Tuesday, November 29, 2022

Treatments Of Congestive Heart Failure

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Although the risk of heart failure doesnt change as you get older, youre more likely to have heart failure when youre older.

Many medical conditions that damage the heart muscle can cause heart failure. Common conditions include:

  • Tobacco and recreational drug use.
  • Medications. Some drugs used to fight cancer can lead to heart failure.

What Medications Are Available To Reduce Edema

Diuretic medications can increase the amount of urine output by your kidneys, and thereby reducing the volume of fluid in your blood vessels. This lightens the load your heart has to pump, reducing swelling.

Diuretic medications are especially useful for people with reduced cardiac output in the left side of the heart.

Examples of diuretic medications used for heart failure include loop diuretics such as Lasix and Demadex and thiazide diuretics such as Zaroxolyn .

Can Heart Failure Be Prevented

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

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What Medications Are Available To Improve Heart Function

Although diuretics are the first-line agents for congestive heart failure, digoxin is first-line in people who also have atrial fibrillation.

According to Medscape, digoxin produces a small improvement in cardiac output by strengthening the heart muscles. Side effects of digoxin can be serious if dosing is too high.

According to Uptodate, digoxin poisoning can result in life-threatening cardiac arrhythmias, nausea, vomiting, abdominal pain, confusion, delirium, weakness, and electrolyte imbalances.

Pharmacological Management Of Heart Failure

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Drugs used in heart failure include those used to initially manage mild to moderate failure and those used more commonly in severe to very severe conditions.

First Agents Used:

  • ACE Inhibitors: work by increasing vasodilation and decreasing workload of the heart in patients with CHF.
  • Diuretics: promote the removal from the body of excess water, salts, poisons, and accumulated metabolic products, such as urea. See also Aldosterone Receptor Antagonists
  • Glycosides and Congestive Heart Failure: a class of drugs that includes digoxin, digitoxin and ouabain. Such agents increase the force of contraction of the heart which underlies their use in some cases of heart failure.
  • Beta-Blockers : decrease the excessive activity of the sympathetic nervous system which is characteristic of CHF.
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy

    Additional Agents:

  • More aggressive diuretic therapy eg Loop diuretics such as Furosemide , one of the most commonly used drugs in the treatment edema caused by congestive heart failure .
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy.

    An implantable cardioverter-defibrillator is indicated for primary prevention of sudden cardiac death in patients with HF who have an LVEF of less than or equal to 35%.

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    What’s The Prognosis For Dogs With Congestive Heart Failure

    Unfortunately, congestive heart failure in dogs is not reversible. The prognosis depends, in part, on the underlying heart disease. For example, only about 50 percent of dogs with mitral valve disease will live beyond about 10 months.

    Treatment can improve quality of life and even slightly extend life expectancy, but dogs with CHF usually do not live beyond one year of their diagnosis. Your veterinarian will be able to help come up with the best care and treatment plan for your individual dog.

    How Is Heart Failure Diagnosed

    Your doctor will ask you many questions about your symptoms and medical history. Youâll be asked about any conditions you have that may cause heart failure . Youâll be asked if you smoke, take drugs, drink alcohol , and about what drugs you take.

    Youâll also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

    Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

    Other tests may be ordered, depending on your condition.

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    What Is Congestive Heart Failure In Dogs

    Congestive heart failure is the end result of underlying heart disease that makes the heart unable to efficiently pump blood. In a healthy heart, blood flow is tightly orchestrated. Valves separate the heart chambers and prevent the backflow of blood.

    Heart disease disrupts normal blood flow through the heart, eventually leading to CHF. CHF is left-sided or right-sided, depending on which side of the heart is affected.

    Left-sided CHF occurs when blood flows backward from the left ventricle to the left atrium through the mitral valve. Blood accumulates in the left atrium and then the lungs. Eventually, the lungs’ blood vessels become leaky, causing pulmonary edema .

    Right-sided CHF occurs when blood flows backward from the right ventricle to the right atrium through the tricuspid valve. A blood-filled right atrium leads to clogged systemic blood vessels. Fluid then leaks into the abdomen and causes limb swelling .

    What Medications Should I Avoid If I Have Heart Failure

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    There are several different types of medications that are best avoided in those with heart failure including:

    • Nonsteroidal anti-inflammatory medications such as Motrin or Aleve. For relief of aches, pains, or fever take Tylenol instead.
    • Most calcium channel blockers
    • Some nutritional supplements, such as salt substitutes, and growth hormone therapies
    • Antacids that contain sodium

    If youâre taking any of these drugs, discuss them with your doctor.

    Itâs important to know the names of your medications, what theyâre used for, and how often and at what times you take them. Keep a list of your medications and bring them with you to each of your doctor visits. Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively.

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    What Are The Treatments For Heart Failure

    Your treatment will depend on the type of heart failure you have and how serious it is. There’s no cure for heart failure. But treatment can help you live longer with fewer symptoms.

    Even with treatment, heart failure usually gets worse over time, so you’ll likely need treatment for the rest of your life.

    Most treatment plans include:

    You may need heart surgery if:

    • You have a congenital heart defect or damage to your heart that can be fixed.
    • The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
    • A biventricular pacemaker .
    • A mechanical heart pump or a total artificial heart).
  • Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.
  • As part of your treatment, you’ll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

    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:

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    What Are The Treatment Options For Congestive Heart Failure

    According to the American Heart Association, main treatment options for congestive heart failure include lifestyle modification, monitored cardiac rehabilitation, prescription medications, electronic heart implants, and surgical procedures. This article will explain in detail the specific treatment options in these broad categories.

    Congestive Heart Failure Care At Uvm Medical Center

    Save Upto Rs. 3, 577 On Congestive Heart Failure Medications Every Year

    The UVM Medical Center is one of nine medical centers selected nationally to participate in the National Institutes of Health Heart Failure Research Network, a clinical research organization that performs studies that allow patients to receive ground-breaking treatments. We offer inpatient consultation services and comprehensive cardiac rehabilitation services and educational classes for patients living with heart failure.

    All aspects of cardiac care at The UVM Medical Center are supported by a team of highly trained & skilled nurses and other healthcare practitioners. Our specialized team of heart experts includes:

    • General Cardiologists
    • Cardiothoracic Surgeons

    American Heart Association Award

    The University of Vermont Medical Center has proudly received the American Heart Associations Gold Get With The Guidelines

    Resuscitation Quality Achievement Award for our commitment to treating in-hospital cardiac arrest, ultimately helping improve patient survival rates.

    The Get With The Guidelines program was developed to help save lives of patients who experience in-hospital cardiac arrests by consistently following the most up-to-date research-based guidelines for treatment.

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    Life Expectancy With Congestive Heart Failure

    The life expectancy of someone with congestive heart failure depends on the type of heart failure, the cause, the stage of the disease, and how effective treatment is.

    When heart failure results from cardiomyopathy or coronary artery disease, a person typically has a less positive outlook than someone with heart failure in its earliest stage.

    Surgical Options To Treat Underlying Causes Of Heart Failure

    • Coronary artery bypass graft to prevent and treat heart failure caused by blocked arteries. During bypass surgery, blood vessels taken from another part of the body usually the leg are attached to the clogged artery to create a detour around the blockage. This is conventionally done through open-heart surgery, but some patients may be candidates for minimally invasive CABG, an alternative offered at UCSF.
    • Angioplasty, another treatment for blocked arteries. A thin flexible tube called a catheter is inserted through a small incision in the groin or neck into a blood vessel. In one procedure, a balloon is introduced through the catheter into the center of a blocked blood vessel. When the balloon is inflated, the blockage material is compressed back against the walls of the artery. A small metal device, called a stent, may be inserted through the catheter to serve as a permanent barrier to keep the plaque compressed. In another type of procedure, instruments are introduced through the catheter to remove the plaque.
    • Implantation of pacemakers and other devices such as artificial heart valves
    • Repairing congenital heart defects

    Surgical treatments for heart failure itself include:

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    Women And Heart Failure

    Women are just as likely as men to develop heart failure, but there are some differences:

    • Women tend to develop heart failure later in life compared with men.
    • Women tend to have heart failure caused by high blood pressure and have a normal EF .
    • Women may have more shortness of breath than men do. There are no differences in treatment for men and women with heart failure.

    Congestive Heart Failure: Prevention Treatment And Research

    Treatment of Congestive Heart Failure (CHF)

    Congestive heart failure is a serious condition in which the heart doesnt pump blood as efficiently as it should. Despite its name, heart failure doesnt mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a result, it cant keep up with the bodys demand, and blood returns to the heart faster than it can be pumped outit becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the bodys other organs.

    The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contractsbut over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they dont receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse.

    More than 5 million people in the United States have congestive heart failure. Its the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause.

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    Stages Of Heart Failure

    In 2001, the American Heart Association and American College of Cardiology described the “Stages of Heart Failure.” These stages, which were updated in 2005, will help you understand that heart failure is often a progressive condition and can worsen over time. They will also help you understand why a new medication was added to your treatment plan and may help you understand why lifestyle changes and other treatments are needed.

    The stages classified by the AHA and ACC are different than the New York Heart Association clinical classifications of heart failure that rank patients as class I-II-III-IV, according to the degree of symptoms or functional limits. Ask your doctor what stage of heart failure you are in.

    Check the table below to see if your therapy matches what the AHA and ACC recommend. Note that you cannot go backward in stage, only forward.

    The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.

    The New York Heart Association clinical classifications of heart failure rank people as class I-II-III-IV, according to the degree of symptoms or functional limits. You can ask your doctor if you want to know what stage of heart failure youâre in.

    What Therapies Does Dr Weil Recommend For Congestive Heart Failure

    Dr. Weil emphasizes the preventive importance of dietary changes to control obesity and diabetes, both of which are linked to the development of congestive heart failure. He advises consulting a nutritionist to develop a diet designed for individual situations and also recommends the following measures:

    • If you smoke, quit. Tobacco has direct and damaging effects on the cardiovascular system.
    • Avoid salt. Sodium promotes fluid retention. Avoid high-sodium foods, heavily processed foods and unnecessary salt.
    • Take your prescribed medication. Diuretics , beta blockers, digoxin and others can reduce stress on the heart and make it work more efficiently.
    • Check other meds. Over-the-counter NSAIDS, such as aspirin, Motrin and Aleve may increase fluid retention. Tell your doctor about any remedies you are taking.
    • Control risk factors. Work with your doctor to address high blood pressure, diabetes and atherosclerosis or other heart problems.
    • Reduce stress. The hormones released by the body in response to stress, anxiety and depression make the heart work harder. Practice relaxation techniques, volunteer, and seek positive social interactions. The relaxing breath exercise can improve the oxygenation of blood and take workload off the heart.

    Nutrition and Supplements If you are coping with, or are at risk of congestive heart failure, Dr. Weil suggests trying the following supplements:

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    Living With Congestive Heart Failure: What To Expect

    Yes, there are several lifestyle changes you should take into account if youve been diagnosed with congestive heart failure. But remember your diagnosis doesnt mean you should necessarily stop doing things you love.

    You are supposed to be exercising walking, biking, swimming, or doing light weight exercises, says Mountis. The American Heart Association recommends at least 30 minutes of moderate intensity aerobic activity at least five days a week for optimal heart health. Avoid exercises that make you feel breathless, and make sure to talk to your doctor before starting a new exercise routine.

    Your healthcare provider will also likely suggest dietary changes that can help reduce the swelling associated with congestive heart failure and slow the progression of the condition. Those changes may include following a low- or reduced-salt diet, or reducing how much fluid you drink to lessen the bodys water content.

    Other lifestyle changes that can slow the progression of heart failure include:

    What Are The Types Of Heart Failure

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    There are many causes of heart failure, but the condition is generally broken down into these types:

    Left-sided heart failure

    Heart failure with reduced left ventricular function The lower left chamber of your heart gets bigger and cannot squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of your body.

    Heart failure with preserved left ventricular function Your heart contracts and pumps normally, but the bottom chambers of your heart are thicker and stiffer than normal. Because of this, your ventricles can’t relax properly and fill up all the way. Because there’s less blood in your ventricles, your heart pumps out less blood to the rest of your body when it contracts.

    Right-sided heart failure

    Heart failure can also affect the right side of your heart. Left-sided heart failure is the most common cause of this. Other causes include certain lung problems and issues in other organs.

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