Treatment Overview

Your treatment for heart failure depends on:

• The cause of your heart failure.
• Which type of heart failure you have.
• How bad your symptoms are (classification).
• How well your body is able to make up (compensate) for your heart failure.

Sometimes heart failure can be fixed if another problem can be corrected, such as by replacing a heart valve or treating hyperthyroidism.

Heart failure caused by a heart attack may be treated with coronary artery bypass surgery or angioplasty, medicine, and cardiac rehabilitation.

Initial treatment

In the early stages of heart failure, you'll take medicines and make lifestyles changes that can improve your symptoms. Treatment also may prevent more damage to your heart.

You will have regular doctor visits to see how treatment is working and to make changes to your care as needed.

Medicines

You will likely take:

• A diuretic to reduce your blood pressure and fluid buildup.
• An ACE inhibitor to reduce how hard your heart has to work, lower your blood pressure, and reduce fluid buildup and swelling.
• An angiotensin II receptor blocker (ARB) if you can't take an ACE inhibitor.
• A beta-blocker to control your blood pressure and slow your heart rate.

You also will likely take medicines to treat the cause of your heart failure. For more information, see the Medications section.

It's very important to take your medicines exactly as your doctor prescribes.

Lifestyle changes

You will need to make some changes in your daily life to treat heart failure. Your doctor may ask you to:

• Eat less salt.
• Be more active.
• Stay at a healthy weight, or lose weight if you need to. Even a few pounds can make a difference.
• Stop smoking.
• Limit alcohol.
• Control your blood pressure.
• Control your diabetes.
• Limit how much fluid you drink.

Making lifestyle changes can be hard. For more information, see the Living With Heart Failure section.

Ongoing treatment

You will keep following your lifestyle changes, such as limiting sodium, not smoking, and being active.

Your doctor will add other medicines and other treatments as you need them. Your doctor also will try to prevent or treat problems—such as fever, arrhythmia, and anemia—that can lead to sudden heart failure.

Your treatment may include:

• Getting vaccines. Your doctor may want you to get vaccines against pneumonia and the flu (influenza). These vaccines can keep you from getting infections that could put you in the hospital.
• Checking your weight. Your doctor will probably give you guidelines for watching fluid buildup and tell you how much weight gain is too much.
• Getting devices to fix heart rhythm problems. In some cases, your doctor may recommend a biventricular pacemaker that is placed in your chest to keep your heart beating at a normal rhythm. This is also called cardiac resynchronization therapy (CRT). Or you may have an implantable cardioverter-defibrillator (ICD) to stop a deadly rhythm. Some people get a pacemaker that is combined with an ICD.
• Oxygen treatment. Your doctor may recommend oxygen therapy to reduce your shortness of breath and increase your ability to exercise.

Treatment if your condition gets much worse

In some cases when standard treatment doesn't help, you may have other treatments. These include:

• Heart transplant, which replaces your heart with a donor heart.
• Ventricular assist devices (VADs), which help the heart pump blood.

But these are options for only a very small number of people.

Palliative care

As your heart failure gets worse, you may want to think about palliative care. It's a kind of care for people who have illnesses that don't go away and often get worse over time. It's different than care to cure your illness. But some people combine both types of care.

Palliative care:

• May improve your quality of life—not just in your body, but also in your mind and spirit.
• May help you manage symptoms or side effects from treatment.
• Can help you cope with your feelings about living with a long-term illness.
• Can help you make plans around your medical care.
• Can help your family better understand your illness and how to support you.

If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.

For more information, see the topic Palliative Care.

End-of-life care

Because heart failure tends to get worse over time, it's important to think about what kind of care you would like at the end of your life. It's also important that your doctor and family know what you want.

An advance directive is a legal document that tells doctors how to care for you at the end of your life. For more information, see End-of-Life Decisions.