Treatment of heart failure is aimed at relieving your symptoms, making your heart stronger and improving your quality of life.
Your symptoms of heart failure can be improved by many lifestyle changes, including:
- eating a healthy, balanced diet
- cutting down on salt
- stopping smoking
- taking regular exercise
- drinking alcohol in moderation or not at all if alcohol has caused your heart failure
- maintaining a healthy weight
- monitoring how much fluid you drink and weighing yourself daily
- managing stress
- having a flu vaccine, if available
If you need help with any of these lifestyle changes, talk to a doctor. He or she may be able to arrange for you to attend a rehabilitation programme and offer information and support.
There is a range of medicines available that can be used to relieve the symptoms of heart failure and help you live longer. Different medicines treat different symptoms, so you may be given more than one medicine. It is important you take each one correctly so that each can do its job properly.
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask a doctor or pharmacist for advice.
Angiotensin-converting enzyme inhibitors
Angiotensin-converting enzyme (ACE) inhibitors widen your blood vessels making it easier for your heart to pump blood around the body. ACE inhibitors are given to most people with heart failure. Side-effects may include a dry cough and low blood pressure, which may make you feel dizzy. If you get a cough when taking ACE inhibitors, see a doctor.
Angiotensin II receptor antagonists
Angiotensin II receptor antagonists (also called angiotensin receptor blockers) work in a similar way to ACE inhibitors. These medicines lower your blood pressure and stop your symptoms from getting worse. You may be given these if you can not take ACE inhibitors because of the side-effects.
There are many different types of beta-blocker but only certain ones are used to treat heart failure. Beta-blockers cause the arteries to widen and they slow down the heart rate. This helps to lower your blood pressure and the amount of work your heart does. If you have asthma or other heart problems, you may not be given beta-blockers. Side-effects can include tiredness, cold hands and feet, disrupted sleep and impotence in men.
Diuretics can help to reduce swollen feet and ankles, and prevent fluid build-up on the lungs, allowing you to be more active and breathe more easily. Diuretics cause your body to get rid of excess fluid by making you urinate more often. Your heart will not have to work as hard if there is less fluid to pump around the body. If you have gout, diuretics can make it worse. They can also lower your blood pressure, which may make you feel dizzy.
Spironolactone or eplerenone are two types of common aldosterone antagonists. They work in a similar way to diuretics by affecting the balance of water and salts going into your urine. These medicines can cause sickness and may affect how well your kidneys work. Your doctor may want to do regular blood tests to check your kidney function if you take this medicine.
Digoxin helps if you have a rapid or irregular heart beat by slowing down your heart rate. Side-effects may include sickness and diarrhoea. If you get these side-effects, see a doctor.
Anticoagulants, also known as blood thinners, reduce how well your blood can clot. They do not actually thin the blood. Anticoagulants such as warfarin are used to help prevent harmful blood clots from forming. You are more likely to get blood clots if you have heart failure because your heart’s pumping action is weaker causing the blood to pool in the body. Blood clots can block narrow blood vessels and stop blood getting to parts of your body. If blood can not get to your brain, this can cause a stroke. Your doctor will consider your risk of having a stroke before prescribing you anticoagulants.
Antiplatelets, such as aspirin, stops blood clots from forming by preventing blood platelets sticking together. Aspirin is not usually taken with warfarin. Side-effects may include sickness and stomach pain.
A pacemaker is a small device that sends electrical signals to your heart to stimulate it to beat at a specific rate. There are several different types of pacemaker. A pacemaker is usually implanted under the skin of your upper chest and is fitted under local anaesthesia – this completely blocks the feeling from your chest area and you will stay awake during the operation.
Cardiac re-synchronisation therapy
Cardiac re-synchronisation therapy restores the normal pumping action of the heart. A specific type of pacemaker is fitted under the skin of your upper chest. The device sends electrical currents to leads connected to the different parts of your heart so they contract in synchronisation with each other.
Implantable cardioverter defibrillator
An implantable cardioverter defibrillator (ICD) is similar to a pacemaker, and is usually implanted under the skin below your collarbone. An ICD can monitor your heart rhythm and deliver a small electric shock to return your heartbeat and rhythm back to normal if it detects a problem. ICDs are usually fitted under local anaesthesia.
Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.
If you have very severe heart failure, a heart transplant may be an option. Heart transplants can be very successful but they are not suitable for everybody because of the risks of surgery. There are also a limited number of donor hearts available.
If your heart failure is caused by one or more of the valves in your heart not working properly, replacing these valves may improve your symptoms.
Coronary artery bypass surgery
If your heart failure is caused by coronary heart disease, you may be offered a coronary artery bypass. This aims to bypass your blocked arteries to increase the blood flow to your heart. This can help to improve the pumping action of your heart.