Treatment of Congestive Heart Failure
The heart is a pump made of specialized muscle tissue. It normally pumps enough blood
to supply the body’s needs. In most people, the heart pumps about 5 to 6 quarts of
blood per minute while at rest and more than 20 quarts of blood during exercise.
Sometimes, following damage to the heart muscle from an illness, (heart attack, viral
infection or some other illness), the heart muscle is weakened. The heart looses the
ability to feed oxygenated blood to the body or remove waste products from the organs of
the body. This weakening of the heart muscle is called congestive heart failure or
cardiomyopathy.
Symptoms that are commonly associated with congestive heart
failure are:
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Fatigue
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Shortness of breath, especially while laying flat or with any
exertion
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Loss of appetite
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Swollen legs or ankles
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Weight gain
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Decrease urination during the day and increased urination at night
People develop congestive heart failure for different reasons. Your doctor will take a
careful history of your condition and often recommends tests to help determine the
underlying cause. The physician may recommend an echocardiogram,
chest x-ray, electrocardiogram or stress test, lab test or angiography
(heart catheterization). Once heart failure is diagnosed, it is often treated with medications, salt
restriction and a balance of exercise and rest.
For patients with heart failure, salt is frequently limited. The
excess salt contributes to water retention. It can also cause imbalances in other
important minerals in your body such as potassium and magnesium. When your heart is not
functioning properly, there is an even greater tendency for your body to retain more
fluid. Salt and water retention lead to shortness of breath and ankle swelling as fluid
accumulates in your body. A daily weight, taken at the same time every day, often is the
first indication that the patient is retaining fluid. Once recognized, this can be easily
treated before other symptoms develop. Severe salt restrictions, however, may lead to poor
tasting food and many patients have difficulty adhering to such a diet. Moderate
restriction is often pursued by simply advising people to not add salt to their food.
Medications are often used to treat congestive heart failure
to improve patient’s symptoms and keep them from being hospitalized.
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A water pill or diuretic will help rid the body of excess water and sodium. This
decrease in fluids reduces the load on the heart, enabling it to handle the daily demands
easier.
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Digoxin (Lanoxin) is often recommended to strengthen the pumping action of the heart
muscle.
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Ace (Angiotensin converting enzyme) Inhibitors are often prescribed to dilate (widen)
the blood vessels throughout the body, allowing blood to flow through them more easily.
The decreased blood pressure in the heart and in the blood vessels reduces the amount of
force needed to pump blood throughout the body. As the heart’s workload decreases,
the heart itself is able to become more efficient and pump blood more efficiently.
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Beta-Blockers have recently become very beneficial in treating heart failure. Where
these were once avoided in heart failure patients, they now have a great influence on
helping patients stay out of the hospital, and feel better overall.
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Special
pacemakers may be utilized in this condition also
known as
biventricular pacemakers.
Medications are intended to improve symptoms; however they cannot cure heart failure.
Generally, medications for heart failure are started at a very low dose and increased as
the patient tolerates them. During a brief office visit, (usually every 2 weeks) the
patient’s blood pressure, heart rate, weight and symptoms are monitored. Medication
adjustments are made while the patient is at the office to be sure that there are no
immediate side effects from the dose adjustment. The patient is often asked to stay at the
office for an hour so that the heart rate and the blood pressure can be monitored. Some
medications must be taken with food, others make no difference. Asking your doctor or
pharmacist about special instructions and possible side effects will be very important.
A balance of exercise and rest is important for strengthening
the heart but not putting too much stress in the heart. At one time, "rest is
best" was thought to be the best treatment for heart failure. We now know that by
severely restricting physical activity, you can get so out of shape that you loose your
stamina and even a short walk in the house may seem like a big task. Being out of
condition places an added stress on the already weakened heart. It’s better to keep
active and by exercising regularly you can keep your body in condition. This will help you
feel better and be able to accomplish more of your daily tasks.
This does not mean that rest is bad. Regular periods of rest and exercise should both
be part of a daily schedule. Resting after meals is good because it allow the heart to be
used for digestion. Extra rest can also help during periods of stress or an illness.
Overall, you will feel better if you exercise daily, rest as needed and learn to listen to
your body.
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