Prevention And Treatment Of Heart Failure

Prevention Of Heart Failure

Heart failure can be prevented by treating the disorders that lead to heart failure before they actually cause it.

  • Heart valve disorders and septal defects can be treated surgically.
  • Coronary artery blocks can be treated with drugs or minimally invasive procedures.
  • High blood pressure can be managed with appropriate medication.
  • Infections, thyroid disorders and anemia can be reversed by rectifying their root causes.
  • Lifestyle changes can prevent unhealthy habits like alcoholism from taking their toll on the heart.

Treatment Of Heart Failure

Heart failure can be treated by a multi-pronged approach, as listed below:

General Measures: Heart failure tends to be a chronic disorder for most people. The main focus however, should be to improve the patient’s quality of life as much as possible. Physical activity is required, but care must be taken to ensure that the exercises performed have received the prior approval of the doctor, with a sufficient amount of breaks for rest in between. The family must be well aware of the patient’s heart disorder, and must be informed enough to recognize any sign of degradation in the patient’s condition, and when to seek medical intervention. Immediate action, like the administration of diuretics, can make all the difference between life and death.

Regular heart check-ups and medical examinations by health care professionals are important for keeping a tab on the progress of the disease.

Special heart clinics which have trained professionals including dietitians, and social workers, can provide further care and support to persons suffering from heart failure. These clinics can help decrease symptoms, and result in the patient having to be hospitalized less frequently. They can greatly improve the quality of life and extend the patient’s life span. However, such clinics merely augment the care provided by primary care doctors and cannot replace them.

Heart failure is a disorder which requires constant monitoring. Any drug taken by the patient must first be approved by the doctor, including non-prescription drugs. This is due to the fact that certain drugs have an adverse effect on those suffering from heart failure. It is also very important that the patient take the correct dose of prescribed medication on time, as failure to do so can result in a severe and possibly life-threatening condition.

Treatment of the Cause: Treatment varies based on the root cause of the heart disorder.

If the cause of heart failure is a valve disorder or a septal defect, surgery can correct the problem.

In the case of a coronary artery being blocked, treatment can be in the form of blockbusting drugs like nitroglycerin, or surgery. Angioplasty can also provide a solution.

High blood pressure on the other hand, can be treated by the use Antihypertensive drugs. Infections too can be curbed by the use of antibiotics.

Anemia due to stomach ulcers can be improved by giving iron supplements. A hyperactive thyroid gland can be managed with help of drugs or radiation therapy, and in extreme cases, surgery. Hypothyroidism is relatively easier to treat, with thyroid hormones or iodine supplements (except in the case of autoimmune thyroiditis) providing an effective solution.

Lifestyle Changes: Lifestyle changes go a long way in improving the quality of life of a person with heart failure.

Exercise should form a very important part of the daily routine, although vigorous exercise should be avoided. People who have mild heart failure should follow safe exercise as prescribed by the doctor. In case of severe heart failure any exercise should be closely monitored, and preferably conducted in a closely monitored environment, under the supervision of trained health professionals.

Overweight people with heart failure should reduce their weight with a weight loss diet before starting an exercise routine, otherwise the additional effort can overload their heart.

Smoking should be avoided, as this can damage the blood vessels, worsening heart failure. Alcohol consumption should also be limited, as is toxic to the heart in large amounts.

Consumption of salt should be limited as excess salt increases fluid retention, worsening the heart failure. Diuretics are usually prescribed to people with heart failure to remove excess water from the body to reduce the load on the heart. Salt counteracts the effect of diuretics. Sodium content in the processed foods is indicated on the label. People with heart failure should carefully assess their total intake of sodium and keep it within the limits recommended by their doctors.

Checking body weight at the same time everyday helps to assess the amount of water retention. People with heart failure should develop the habit of weighing themselves very accurately as soon as they get up in the morning; on the same scale and wearing the same amount of clothing. The daily readings should be recorded and any increase in weight exceeding two pounds (or 1 kilogram), indicating fluid retention should be taken seriously and reported to the doctor.

Even with limited salt intake, swelling in the legs may persist. Using a foot stool to keep the feet raised help the reverse flow fluid, reducing swelling. Wearing full length stockings also help. When there is fluid retention in the lungs, raising the head on pillows make sleep more comfortable.

Drugs for Heart Failure: Diuretics, ACE inhibitors, angiotensin II receptor blockers, beta-blockers and digoxin are a few of the different categories of drugs used to treat heart failure.

Diuretics that help the kidneys flush out excess salt and water by increasing urine formation and decreasing amount of fluid in the body, is an important group of drugs in the treatment of heart failure.

Loop diuretics for moderate to severe heart failure are usually taken by mouth, but in an emergency, it can be administered intravenously.

Thiazides are milder diuretics, recommended for people with hypertension as they help reduce blood pressure.

Potassium-sparing diuretics such as spironolactone may be given in case of severe heart failure resulting from systolic heart failure. They prevent the loss of potassium in urine, unlike loop diuretics and thiazides.

Worsening of urinary incontinence is an unpleasant consequence of taking diuretics. Careful timing of doses can help avoid difficult situations when access to a bathroom is not feasible.

ACE inhibitors, is a group of drugs that is most important in heart failure treatment. They reduce symptoms of heart failure and help prolong life. They act by reducing the hormones angiotensin II and aldosterone which raise blood pressure. ACE inhibitors help dilate arteries and veins reducing blood pressure and helping the kidneys eliminate excess water, reducing the load on the heart. They may have a beneficial effect on the walls of the heart and blood vessels.

Angiotensin II receptor blockers are another group of drugs similar to ACE inhibitors. Some people with persistent symptoms of heart failure are advised both the drugs together. In people with poor tolerate for ACE inhibitors because of their side effects such as a persistent cough, Angiostenin ll receptor blockers are used alone.

Vasodilators such as hydralazine, isosorbide dinitrate and nitroglycerin are resorted to, in people who do not tolerate ACE inhibitors or angiotensin II receptor blockers. They help dilate the blood vessels, reducing blood pressure but are not as effective as the other drugs.

Beta-blockers act by blocking the action of the hormone norepinephrine (which causes the heart to pump faster and more forcefully), thus improving long-term functioning of the heart and prolonging life. They are used along with ACE inhibitors to treat heart failure. In heart failure due to diastolic heart failure, beta-blockers reduce the heart rate and help relax the stiff muscle allowing the heart to fill with more blood.

Digoxin: In patients with atrial fibrillation along with systolic heart failure, the drug Digoxin helps to increases the force of each heartbeat and slows heart rate. One of the oldest drugs for heart failure, it does not prolong life.

Anticoagulants such as Warfarin, prevent clot formation in the heart.

Abnormal heart rhythm is treated with antiarrhythmic drugs.

Other Measures:

A cardioverter defibrillator can be implanted, especially in people not responsive to the best medical treatment, as their risk of sudden death is great.

A pacemaker that stimulates both ventricles can provide better coordination of the heart muscles improving their function.

People who are generally healthy but for a damaged heart, and those with poor response to drugs can opt for a heart transplantation. Mechanical devices that help pump blood called artificial heart can help patients with very severe heart failure that does not respond to drug therapy.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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