasodilators directly or indirectly cause the blood vessel walls to widen and relax, which decreases the pressure needed to fill the heart's left ventricle, allowing the heart to pump more normally.

Inotropes such as digoxin improve the effectiveness of the heart's pumping action.

Diuretics reduce the volume of fluid in the body, which eases the heart's pumping action. These drugs are prescribed for almost all patients who are experiencing fluid buildup in the body and swelling in the tissues.

Beta-blockers reduce the heart's tendency to beat faster. In some heart failure patients, the heart tries to compensate for its weakened pumping action by beating faster, which puts more strain on it. These drugs allow the heart to maintain a slower rate and reduce blood pressure.

Blood thinners, which can help prevent blood from clotting. Because people with heart failure are at risk of developing blood clots, physicians may prescribe these types of drugs to help prevent stroke or atrial fibrillation.

Antiarrhythmic drugs are also used to help treat irregular heart rhythms, a particular danger for patients with heart failure.

Medications often carry side effects, which need to be monitored closely by physicians. Additionally, because of the complexity of heart failure, many patients require multiple medications at varying doses to adequately control their disease and symptoms.

Surgical and Other Medical Procedures

Some patients with heart failure may require surgery or other medical procedures. Although surgery is not often used, it is recommended when there is a correctable problem that is causing heart failure such as a heart valve defect. Surgery also may be in order when the heart failure is so severe that it can't be helped with medications or dietary and lifestyle changes. Surgical and other medical procedures include:

Valve replacement, which regulates the flow of blood inside the heart. Because heart failure is sometimes the result of a defective or diseased valve, correcting the problem surgically can often improve or resolve the condition.

Defibrillator implantation, which delivers an electric shock to the heart when an abnormal rhythm is detected. These devices are surgically implanted under the skin near the shoulder through a small incision. Defibrillators effectively protect against sudden cardiac death but currently do not address other symptoms of heart failure. This therapy is an option for patients who meet current ICD indications.

Left Ventricular Assist Device (LVAD) implantation involves surgically implanting a mechanical pump that helps maintain the pumping ability of a heart that is unable to effectively function on its own.

Heart transplant surgery may be the only effective option for those patients with severe, progressive heart failure who can't be helped by medications and lifestyle changes. The number of patients who receive heart transplants is relatively low - about 2,500 each year.¹

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