Heart failure is a lifelong condition that needs to be managed. There are a number of treatment options, which will ultimately depend on:
- The underlying reason for the heart failure—for example, if you had a prior heart attack, or have high blood pressure or a valve problem
- Your type of heart failure—often based on your ejection fraction (normal vs. low)
- How severe your heart failure is; there is a very wide range of severity from very mild to extremely severe. This is estimated based on your symptoms.
- Other existing conditions such as what your kidney function is
Treatment generally includes a combination of lifestyle changes, medications, cardiac rehab, and procedures.
Adopt healthier habits everyday
When you live with heart failure, you must take steps to make your health a priority. Simple lifestyle changes can help support you heart health. That means finding ways to:
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Medications are an important part of treating heart failure. Your doctor may recommend one or a combination of the following:
- Diuretics (water or fluid pills) help keep fluid from building up in your body or lungs—they will also make you urinate more frequently
- ACE inhibitors/ARBs relax your blood vessels to lower blood pressure and reduce strain on your heart and improve blood flow
- Aldosterone antagonists help the body to get rid of salt and water through urine. This lowers the volume of blood that the heart must pump.
- Beta blockers can slow a rapid heart rate and lower your blood pressure
- Digoxin (brand name: Lanoxin) can make you feel better and may make the heart pump better
- Nitrates and hydralazine, a combination that
- has shown to improve outcomes in African Americans, and
- is often used if someone is allergic to or can’t take ACE inhibitors or ARBs
- Angiotensin receptor-neprilysin inhibitor (ARNI): This new drug is a combination of an ARB and a medicine that inhibits the production of neprilysin, an enzyme that breaks down natural substances in the body that widen blood vessels and reduce sodium retention. The effect is to lower blood pressure and decrease strain on the heart.
- Sinoatrial node modulator: This new drug is used with beta blockers when they cannot lower your heart rate sufficiently. It helps reduce the amount of oxygen your heart
needs and the amount of work your heart has to do to pump blood through the body.
Cardiac rehabilitation provides you with a supervised exercise program that’s geared toward your fitness level and health needs. It also provides a support system to help you adopt lifelong healthy behaviors and monitor your progress.
Cardiac rehab was recently approved for patients living with heart failure. Participating in this program can help you feel better, make your heart stronger and may reduce your need to go to the hospital.
Many people with heart failure also have a problem with the way their heart beats (arrhythmia). Many patients with a low ejection fraction—when the amount of blood the heart is able to squeeze out is much less than what it normally would be—may benefit from small electric devices implanted in the chest, just under the skin, with wires going to the heart. These devices can be useful to prevent sudden cardiac death or help the heart beat in a more coordinated manner in select patients.
- Implantable cardioverter defibrillator (ICD) – a battery-powered device that keeps track of your heart rate and releases an electric shock if it detects a dangerously fast heart rate, resetting the heart rhythm
- Cardiac resynchronization therapy (CRT) – this small device is implanted just below the collarbone. It sends electric signals to the lower chambers of the heart so that they beat together in a more synchronized way, helping the heart to pump better.
Studies show that these devices can help improve quality of life and may prolong survival in properly selected patients.
For very late stages of the disease, a person may need a left ventricular assist device—a mechanical heart pump—to help the heart move blood through the body. This is often used in individuals who are awaiting a heart transplant.
Published: October 2015; updated 9/16/2016
Medical Reviewer: David E. Lanfear, MD, MS, FACC, Henry Ford Hospital, Detroit, MI