Treatment:

The goals of treatments are:

• Treat the disease that is causing the heart failure
• Reduce symptoms
• Relieve stress on the heart
• Reduce risks of worsening heart failure
• Improve chances of survival

You should see a heart specialist. You may need to stay in the hospital when symptoms are severe.

Treatment may involve:

• Lifestyle changes such as stopping drinking alcohol
• Medicines for high blood pressure
• Surgery or cardiac catheterization to open blocked heart arteries

Persons with heart failure should eat less salt, avoid alcohol, and exercise moderately.

Medicines that may be used include:

• Beta-blockers to prevent death in certain patients
• Digitalis to help slow heart rhythms and increase the heart beat
• Diuretics to help the body get rid of extra fluid
• Spironolactone or epleronone to prevent salt retention and help patients with severe heart failure
• ARBs, ACE inhibitors, long-acting nitrates, and hydralazine to reduce the stress on the heart and to prevent further muscle damage and scarring
• Digoxin to increase muscle strength and slow down abnormally fast heart rates

In severe cases, medicines are given through a vein.

When heart function decreases significantly, a defibrillator may be recommended to prevent sudden cardiac death. A defibrillator is used to prevent dangerous heart rhythms, which often occur in people with very weak hearts.

A number of studies have shown that heart failure symptoms can be improved with a special type of pacemaker. It paces both the right and left sides of heart. This is referred to as biventricular pacing or cardiac resynchronization therapy. Ask your provider if you are a candidate for this.

In very severe cases, when medicines alone do not work, a heart pump (ventricular assist device) can be implanted. A heart transplant may be needed.

Expectations (prognosis):

Heart failure is a serious condition that can result in early death. How well a person does depends on the cause of the heart failure, as well as the person's age and ability to tolerate exercise.

In many cases, there is little chance that the heart will fully recover. However, many forms of heart failure are well controlled with medication and the condition can remain stable for many years with only occasional flare ups of symptoms.

Complications:

• Pulmonary edema
• Total failure of the heart to function (circulatory collapse)
• Abnormal heart rhythms
• Side effects of medications
  • Low blood pressure (hypotension)
  • Lightheadedness, fainting
  • Headache
  • Chronic cough
  • Low electrolyte levels
  • Difficulty with sexual intercourse

Calling your health care provider:

Call your health care provider if symptoms indicating congestive heart failure occur.

Call your health care provider or get to the emergency room if symptoms are severe or if you experience chest pain, weakness, fainting, rapid or irregular heartbeat, increased cough or sputum production, sudden weight gain, or swelling.

Call your baby's health care provider if the infant has weight loss, poor feeding, or does not appear to be growing or developing normally.