Treatments for CHF:

Heart failure caused by an excessive workload is curable by treating the primary disease, such as anemia or thyrotoxicosis or hypertension or diabetes. 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 due to damaged heart muscle no known cure (like a heart attack that damages the heart muscle where the attack took place on the organ) but prevention of it happening again can take place in many cases through treatment of the disease or illness with being compliant in following up with your doctor for the disease or illness and being compliant in following doctor’s orders.   The worst thing you can do is ignore it. The treatment seeks to improve patients quality of life and length of survival through lifestyle change and drug therapy.

Patients can minimize the effect t of heart failure by controlling the risk factors for heart disease they may have. Obvious steps include: Don’t smoke or quit smoking, lose weight if necessary, abstaining from alcohol, and making those dietary changes to reduce the amount of salt and fat consumed Regular, modest exercise is also helpful for many patinets, though the amount and intensity should be carefully monitored by a physician.

Even with lifestyle changes, most heart failure patients must take medication. Many patients receive 2 or more meds. Types of medication given: ACE inhibitors, Digitalis, Diuretics, Hydralazine, and Nitrates.

These are some of the meds given for heart failure.   Not all medications are suitable for patients, and more than one drug may be needed. Always review the list your pharmacist provides in the action, side effects, with instructions of how to take the drug to make it most effective in your body with what to look for while on this medication to keep you the patient most informed on what you should know.

Results of studies over the years have placed more emphasis on the use of drugs known as angiotensin converting enzymes (ACE) inhibitors. Several studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow perhaps even prevent the loss of the heart pumping activity. This drug prevents the transfer of your enzyme Angiotensin 1 to convert to Angiotensin 2 which prevents the vessels in your body to do vasoconstriction which prevents the pressure in the bloodstream to raise = high B/P (hypertension). This prevents stress to the heart, due to high B/this causes blood to get to the heart slowly and more difficult causing the heart to pump harder but the ACE inhibitor with allowing vasodilation (opening of vessels) keeping pressure down to make the job easier= less stress on the heart. Originally these medications where for patients in the treatment of hypertension but they help patients with heart failure, among other things, decreasing the pressure inside the blood vessels causing the heart to do its job easier.

Digitalis increases the force of the heart’s contractions, helping to improve circulation in the body.

Diuretics are for reducing the amount of fluid in the bloodstream and body by releasing them via the kidneys and having us void the excess out in our urine, these are useful for patients with fluid retention.

Those who aren’t prescribed or cannot take these meds already mentioned may be given a hydralazine medication and/or a drug in the Nitrate classification, each of which help relax tension in the blood vessels to improve blood flow. Also, both Hydralazine and Nitrates function is they cause vasodilation in the vessels improving blood flow to the heart.

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.

Studies over the years 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 device (LVADs), the machine takes 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. Worldwide, about 3,500 heart transplants were performed annually. The vast majority of these are performed in the United States (2,000-2,300 annually). Cedars Sinai Medical Center in Los Angeles, California has performed the most heart transplants in the last three consecutive years performing 95 transplants in 2012 alone. About 800,000 people have a Class IV heart defect indicating a new organ. The degrees of CHF are I, II, III and IV. In learning more about CHF with heart transplants (including becoming a candidate for one) go to wwwtransplantexperience.com or even hearttransplant.com.

Another surgical procedure for heart failure that is available in America is cardiomyoplasty. This is a surgical procedure in which healthy muscle from another part of the body is wrapped around the heart to provide support for the failing heart. Most often the latissimus dorsi muscle is used for this purpose. A special pacemaker is implanted to make the skeletal muscle contract. The electrical stimulator icauses the back muscle to contract, pumping the blood from the heart (this allows the heart to do its job more effectively).

Complications of CHF:

Through the Mayo clinic as a reference regarding complications their website stated: “If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age. Complications can include:

• Kidney damage or failure. Heart failure can reduce the blood flow to your kidneys, which can eventually cause kidney failure if left untreated. Kidney damage from heart failure can require dialysis for treatment.
• Heart valve problems. The valves of your heart, which keep blood flowing in the proper direction through your heart, may not function properly if your heart is enlarged, or if the pressure in your heart is very high due to heart failure.
• Liver damage. Heart failure can lead to a buildup of fluid that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes it more difficult for your liver to function properly.
• Stroke. Because blood flow through the heart is slower in heart failure than in a normal heart, it’s more likely you’ll develop blood clots, which can increase your risk of having a stroke.Tips on CHF:Closely follow your doctor’s instructions, being compliant with the instructions and taking your meds.Control your weight in making it easier for your heart, that’s in failure, to function better (less stress).Limit or stop alcohol consumption as your doctor informs you.                 The best defense against heart failure is PREVENTION! Almost all the cardiac risk factors can be controlled of eliminated (smoking, obese, high cholesterol, high B/P, diabetes).
• Going to the doctor can be stressful but know he is there for you. It is hard to remember everything you want to ask the doctor with everything you hear at your visit. It helps to prepare a list of questions you may have and bring it with you at your appointment to address to the doctor your concerns. In doing this it helps you with your appointment so you can record the answers by listing them on the paper you have. Before you leave the doctor’s office, be sure you understand your condition and its treatment, including any medications your taking this doctor ordered for you with him or her knowing any other medications you may be on through a different doctor to prevent side effects or adverse reactions but if you forget this about the medications there is always your pharmacist you can ask than your M.D. later. With you knowing this information you will see why it is so vital for you doing all these actions or inter- ventions for your disease that the doctor ordered and you’re more out to follow them as well.
• Of course, stop smoking permanently if actively smoking.
• Watch what you eat and how much. Watch the diet intake of cholesterol and sodium that can cause a negative impact on the heart by causing stress to the organ through either high B/P=high sodium that causes vasoconstriction or high cholesterol frequently=blockage in an artery and both cause diminishing of oxygenated blood getting to the heart. Without oxygen to our tissues or cells this causes tissue & cellular starvation. What is starvation to the heart=chest pain (what we call angina). Take a brittle diabetic, the furthest area from the heart is the feet the first area to experience starvation is the toes, foot or lower extremity which is why this is usually the first to be amputated if necessary (you usually see an upper extremity amputated due to trauma).
• Immediately call your doctor of any significant change in your condition, such as an intensified shortness of breath or swollen feet or weight gain of 3lbs or more within one week.
• See your doctor regularly in evaluating your CHF.
• Some people’s symptoms and heart function will improve with proper treatment. However, heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may require heart transplantation or support with an artificial heart device.”

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