Heart failure treatment
Treatment at HonorHealth has helped countless patients lessen their heart failure symptoms, return to daily activities and enjoy improved energy levels. Through careful lifestyle modification and medical intervention, it's possible to prevent or slow the progress of heart failure.
Heart failure treatment options depend on the type and severity of the patient's condition. The underlying causes of heart failure — heart disease (coronary artery disease), high blood pressure (hypertension) and diabetes, for example must be taken into account as well.
Heart failure treatment can be grouped into three general categories:
1. Lifestyle changes
Maintaining a heart-healthy lifestyle is key to controlling heart failure. Lifestyle factors include eating the right foods drinking the right amount of fluids, maintaining a proper weight, being physically active, not smoking, avoiding alcohol and getting plenty of rest. Many of these lifestyle factors also can help prevent heart disease.
- Moderation in sodium intake: Consuming no more than 2,000mg, or slightly less than one teaspoon of salt daily, can help keep blood pressure in check. Sodium increases blood pressure because it holds fluids in the body, making the heart work harder. Because many foods have salt in them — especially prepared foods — table salt should be avoided.
- Foods that are high in potassium: These food items may be recommended as part of a heart failure treatment regimen. They include fruits such as bananas and strawberries, vegetables such as spinach, broccoli and squash, nuts and whole grains. Patients taking diuretics sometimes have low potassium levels, leading to symptoms such as weakness, fatigue, muscle cramps, severe thirst, excessive urination and heartbeat changes.
- Fluid intake: This plays a role in heart failure treatment, especially if you have advanced heart failure and if you're experiencing swelling. Generally speaking, you should limit your intake of fluids to eight cups, or 64 ounces, a day. With Arizona's notoriously hot summers, you may need to drink more fluids. A heart treatment specialist can recommend the appropriate amount to drink, based on your condition and prescribed activity level.
You should follow a prescribed treatment regimen — the key to managing heart failure successfully. Take medications as prescribed and attend follow-up appointments. Several drugs may be used to manage heart failure. Among the most common are ACE inhibitors, beta blockers and aldosterone antagonists.
- ACE (angiotensin-converting enzyme inhibitors) inhibitors: They can improve heart function, enhance patient well-being, reduce hospitalization and increase survival rates. ACE inhibitors work by limiting angiotensin, a hormone that causes the blood vessels to tighten and make the heart work harder.
- Beta blockers: They slow the heart rate and reduce the heart's workload. Over time, beta blockers can help reshape a previously enlarged and stretched heart, which improves the heart's blood pumping efficiency.
- An aldosterone antagonist: This blocks aldosterone, a hormone that causes cardiac inflammation and other cardiac conditions. The drug may be administered cautiously if a patient's ejection fraction is less than 35 percent.
3. Surgical Heart Failure Treatment Options
When a patient's heart failure is treatable with surgery, your doctors will explore these surgical options:
- Biventricular pacemaker: A highly common option, this electronic device is implanted under the skin. Each pacemaker is equipped with wires positioned in the heart to balance how the heart pumps blood. When a patient's heart rate drops below the programmed rate, the device's wires fire small electrical impulses to the heart muscle.
- An implantable cardioverter defibrillator (ICD): It can help prevent sudden cardiac death caused by cardiac arrhythmias (irregular heartbeat). In many ways, an ICD is like a pacemaker: It can send low-energy electrical impulses to restore normal rhythm to the heart. Yet an ICD also can send stronger impulses to the heart if low-energy impulses fail to restore regular heartbeat.
- A left-ventricular assist device (LVAD): This is an artificial heart, a mechanical pump implanted in a heart's weakened left ventricle, the heart's major pumping chamber. An LVAD can be used either as a "bridge to transplant" therapy (as a patient awaits heart transplant surgery) or as a long-term therapy for patients who are not candidates for heart transplant.
- Heart transplantation: This is viable for patients who suffer from end-stage heart failure when all non-surgical treatments for heart failure have not succeeded in managing the condition. A healthy heart from a deceased donor replaces the diseased heart. Because the process for qualifying for heart transplantation is complex, the procedure may not be an option for every patient.
Comprehensive, individualized care
Although cardiologists approach heart failure treatment on a patient-by-patient basis, the HonorHealth team focuses on providing essential components of care to each heart failure patient:
- Assessment of the left ventricle's capacity to pump blood (systolic function).
- Prescription of appropriate medications, such as ACE inhibitors, if the left ventricle's systolic function is significantly compromised.
- Discharge instructions that encompass activity, diet, medications, follow-up appointments, weight monitoring and action to take if symptoms worsen.
- Smoking cessation counseling, if necessary.
- Immunizations for pneumonia and seasonal flu.