Congestive heart failure is a condition in which the heart can't pump enough oxygen-rich blood to other organs in the body. It is caused by diseases that weaken or stiffen the heart muscle, or diseases that increase the demand for oxygen beyond the heart's ability to deliver. The treatment of CHF may include surgery, medical devices, medications and lifestyle changes.
Surgery
A cardiologist may recommend heart valve repair or replacement surgery to treat an underlying condition that led to the development of CHF. Coronary bypass surgery is recommended for patients with severely narrowed arteries. In patients with severe CHF, a heart transplant may be necessary to improve quality of life. A myectomy is performed as a result of hypertrophic cardiomyopathy in which part of the septal muscle is removed to decrease a blockage.
Medical Devices
A ventricular assist device, or VAD, is planted into the abdomen and is attached to the heart. These mechanical devices are utilized in patients who are not candidates for a heart transplants. A cardiac resynchronization therapy (CRT) device sends electrical impulses to the heart to help it pump. They are utilized in patients with moderate to severe CHF. An internal cardiac defibrillator, or ICD, is implanted under the skin to monitor abnormal heart rhythms or arrhythmias.
Medications
Medications can be used to help treat CHF by alleviating symptoms. Drugs that help lower blood pressure, improve circulation, or improve blood flow may be prescribed. Angiotensin-converting enzyme (ACE) inhibitors can help decrease the heart's workload by improving blood flow. Angiotensin II receptor blockers are similar to ACE inhibitors without the potential coughing side effect. Beta blockers slow the heart rate down, resulting in lower blood pressure. Digoxin increases the strength of heart contractions and slows down heartbeats. Diuretics are prescribed to prevent fluid from collecting in the body, making breathing easier and putting less stress on the heart. Aldosterone antagonists help the heart pump more efficiently and help reverse scarring of the heart. Inotropes improve heart pumping function and help to maintain blood pressure.
Diet
Restricting both sodium and fluids is recommended in CHF to help avoid fluid retention or build-up in the lungs and other surrounding tissues. In patients with CHF, a sodium restriction of 2 grams of sodium per day is advised. Although patients with CHF often are prescribed diuretics to rid the body of excess fluids, the action of these medications can be overwhelmed by excessive fluid intakes. In cases of severe CHF, fluid intakes may need to be limited to 2 quarts per day.
Exercise
Regular exercise either on your own, or in a structured cardiac rehabilitation program is recommended to help relieve symptoms of CHF. Exercise is beneficial in maintaining functional capacity, quality of life and may even improve survival.
