Congestive Heart Failure Treatments

Treatment for congestive heart failure is determined by how advanced the disease is. It can range from lifestyle changes, such as adopting a better diet and getting more exercise, to more extreme interventions, such as heart surgery or a heart transplant.

Diet and Exercise as Treatments for Congestive Heart Failure

Fluid retention in the lungs (pulmonary edema) and in the organs and tissues (peripheral edema) is a major concern in patients with congestive heart failure. Since eating salty foods and drinking liquids only exacerbates the problem, salt and liquid restrictions are among the first dietary changes that your cardiologist will require. Excess liquid results in swollen ankles, feet and legs, and can also cause abdominal swelling and breathing difficulties.

Your physician will encourage you to exercise regularly. Aerobic exercise is best. Your hospital or clinic probably has a cardiac rehabilitation specialist who can customize an exercise program for you based on the results of exercise tolerance tests.

Medications

The medications your physician or cardiologist prescribes will be based on your symptoms and test results. Once your doctor knows what part of your heart is damaged and the nature of the malfunction, he or she can select medications that help increase the amount of blood that your heart is able to pump.

Three major classes of drugs are used to treat heart failure: vasodilators, diuretics, and inotropic drugs. Visit our prescription drugs page to learn more about them.

Heart Surgery

When a specific heart defect can be pinpointed, heart surgery may be an acceptable treatment. For example, the surgery may involve any one of the following procedures, depending on the source of the problem:

  • valve replacement
  • angioplasty
  • a coronary bypass
  • surgical ventricular restoration (SVR)
  • implantation of a defibrillator.

The Heart Transplant

A patient in the advanced stages of congestive heart failure whose condition does not respond to medications or surgeries may become eligible for a heart transplant, provided he or she meets the required criteria. The most urgent cases are designated as Status 1 patients, and the less seriously ill are Status 2 patients. In the past five years, Status 1 has been further subdivided into 1A and 1B, with 1A being most critical.

The good news is that heart transplant patients have a 1-year survival rate of 82 percent and a 3-year survival rate of 75 percent. This compares very favorably to overall survival rates for patients with congestive heart failure.

Status 1 patients typically wait anywhere from a few days to several months to receive a transplant. The wait for Status 2 patients tends to be much longer. Unfortunately, twelve to fifteen percent of patients on the waiting list die before receiving the awaited transplant. As of January 2004, 3515 patients were on the heart transplant waiting list in the United States.

While awaiting a heart transplant, some patients gain assistance from a left ventricular assist device (LVAD), designed to help boost the heart’s pumping action.

End of Life Care

Some patients, for one reason or another, are ineligible for a heart transplant. If critically ill, a patient may not be able to survive the surgery. Treatment for these patients is palliative. The goal of end of life care is to minimize pain and prevent suffering.