What is the treatment for congestive heart failure?
The goal of treatment for congestive heart failure is to have the heart beat more efficiently so that it can meet the energy needs of the body. Specific treatment depends upon the underlying cause of heart failure.
Treatment may try to decrease fluid within the body so that the heart does not have to work as hard to circulate blood through the blood vessels in the body.
Fluid restriction and a decrease in salt intake may be very helpful. Diuretic medications (water pills) may be prescribed if appropriate. Common diuretics include furosemide (Lasix), bumetanide (Bumex), and hydrochlorothiazide.
Medications are available that can make the heart pump more efficiently, increase cardiac output, and increase ejection fraction, as well as improve long-term survival
ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotension receptor blockers) are medicines that are also shown to increase survival by decreasing systemic resistance and favorable altering the hormonal milieu, which affects the cardiac performance; they are often used with other drugs. Beta blockers may control heart rate and increase cardiac output and ejection fraction, and provide a beneficial response to circulating epinephrine ("adrenalin"). Digoxin (Lanoxin) is an older medicine that may help increase cardiac output and control symptoms.
A very mild newer diuretic, spironolactone, has been shown to be of long-term benefit as well.
Cardiac risk factor modification is the cornerstone of prevention but may also benefit patients with established congestive heart failure.
Weight loss, establishing an exercise program, stopping smoking, and controlling high blood pressure, high cholesterol, and diabetes may help in the management of congestive heart failure.
End stage congestive heart failure (NYHA stage IV) patients may require aggressive treatments including left ventricular assist devices (LVAD), an implanted pump that helps increase the heart's ability to squeeze, or even heart transplantation. In older patients, not considered transplant candidates, LVAD may be a permanent treatment.