“Heart failure can be heart success.”
The term “heart failure” is a bit misleading. It doesn’t mean your heart has stopped working. “It’s a misnomer,” says Satjit Bhusri, MD, a cardiologist at Lenox Hill Hospital in New York City. “Heart failure is treatable.”
Heart failure occurs when the heart muscle has become weak and can’t pump blood well enough to meet the body’s needs. Basically, it can’t keep up with its workload. Here’s more about what happens to your heart during heart failure.
After you’re diagnosed with heart failure, your doctor will likely suggest a treatment regimen, which may include a series of lifestyle changes, medications, or devices or surgery. The success of heart failure treatment greatly depends on your commitment to managing the condition by following your doctor’s recommendations and making the necessary changes in diet, exercise, and lifestyle to give you the highest possible quality of life.
“Heart failure can be heart success,” says Dr. Bhusri. “And it gets to be heart success if you really make it into a life event.”
Treating Heart Failure with Medication
“We use medications in heart failure, both to make symptoms better, but also improve survival with heart failure,” says Michelle Weisfelner Bloom, MD, a cardiologist at Stony Brook University Medical Center.
The same medications used to treat heart disease are used to treat heart failure, but they’re prescribed in more robust amounts, says Dr. Bhusri. The classes of medications routinely used to treat heart failure include:
- Angiotensin-converting enzyme (ACE) inhibitors: “ACE inhibitors are used to relax the blood vessels, decrease blood pressure, and increase the amount of blood that’s getting pumped forward to the body,” says Dr. Bloom.
- Angiotensin II receptor blockers (ARBs): ARBs block the action of angiotensin II, allowing blood vessels to widen (dilate).
- Angiotensin-receptor neprilysin inhibitors (ARNIs): ARNIs are a new drug combination of a neprilysin inhibitor and an ARB (sacubitril/valsartan). “Valsartan is a relative of an ACE inhibitor. Sacubitril is a brand new class of medication, says Dr. Bhusri. “It’s actually a hormone that’s released by the top of your heart to help patients unload the pressures of their heart.”
- Beta blockers: These medications reduce blood pressure and heart rate.
- If channel blocker (or inhibitor): This drug class reduces the heart rate, similar to beta blockers.
- Mineralocorticoid antagonist, or aldosterone antagonist: “Not only do [these medications] help with fluid retention, we know that they actually affect mortality,” says Dr. Bloom.
- Hydralazine and isosorbide dinitrate: This class of drugs specifically benefits African Americans with heart failure.
- Diuretics (water pills): “These are medications that decrease the amount of fluid in your body,” says Dr. Bhusri.
Lifestyle Modifications for Managing Heart Failure
Patients with mild to moderate heart failure can lead normal, healthy lives. Adjusting your lifestyle can help reduce your heart failure symptoms, slow disease progression, and improve your quality of life. Here are some lifestyle adjustment that can help.
- Skip the salt shaker. “A lot of patients with heart failure are very sensitive to salt intake or fluid intake,” says Dr. Bloom. Check the sodium count on your food labels, and aim for no more than 1,500 mg per day, says Dr. Bhusri. Here are ways to eat less salt for heart failure treatment.
- Get moving. It may be tempting to avoid physical activity after learning you have heart failure, but exercising with heart failure actually plays a key role in managing the condition and improving heart failure symptoms. Here’s how to start exercising with heart failure (with your doctor’s permission and guidance).
- Lose weight if you need to. Losing weight could have a major impact on your heart failure treatment and recovery. Here’s how weight loss can impact heart failure treatment.
- Quit smoking. Smoking is not only a cause of heart failure, but it can increase complications associated with heart failure. Here’s more on why you should quit smoking if you have heart failure.
Devices and Surgical Procedures for Heart Failure
“After you’ve been on a series of medications, [we’ll check] to see if the pumping of the heart improved,” says Rachel Bond, MD, a cardiologist at Lenox Hill Hospital. “If we notice that the muscle still remains weak, we may suggest that you need a device that’s called a defibrillator. If your heart were to go into an abnormal rhythm, it would ultimately shock you out of it.”
Sometimes, despite doctors’ best efforts to treat heart failure with medication, lifestyle changes, and device therapy (like defibrillators), patients are still hospitalized for their heart failure. “Patients find that their heart failure is really limiting their quality of life,” says Dr. Bloom. “In those situations we tend to escalate care. For example, we start to evaluate patients for more aggressive therapies like a left ventricular assist device (LVAD), or in certain situations a heart transplant.”
00:00:00,036 --> 00:00:02,535
00:00:02,535 --> 00:00:06,718
One misconception that patients have with
heart failure is the simple term that it's
00:00:06,718 --> 00:00:08,881
called heart failure, that it has failed.
00:00:08,881 --> 00:00:11,613
That's a misnomer,
heart failure is treatable.
00:00:11,613 --> 00:00:16,609
00:00:16,609 --> 00:00:21,239
The same medications that we use to treat
heart disease are used to treat heart
00:00:21,239 --> 00:00:23,816
failure, except in more robust amounts.
00:00:23,816 --> 00:00:28,411
So we use medications in heart
failure both to make symptoms better,
00:00:28,411 --> 00:00:31,593
but also improve survival
with heart failure.
00:00:31,593 --> 00:00:35,174
There are certain classes of
medications that we routinely use.
00:00:35,174 --> 00:00:37,885
Angiotensin Receptor Blockers or
00:00:37,885 --> 00:00:42,458
ACE inhibitors are used to relax the blood
vessels, to decrease blood pressure.
00:00:42,458 --> 00:00:47,028
And increase the amount of blood that's
getting pumped forward to the body.
00:00:47,028 --> 00:00:51,220
Beta blockers are another type of
medications that we routinely use in heart
00:00:51,220 --> 00:00:52,340
00:00:52,340 --> 00:00:56,915
In addition to those medications
we use what are called diuretics.
00:00:56,915 --> 00:01:01,904
These are medications that decrease
the amount of fluid in your body.
00:01:01,904 --> 00:01:05,284
We also use a class of
medications very routinely,
00:01:05,284 --> 00:01:09,856
called mineralocorticoid antagonist or
00:01:09,856 --> 00:01:12,245
Not only do they help
with fluid retention,
00:01:12,245 --> 00:01:14,774
we know that they actually
00:01:14,774 --> 00:01:21,651
There's a new medication now that is
a combination of Valsartan and Secubitril.
00:01:21,651 --> 00:01:25,113
Valsartan is a relative
of an ACE inhibitor.
00:01:25,113 --> 00:01:28,619
Secubitril is a brand
new class of medication.
00:01:28,619 --> 00:01:33,619
And it’s actually a hormone
that’s released by the top of
00:01:33,619 --> 00:01:39,241
your heart to help patients unload
the pressures of their heart.
00:01:39,241 --> 00:01:44,178
We recommend dietary modifications for
example a lot of patients with heart
00:01:44,178 --> 00:01:48,047
failure are very sensitive to
salt intake or fluid intake.
00:01:48,047 --> 00:01:51,991
We recommend 1,500 mg of sodium or
less per day.
00:01:51,991 --> 00:01:55,495
So you have to be very cognizant
of what you're eating and
00:01:55,495 --> 00:01:59,220
really look at the labels, and
you'll be quite surprised.
00:01:59,220 --> 00:02:01,917
After you've been on
a series of medications, and
00:02:01,917 --> 00:02:04,814
we recheck to see if the pumping
of the heart improved.
00:02:04,814 --> 00:02:08,886
If we notice that the muscle still
remains weak we may suggest that you need
00:02:08,886 --> 00:02:11,852
this device is called the defibrillator.
00:02:11,852 --> 00:02:15,999
If your heart were to go into
an abnormal rhythm it would ultimately
00:02:15,999 --> 00:02:17,267
shock you out of it.
00:02:17,267 --> 00:02:22,103
There are certain situations where
despite our best efforts with medical
00:02:22,103 --> 00:02:26,472
physical therapy and
other device therapy like defibrillators,
00:02:26,472 --> 00:02:31,168
that patients still continue to get
hospitalized with heart failure.
00:02:31,168 --> 00:02:35,377
And they find that their heart failure is
really limiting their quality of life.
00:02:35,377 --> 00:02:39,286
In those situations we generally
tend to escalate care.
00:02:39,286 --> 00:02:44,404
For example we start to evaluate patients
for more aggressive therapies like
00:02:44,404 --> 00:02:49,688
a left ventricular assist device or
in certain situations a heart transplant.
00:02:49,688 --> 00:02:52,230
Heart failure can be heart success.
00:02:52,230 --> 00:02:57,721
And it can be heart success if you
really make it into a life event.
00:02:57,721 --> 00:03:02,269
Medications Used to Treat Heart Failure. American Heart Association. (Accessed on March 29, 2018 at http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Medications-for-Heart-Failure_UCM_306342_Article.jsp#.Wr0VtpPwaL4)
What is Heart Failure? American Heart Association. (Accessed on March 29, 2018 at
Lifestyle Changes for Heart Failure. American Heart Association. (Accessed on March 29, 2018 at http://www.heart.org/HEARTORG/Conditions/HeartFailure/TreatmentOptionsForHeartFailure/Lifestyle-Changes-for-Heart-Failure_UCM_306341_Article.jsp#.Wr0eE5PwaL4)
Heart Failure. U.S. National Library of Medicine, MedlinePlus. (Accessed on March 29, 2018 at https://medlineplus.gov/heartfailure.html)