Congestive Heart Failure Treatments
Currently, there is no cure for congestive heart failure. Treatments are designed to reduce symptoms and slow the progression of the disease. However, early diagnosis and treatment can help you lead a long and active life. The good news is that more congestive heart failure treatment options exist today than ever before. The specific treatment plan prescribed for you will depend largely upon the type of heart failure you have and on its underlying causes. All treatment options will have the same four basic goals:
1. Treat the underlying diseases and conditions causing your heart failure.
2. Reduce the symptoms of heart failure.
3. Stop your heart failure from getting worse.
4. Maximize the quality and length of your life after diagnosis.
Treatment options for congestive heart failure will fall under one of four categories:
Coronary Angioplasty And Stenting
Coronary angioplasty and stenting is used to open up narrowed or blocked arteries which supply your heart muscle. This treatment is done to provide relief from symptoms of angina.
During angioplasty and stenting, the narrowed artery is stretched open with a balloon , and a metal strut known as a stent is implanted into the coronary artery. This keeps the narrowing open and allows your blood to flow more freely through it.
Angioplasy is also known as Percutaneous Coronary Intervention .
Stage B Treatment Options
While stage A CHF is managed with lifestyle changes, the treatment plan for stage B typically includes taking medications regularly. People at this stage should still make the same lifestyle changes as those appropriate for stage A. However, your doctor may also prescribe additional treatments such as:
- Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, if you arent taking any as part of your stage A treatment plan
- Beta blockers if youve had a heart attack and your EF is 40% or lower, if you arent taking any as part of your stage A treatment plan
- Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease, or congenital heart disease
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Mental And Behavioral Home Health Services
A congestive heart failure diagnosis comes with a high emotional cost. Its life-changing, and its never easy. Living with congestive heart failure takes a toll on your physical health and your mental health. Centric Healthcare offers compassionate professional services to help as you learn to cope with your new normal. Its important to remember as you live with your disease that you dont need to do it alone. We can help.
To schedule a free consultation and learn more about these and other services offered by Centric Healthcare, call us at 224-5535 in the Twin Cities, or call us at 205-7322 in Rochester.
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Left Ventricular Assist Devices
These may be implanted in the chest to increase heart pumping action. Until recently, LVADs required that the patient be hooked up to a large, hospital-based console while awaiting a transplant. Miniaturized battery-powered LVAD units, however, are allowing many patients to leave the hospital. The devices may be used as a primary treatment or as a bridge to heart transplant in adults.
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What Are Some Types Of Heart Surgery
There are many types of heart surgery. The National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health, lists the following as among the most common coronary surgical procedures.
In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary. This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with a valve made from animal tissue, MitraClip® placement for mitral valve abnormalities, and WATCHMAN® placement for nonvalvular atrial fibrillation patients.
What Is The Outlook For People With Heart Failure
With the right care, heart failure may not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.
Everyone with a long-term illness, such as heart failure, should discuss their desires for extended medical care with their doctor and family. An “advance directive” or “living will” is one way to let everyone know your wishes. A living will expresses your desires about the use of medical treatments to prolong your life. This document is prepared while you are fully competent in case you are unable to make these decisions at a later time.
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Thanks Shae Thanks Dr Smith
I hope that helped Shae learn more about heart failure and valvular disorders. I know it helped me!
Many thanks to Shae for her excellent question. And, once again, a special thanks goes out to Dr. Craig Smith for sharing his research and clinical experiences with our patient community. As mentioned above, Dr. Smith has been a long-time supporter of our community and I can not thank him enough for his educational contributions specific to aortic valve debris after TAVR, exercise and durability of heart valve replacements, mitral regurgitation progression, pericardium adhesions, and so many more topics.
Medicines For Heart Failure
Most people with heart failure are treated with medication. Often you’ll need to take 2 or 3 different medicines.
Some of the main medicines for heart failure include:
- SGLT2 inhibitors
You may need to try a few different medicines before you find a combination that controls your symptoms but doesn’t cause unpleasant side effects.
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Managing Your Condition From Home
When you have advanced heart failure, it’s important for your doctor to know if your condition is worsening, even before you notice symptoms. The CardioMEMS HF System is a remote monitoring device that detects fluid build-up in your lungs and informs your doctor quickly. If this fluid build-up is left untreated, it can lead to hospitalization or life-threatening complications.
What Are The Options For Heart Failure Surgery
If the patients heart failure has an underlying cause, doctors first consider treating that. That may mean coronary bypass surgery to unblock clogged arteries or, if the condition has been caused by a faulty valve, heart valve repair or replacement.
Other surgical options include:
Left ventricular assist device . LVADs are mechanical devices that supplement the work of the heart. They take over the work of the left ventricle, assuming the responsibility of pumping blood around the body.
An LVAD can be an effective long-term solution for cases of heart failure, or it can be a way to stabilize and improve a patients cardiac health while she waits for a heart transplant to become available.
Some patients come in with late stages of heart disease, and theyre the ones who can benefit from LVAD and transplant, says Pramod Bonde, MD, surgical director of Mechanical Circulatory Support.
Heart transplant. Heart transplantation is a solution that can radically improve a patients heart function and quality of life, but receiving a transplant depends on availability. Donations are tightly regulated, and to be on the list, a patient must be relatively young, have excellent organ function in the rest of the body, and document strong family and social support.
A few years ago, people were dying while waiting for the heart to come, Dr. Bonde says. Now, thanks to LVADs, they have an option that will help them survive.
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Follow Your Treatment Plan
Treatment can relieve your symptoms and make daily activities easier. It also can reduce the chance that youll have to go to the hospital. For these reasons, its vital that you follow your treatment plan.
- Take all of your medicines as your doctor prescribes. If you have side effects from a medicine, tell your doctor. You should never stop taking medicine without asking your doctor first.
- Make all of the lifestyle changes that your doctor recommends.
- Get advice from your doctor about how active you can/should be. This includes advice on daily activities, work, leisure time, sex and exercise. Your level of activity will depend on the stage of your heart failure . Studies show that aerobic exercise improves heart function other types of exercise dont.
- Keep all of your medical appointments, including visits to the doctor and appointments to get tests and lab work. Your doctor needs the results of these tests to adjust your medicine doses and help you avoid any harmful side effects.
What Are The Risks Of Heart Failure Surgery
Risks include but arent exclusive to death, stroke, bleeding and infection. You may have additional risks, depending on your age and medical condition.
Your surgeon will explain your risks to you before surgery. Let your surgeon know if you have any questions or concerns about the procedure and any potential risks.
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Endoventricular Circular Patch Plasty
Dor and associates first described the technique of endoventricular circular patch plasty , which is used to treat patients with postinfarction left ventricular scarring. The procedure involves placement of a circular synthetic or autologous-tissue patch, which is anchored in the contractile left ventricular myocardium after the aneurysm has been resected or excluded. Both akinetic and aneurysmal segments may be repaired with this technique, which restores the circular ventricular architecture by excluding the septal scar and adjusting the Laplace relationship. In this manner, the ventricular cavity is reduced in size, improving its wall tension and hemodynamic status, and is rendered more physiologic. When indicated, myocardial revascularization is also performed., The advantages of EVCPP with geometric reconstruction are that this approach allows exclusion of nonresectable scarred areas in the septum uses an intraventricular patch to redirect the normal muscle bundles toward their original orientation and position reduces the size of the ventricular cavity and involves grafts between the infarct territory and remote muscle, which improve contractility and reduce the risk of arrhythmias.
When Should I See My Healthcare Provider
Heart failure is a long-term condition. You should maintain close communication with your healthcare provider. Let your provider know if your symptoms get worse or you notice any new symptoms, such as:
- Shortness of breath.
- Swelling in your feet, ankles, legs or abdomen.
After surgery, follow your providers instructions for care and follow-up appointments. Talk to your provider if you have any problems or concerns with your progress as you recover.
A note from Cleveland Clinic
Heart failure surgery is usually an option if other treatments arent effective and your condition persists or gets worse. The types of heart failure surgery range from catheter-based procedures to open-heart surgery. Your healthcare provider will help you determine if heart failure surgery is right for you. Talk to your provider about what to expect before, during and after the procedure. Be sure to ask any questions or express any concerns you have about your treatment plan and recovery.
Last reviewed by a Cleveland Clinic medical professional on 09/15/2022.
References
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What Is An Ejection Fraction
An ejection fraction is a measurement of the blood pumped out of your heart with each beat, expressed in a percentage. It can be measured using an echocardiogram , multigated acquisition scan, nuclear stress test, magnetic resonance imaging , or during a cardiac catheterization. A normal ejection fraction is between 50% and 70%.
Heres The Process To Help You Be Prepared:
- You will be given general anesthesia.
- The surgery may take 3 to 6 hours.
- After the surgery, you will be shifted to an intensive care unit for one to two days. Your family will be allowed to visit you briefly.
- When you wake up after the surgery, you may feel totally disoriented. You may lose track of time as the lights are always on in the ICU.
- A tube will be in your mouth, passing through your throat to help you breath. It will be removed immediately after you are able to breathe on your own. Its likely that you will be uncomfortable and will not be able to talk. However, your nurse will help you communicate.
- A catheter/pipe is entered into your urinary bladder to collect your urine. It will be removed immediately after you are able to move and are able go to the washroom.
- You are connected to machines that monitor your blood pressure and heart rate for 12 to 24 hours.
- You will have an intravenous inlet in your arms. This will help inject medicines, which keep up your blood circulation and maintain your blood pressure. Once you are able to have food, this will be removed.
- You will be shifted to a ward in a day or two.
- The incision that is made in your chest during surgery will be sore for 48 to 72 hours. You will be given painkillers and other medications.
- You might be coughing harder to get rid of excess fluid that has entered your lungs.
- You can walk and move right away.
- You can have a normal diet.
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Congestive Heart Failure: What Is Coronary Artery Bypass Surgery
Congestive Heart Failure is the leading cause of emergency hospitalization among people aged over sixty. It is a condition where the heart is inefficient in pumping the required amount of blood to the other parts of the body. This inefficiency can sometimes be so severe that it can impair the pumping action of the heart, causing congestive heart failure. This disease affects roughly 6 million people in the United States.
The mechanism behind congestive heart failure suggests that it doesn’t necessarily mean that the heart has stopped working. It just indicates that the pumping efficiency of the heart has deteriorated. As the blood moves through the heart and body at a slower rate during heart failure, there is a sudden increase in the pressure inside the heart. This leads to impaired heart function with less oxygen being pumped through the heart, and less oxygen reaches the body. The chambers of the heart respond to the situation by either stretching to hold more blood or becoming thick and stiff. This weakens the muscles of the heart and leads to inefficient pumping ability. The kidneys respond to the change by making the body retain fluids and salts. This abnormal retention leads to congestion in the body, and the condition is termed as congestive heart failure.
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There are many heart diseases affecting a large portion of the population, and there are many reasons behind congestive heart failure. Coronary Artery Disease is one of them.
Procedures And Surgery To Improve Blood Supply To The Heart
The most common cause of heart failure is coronary artery disease , which is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CAD may become worse and make it harder to manage your symptoms.
After performing certain tests your health care provider may feel that opening a narrowed or blocked blood vessel will improve your heart failure symptoms. Suggested procedures may include:
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Congestive Heart Failure Drugs
There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.
ACE inhibitors
Angiotensin-converting enzyme inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cant tolerate ACE inhibitors.
You may be prescribed one of the following:
voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.
ACE inhibitors shouldnt be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:
- Potassium-sparing diuretics and potassium supplements. These diuretics can cause potassium buildup in the blood, which may lead to abnormal heart rhythms. Examples include: riamterene , eplerenone , and spironolactone .
- Nonsteroidal anti-inflammatory drugs .NSAIDs such as ibuprofen, aspirin, and naproxen, can cause sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.
Beta-blockers
This may be achieved with:
Diuretics
Your doctor may recommend:
What Causes Heart Failure
Heart failure is caused by many conditions that damage the heart muscle, including:
- Coronary artery disease.Coronary artery disease , a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
- Heart attack. A heart attack happens when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that doesnât work the way it should.
- Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.
- Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can happen when several diseases or conditions are present at once.
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