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Treating heart failure

Congestive heart failure is caused by a number of ailments that damage the organ and make it work harder to pump blood—but it doesn't mean that the heart has failed.

Rather, the heart has been weakened by age or by problems such as high blood pressure, clogged arteries, a defect in the muscle walls or valves, or some other medical condition.

When the heart is damaged, it can't circulate blood properly throughout the body. This can cause fatigue; shortness of breath; swelling in the feet, ankles, legs or abdomen; loss of appetite; and heart palpitations.

Heart failure usually can't be cured. But treatment can help you manage the condition and improve your quality of life.

"Good compliance with the right medicines and avoiding things that we know make heart failure worse can really dramatically improve someone's status," says Ann Bolger, MD, a spokeswoman for the American Heart Association (AHA).

Medicines a major help

A number of medications can help treat heart failure, according to the AHA.

Some improve circulation by strengthening the heart's pumping action or expanding blood vessels. These drugs include ACE inhibitors, vasodilators, beta-blockers and digitalis.

Others, called diuretics, help lower the amount of water and sodium in the body, which helps reduce the heart's workload.

"We have seen some pretty dramatic improvements in our ability to help the heart function, even when it has been weakened," Dr. Bolger says.

But it's important, she notes, to make sure people get the correct medicine in the correct dose. This is most likely when people and healthcare providers work as a team to closely monitor the ailing heart and adjust medicines as needed, Dr. Bolger says.

Lifestyle changes also important

Medicine, however, isn't the only answer to coping with heart failure.

Lifestyle changes, such as quitting smoking and eating a healthful diet, are also important.

The AHA recommends:

  • Quitting smoking.
  • Controlling high blood pressure.
  • Working with your healthcare team to create an appropriate exercise program.
  • Cutting down on the amount of salt you eat.
  • Eating foods that are low in fat.
  • Scheduling times to rest, and making sure you get a good night's sleep.
  • Avoiding or limiting caffeine.
  • Reducing stress.
  • Seeing your doctor frequently.

Making lasting lifestyle changes isn't easy and takes dedication, persistence, discipline and a little help from your friends and medical team.

"When you have to take a lot of medicines and you have to avoid salt and do all these other things, nobody gets an A+. It's hard," says Dr. Bolger. "So it's really important to have a team approach."

Surgery sometimes helps

A doctor may recommend surgery to help correct some of the illnesses that cause heart failure.

For instance, coronary artery bypass surgery and angioplasty can ease heart failure symptoms by increasing blood flow to the heart. Pacemakers may also be able to help the heart pump efficiently, says Dr. Bolger.

And left ventricular assist devices can sometimes be implanted to improve the heart's pumping ability.

Heart transplants may be done for people in the very late stages of heart failure, Dr. Bolger notes, but people often wait months or years for a suitable donor heart.

No reason to despair

It's important to understand that if you or someone you love has heart failure, there's much that can be done to make life better.

"With good medical management and with a close team approach between the person and the care provider…people find that they can live with their symptoms, stay out of the hospital and prolong their lives," Dr. Bolger says.

reviewed 7/17/2019

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