What treatments for heart failure are available?
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 the patient's quality of life and length of survival through lifestyle change and drug therapy.
Read what Dharam Pal Jain, M.D., a cardiologist with Columbia St. Mary's, advises heart failure patients.
Lifestyle changes
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.
Medications
Several types of drugs have proven useful in the treatment of heart failure.
Heart transplants
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.
Source: National Institutes of Health
