A diagnosis of heart failure may make you feel overwhelmed or unsure about your future. With heart failure, your heart either can’t pump out enough blood, or works under high pressure due to hardening or stiffening.
Your doctor will discuss heart failure treatment options with you. Here are a few questions you can ask to make sure your doctor has covered everything you need to know.
Some of the treatment goals for heart failure are to:
- treat the underlying condition that caused heart failure, like heart disease or diabetes
- relieve symptoms
- slow or prevent heart failure from getting worse
- prevent admissions to the hospital
- help prolong life
Tell your doctor what you want to get out of treatment. This can help you get the therapy that gives you the best possible quality of life.
Exercise is one way to strengthen your heart. Regular activity can help your heart pump blood more efficiently, and increase your energy levels. Taking medications as prescribed for your heart failure also helps your heart to get stronger. You should also follow sodium and fluid restrictions if they’re recommended by your doctor.
Your doctor may recommend a cardiac rehabilitation program to help strengthen your heart. These types of programs provide you with:
- education to help you understand your condition
- exercises that are tailored to your abilities
- nutritional advice
- strategies for stress management
- monitored exercise
- tips to help you get back to work and other activities safely
- guidance on how to take your medications
Treatments for heart failure range from making heart-healthy lifestyle changes to taking medication. More severe heart failure may need treatment with procedures or surgery.
Some of the medications that treat heart failure include:
- ACE inhibitors. These help widen arteries to improve blood flow, which can help lower blood pressure.
- Angiotensin II receptor blockers. These open tight blood vessels and reduce blood pressure to decrease stress on the heart.
- Angiotensin receptor-neprilysin inhibitors. These help to inhibit angiotensin, reduce blood pressure, and inhibit neprilysin, which increases levels of hormones that help with fluid retention.
- Beta-blockers. These medications help lower blood pressure and slow your heart rate to reduce your heart’s workload.
- Aldosterone antagonists. These help your body remove extra sodium through your urine, so your body doesn’t have to work as hard to pump blood.
- Diuretics. These help your body get rid of excess fluid to reduce swelling in your legs and other parts of your body, which eases your heart’s workload and reduces pressure in your heart and lungs.
- Digoxin. This medication helps your heart beat with more force to pump out your blood.
- Sodium glucose transport inhibitors (SGLT2 inhibitors). These medications help lower your blood sugar and can also regulate your sodium balance.
Your doctor might prescribe more than one of these drugs. They each work in a different way.
If the heart failure gets worse and medication can no longer control symptoms, surgical treatments include:
- Coronary artery bypass graft (CABG). This procedure uses a blood vessel from your leg or another part of your body to divert blood around a blocked artery. Opening the blockages with this “detour” can improve the function of the heart.
- Angioplasty. This procedure places a thin tube into a blocked blood vessel. Your doctor then inflates a balloon to open up the blockage. Your doctor may also insert a metal tube called a stent into the vessel to keep it open. Opening the blockages can improve the function of the heart.
- A pacemaker or CRT. Your doctor can implant this type of device to help keep your heart in rhythm and the left and right side working together.
- A defibrillator. Your doctor can implant this type of device to shock the heart out of a potentially unstable or fatal abnormal electrical rhythm.
- Valve surgery. This procedure repairs or replaces the valves in your heart that are blocked or leaking to help it pump more effectively.
- Left ventricular assist device (LVAD). Your doctor can implant this type of “artificial heart” mechanical pump to help your heart send more blood out to your body.
- A heart transplant. This procedure replaces your damaged heart with a healthy heart from a donor. This surgery is done only after all other treatments have failed.
It might seem hard to be active when your heart isn’t working well, but it’s really important to exercise. Aerobic activities like walking, bike riding, and swimming can help strengthen your heart and improve your overall health. But make sure to discuss exercise safety with your doctor before starting.
Add in strength training with light weights or resistance bands 2 or 3 days a week. These exercises tone your muscles.
You can learn some of these activities in a cardiac rehabilitation program. Or, you can do these activities on your own. Just check with your doctor first to see which exercises are safe for you.
Most people with heart failure should try to do at least 30 minutes of aerobic exercise on most days of the week. If you’re new to exercise, start slowly. Start by taking a walk for just 5 or 10 minutes. Slowly increase the pace and length of your workouts over time.
Warm up for 5 minutes before you begin, and cool down for 5 minutes after you finish. If you have severe heart failure, increase your warm-ups and cool-downs to 10 or 15 minutes. A good warm-up and cool-down can help ensure that you don’t put too much stress on your heart.
Don’t exercise outdoors when it’s too hot or cold. And never hold your breath during exercise. It could cause your blood pressure to spike.
Your medications for heart failure can make you more sensitive to exercise. Stop and call your doctor if you experience any of these symptoms during exercise:
- chest pain
- shortness of breath
- fast or abnormal heart rate
- nausea or vomiting
Adopt healthy eating habits to protect your heart and your overall health. You can follow a heart-healthy eating plan like the
- whole grains
- low- or non-fat dairy
- healthy fats
You should also limit the following foods and drinks:
- sodium (aim for around 1,500 mg per day)
- added sugars from sodas, snack foods, and desserts
- saturated fats from fatty red meat, whole milk, and butter
- caffeine in coffee, tea, and chocolate
For some people with heart failure, your doctor may ask you to limit the total amount of fluids you consume to less than 2 liters. Discuss this with your doctor.
Yes. Smoking causes inflammation that narrows blood vessels and makes it harder for your heart to pump blood through them. The extra work your heart has to put into pumping blood through narrowed blood vessels can damage it even more.
Even if you’ve smoked for years, it’s never too late to quit. Quitting may result in an immediate drop in your blood pressure and heart rate. It can also improve heart failure symptoms like tiredness and shortness of breath.
Ask your doctor for advice to help you quit. You might try smoking cessation aids like prescription medications that reduce your urge to smoke, nicotine replacement products, or talk therapy.
If the cause of heart failure is treatable, it’s possible to reverse. For example, your doctor can repair a faulty heart valve with surgery. Some medications can also help the heart to get stronger over time.
In other cases, heart failure isn’t reversible. But treatments like medication, lifestyle changes, and surgery can help prevent it from getting worse.
Heart failure is serious, but treatable. Work with your doctor to come up with a treatment plan tailored to you. Your plan might include diet, exercise, cardiac rehab, and medication or surgery.
Make sure to stick with your treatment and take your medication as prescribed. If you have any side effects, ask your doctor if you can adjust the drug or dose.