Cardiovascular and Thoracic Surgery

ALERT BAR

Heart Failure

About

Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve and the heart sometimes becomes stronger.

Heart failure, also called congestive heart failure, is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the loss in the heart's pumping action is a symptom of an underlying heart problem. Heart failure affects nearly 5 million US adults. It is on the rise with an estimated 400,000 to 700,000 new cases each year.

Treatment may help you live longer and reduce your chance of dying suddenly. Doctors sometimes can correct heart failure by treating the underlying cause. For example, repairing a heart valve or controlling a fast heart rhythm may reverse heart failure. But for most people, the treatment of heart failure involves a balance of the right medications, and in some cases, devices that help the heart beat and contract properly.

Specific treatment for heart failure will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The cause of the heart failure will dictate the treatment protocol established. If the heart failure is caused by a valve disorder, then surgery is usually performed. If the heart failure is caused by a disease, such as anemia, then the disease is treated. And, although there is no cure for heart failure due to a damaged heart muscle, many forms of treatment for symptoms and improved quality of life have proven to be successful.

Treatment

The goal of treatment is to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy. Treatment of heart failure may include:

  • controlling risk factors
  • losing weight (if overweight)
  • restricting salt and fat from the diet
  • stop smoking
  • abstaining from alcohol
  • proper rest
  • controlling blood sugar if diabetic
  • limiting fluids
  • medication, such as
    • angiotensin converting enzyme (ACE) inhibitors - to decrease the pressure inside the blood vessels, or angiotensin II receptor blockers if ACE inhibitors are not tolerated
    • diuretics - to reduce the amount of fluid in the body
    • vasodilators - to dilate the blood vessels and reduce workload on the heart
    • digitalis - to increase heart strength and control rhythm problems
    • inotropes - increase the pumping action of the heart
    • antiarrhythmia medications - keep the rhythm regular and prevent sudden cardiac death
    • beta-blockers - reduce the heart's tendency to beat faster by blocking specific receptors on the cells that make up the heart
    • aldosterone blockers - block the effects of aldosterone which causes sodium and water retention
  • Biventricular pacing/cardiac resynchronization therapy - a new type of pacemaker that paces both sides of the heart simultaneously to coordinate contractions and improve pumping ability. Heart failure patients are potential candidates for this therapy
  • Implantable cardioverter-defibrillators (ICDs). An ICD is a device similar to a pacemaker. It's implanted under the skin in your chest with wires leading through your veins and into your heart. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to pace your heart or shock it back into normal rhythm. An ICD can also function as a pacemaker and speed your heart up if it is going too slow.
    • AICD to BIV ICD upgrade
  • Ventricular Assist Devices (VADs) - a mechanical device that is used to take over the pumping function for one or both of the heart’s ventricles. A VAD may be necessary when heart failure progresses to the point that medications and other treatments are no longer effective.
  • Heart Transplantation