Medical Treatment

If no underlying correctible cause of heart failure is established, medical treatment is composed of lifestyle changes and medications.

• Lifestyle changes recommended by your health care provider can help relieve symptoms, slow the progression of heart failure, and improve one's quality of life. Lifestyle changes that may be helpful in preventing or relieving heart failure include those recommended by the American Heart Association and other organizations as part of a heart-healthy lifestyle. See Self-Care at Home for more information.
  
  
• Medications help control both the underlying causes of heart failure and the symptoms. Medications are the most critical part of therapy for heart failure. Usually, several types of medications are required to address as many of the physiologic imbalances as possible.

Procedures

Other treatment or procedures, such as angioplasty or a pacemaker, may be offered, depending on the underlying cause of the heart failure.

Angioplasty: This is an alternative to coronary bypass surgery for some people whose heart failure is caused by coronary artery disease and is compounded by heart damage/heart attack. Angioplasty is used to treat narrowing or blockage of a coronary artery that supplies the left ventricle with blood.

• A long, thin tube called a catheter is inserted through the skin, into a blood vessel, and threaded into the affected artery. This procedure is performed while the person is under local anesthesia.
  
  
• At the point of the atherosclerotic narrowing or blockage, a tiny balloon and/or an expandable metal stent, attached to the end of the catheter, is inflated/deployed.
  
  
• The inflated catheter pushes aside the cholesterol deposits (plaque) that are blocking the artery so that blood can flow through in a more normal manner.

• A pacemaker is an electrode on the tip of a wire, usually implanted inside the heart by an electrophysiologist or specialized cardiologist in the cardiac cath lab. This wire goes to the right ventricle, frequently with a second wire to the right atrium (dual chamber pacemaker).
  
  
• A pacemaker can stimulate a heart that is beating too slowly to beat faster, or it can control an irregular heartbeat (sometimes, this requires medications in addition to the pacemaker). In certain circumstances, a device called an intracardiac defibrillator (ICD) may be implanted as part of a pacemaker device. This defibrillator can detect and electrically shock a life-threatening arrhythmia back to normal.
  
  
• The pacemaker may also be used to synchronize the pumping action of the left and right ventricles (cardiac resynchronization therapy). This approach requires an extra lead placed behind the heart in a coronary vein overlying the left ventricle. Synchronization improves the effectiveness of the heart as a pump.

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