Treatments for Heart failure


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Treatment list for Heart failure: The list of treatments mentioned in various sources for Heart failure includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatment of Heart failure: medical news summaries: The following medical news items are relevant to treatment of Heart failure:

Treatments of Heart failure discussion: Heart failure caused by an excessive workload is curable by treating the primary disease, such as anemia or thyrotoxicosis. Also curable are forms caused by anatomical problems, such as a heart valve defect. These defects can be surgically corrected.

However, for the common forms of heart failure--those due to damaged heart muscle--no known cure exists. But treatment for these forms may be quite successful. The treatment seeks to improve patients' quality of life and length of survival through lifestyle change and drug therapy.

Patients can minimize the effects of heart failure by controlling the risk factors for heart disease. Obvious steps include quitting smoking, losing weight if necessary, abstaining from alcohol, and making dietary changes to reduce the amount of salt and fat consumed. Regular, modest exercise is also helpful for many patients, though the amount and intensity should be carefully monitored by a physician.

But, even with lifestyle changes, most heart failure patients must take medication. Many patients receive two or more drugs.

Several types of drugs have proven useful in the treatment of heart failure:

  • Diuretics help reduce the amount of fluid in the body and are useful for patients with fluid retention and hypertension.

  • Digitalis increases the force of the heart's contractions, helping to improve circulation.

  • Results of recent studies have placed more emphasis on the use of drugs known as angiotensin converting enzyme (ACE) inhibitors. Several large studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow, or perhaps even prevent, the loss of heart pumping activity.
Originally developed as a treatment for hypertension, ACE inhibitors help heart failure patients by, among other things, decreasing the pressure inside blood vessels. As a result, the heart does not have to work as hard to pump blood through the vessels.

Patients who cannot take ACE inhibitors may get a nitrate and/or a drug called hydralazine, each of which helps relax tension in blood vessels to improve blood flow.

Sometimes, heart failure is life-threatening. Usually, this happens when drug therapy and lifestyle changes fail to control its symptoms. In such cases, a heart transplant may be the only treatment option. However, candidates for transplantation often have to wait months or even years before a suitable donor heart is found. Recent studies indicate that some transplant candidates improve during this waiting period through drug treatment and other therapy, and can be removed from the transplant list.

Transplant candidates who do not improve sometimes need mechanical pumps, which are attached to the heart. Called left ventricular assist devices (LVADs), the machines take over part or virtually all of the heart's blood-pumping activity. However, current LVADs are not permanent solutions for heart failure but are considered bridges to transplantation.

An experimental surgical procedure for severe heart failure is available at a few U.S. medical centers. The procedure, called cardiomyoplasty, involves detaching one end of a muscle in the back, wrapping it around the heart, and then suturing the muscle to the heart. An implanted electric stimulator causes the back muscle to contract, pumping blood from the heart.

Common Heart Failure Medications

Listed below are some of the medications prescribed for heart failure. Not all medications are suitable for all patients, and more than one drug may be needed.

Also, the list provides the full range of possible side effects for these drugs. Not all patients will develop these side effects. If you suspect that you are having a side effect, alert your physician.

  • ACE Inhibitors.
    These prevent the production of a chemical that causes blood vessels to narrow. As a result, blood pressure drops and the heart does not have to work as hard to pump blood.
    • Side effects may include coughing, skin rashes, fluid retention, excess potassium in the bloodstream, kidney problems, and an altered or lost sense of taste.
  • Digitalis.
    Increases the force of the heart's contractions. It also slows certain fast heart rhythms. As a result, the heart beats less frequently but more effectively, and more blood is pumped into the arteries.
    • Side effects may include nausea, vomiting, loss of appetite, diarrhea, confusion, and new heartbeat irregularities.
  • Diuretics.
    These decrease the body's retention of salt and so of water. Diuretics are commonly prescribed to reduce high blood pressure. Diuretics come in many types, with different periods of effectiveness.
    • Side effects may include loss of too much potassium, weakness, muscle cramps, joint pains, and impotence.
  • Hydralazine.
    This drug widens blood vessels, easing blood flow.
    • Side effects may include headaches, rapid heartbeat, and joint pain.
  • Nitrates.
    These drugs are used mostly for chest pain, but may also help diminish heart failure symptoms. They relax smooth muscle and widen blood vessels. They act to lower primarily systolic blood pressure.
    • Side effects may include headaches.
1

To improve the chances of surviving with heart failure, patients must take care of themselves.

Patients must:

  • See their physician regularly;
  • Closely follow all of their physician's instructions;
  • Take any medication according to instructions; and
  • Immediately inform their physician of any significant change in their condition, such as an intensified shortness of breath or swollen feet.
Patients with heart failure also should:
  • Control their weight;
  • Watch what they eat;
  • Not smoke cigarettes or use other tobacco products; and
  • Abstain from or strictly limit alcohol consumption.
Even with the best care, heart failure can worsen, but patients who don't take care of themselves are almost writing themselves a prescription for poor health.1

Footnotes:
1. excerpt from NHLBI, Heart Failure: NHLBI

Last revision: May 29, 2003

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