Treatment depends on the cause of heart failure, the type and severity of symptoms and how well the body is able to compensate. Early testing is important because early treatment can sometimes prevent heart failure from worsening or even reverse its progress. Lifestyle changes and medication can improve the quality and length of life.
Life style modifications:
Regardless of cause of failure and severity of symptoms, there are certain rules to follow for every one. Diet and lifestyle modifications are important in managing the symptoms.
Limit Fluid intake. Excessive fluid puts extra load on heart and can make it harder for the already weakened heart to pump. Monitoring fluid intake can reduce complications and hospitalization. All foods that melt such as ice cream, gelatin, or frozen ice treats and foods that contain a lot of liquid such as soup are considered liquids. To relieve thirst without taking extra water, chewing gum or rinsing mouth with water and spitting it out can be tried.
Limit sodium intake: When a patient has heart failure, one need to eat less sodium, a component of salt, Excessive sodium leads to retention of water that makes it harder for the weakened heart to pump and leads to worsening of heart failure. Fluid may build up in the lungs – making it harder to breath. It may accumulate in feet, ankles, legs, and abdomen. Sodium intake should be limited to less than 2 g (2000 mg) per day and keeping track of sodium intake is the surest way of evaluating diet. Processed and restaurant food are high in sodium. Remember, food can be tasty and still be low in sodium.
Exercise: Exercise is very important for people with heart failure. If the patient is not already active, he should be encouraged to start an exercise program. Prescribed exercise is often part of a cardiac rehabilitation program.
Weight: Heart is entrusted with the responsibility of supplying nutrition in the form of blood to all parts of body. Losing weight can favourable lessen the load on heart. Over weight patients should be very strongly urged to lose weight.
Smoking: Smoking increases the risk of heart disease and makes it more difficult to exercise.
High blood pressure: Exercising, limiting salt intake, and controlling stress can help keep blood pressure in a healthy range.
2. Drugs: We are lucky that we have a host of drugs available, to not only control the complaints associated with heart failure but also favourably effect the eventual outcome. Added medications may be used depending on how well the patient tolerates the prescribed medications:
· Diuretics: Water tablets form the corner stone of heart failure treatment. The body is over loaded with extra fluid and the only way to get ride of this is through increased urine output. The drug has to be used very carefully because excessive use can lead to loss of salts and water leading to dehydration. Supplements of potassium are required on a regular basis to compensate for the loss. Some diuretics have special Potassium retaining effect and the combination of a loop diuretic and potassium sparing diuretic makes a logical choice. Renal function may dictate the type of diuretic to be used.
· ACE inhibitors: ACE inhibitors have been a wonderful addition in the armamentarium of anti-failure drugs. They have been proven to reduce death rate and improve symptoms in patients with mild, moderate or severe heart failure. Their efficacy has been established in patients with poor heart function but no obvious evidence of heart failure. This medication reduces the heart’s workload, lowers blood pressure, and optimizes heart function. Every patient with heart failure should benefit from ACE inhibitors. Some patients develop intractable cough with ACE inhibitors, they can benefit from the new class of drugs called Angiotensin receptor inhibitors.
· Beta Blockers: Beta blockers have revolutionized the management of heart failure patients. The research one the use of Beta blockers in heart failure, has shown that Beta blockers prevent worsening heart failure and in some cases improve heart function. However, some patients are not able to take them because of their side effects.
· Additional medications for coronary artery disease (CAD), high blood pressure, diabetes, infection or inflammation of the heart muscle (such as myocarditis), thyroid problems, heart valve problems, and abnormal heart rhythms (arrhythmias) may be required.
3. Definitive treatment:
In some cases, heart failure can be reversed when the underlying problem can be corrected, such as heart valve replacement surgery and treatment for hyperthyroidism. Sometimes heart failure develops shortly after a heart attack; heart failure can sometimes be reversed in these cases when treatments such as coronary artery bypass surgery or angioplasty, medication, and cardiac rehabilitation improve blood flow.
4. New treatment options:
Recent research has focused on developing devices that can help cardiac failure.
· Cardiac resynchronization therapy: Biventricular pacemakers can synchronize the rhythm of the heart’s chambers (cardiac resynchronization). Cardiac resynchronization is typically used for people with heart failure who also have certain problems with their heart’s electrical system. A recent study suggests that cardiac resynchronization may offer improvements in heart function, exercise capacity, and quality of life beyond that seen with medications alone in these people.
· In some cases when standard medical treatment does not help worsening symptoms of heart failure, other measures are considered. These include heart transplant, artificial hearts, and left ventricular assist devices (LVADs) – mechanical pumping devices that are implanted into the chest. However, these options are only for a very small number of people.
Heart failure is a life long malady and it demands understanding and commitment by the patient. Patient’s attitude and level of participation in the treatment can strongly effect the treatment outcome. Making the required changes in life style and complying with dietary restrictions can have a positive impact on the eventual prognosis. Taking the medications as directed, controlling the diet, and getting regular exercise are key lifestyle changes to control heart failure symptoms and preventing worsening of heart failure.
___________________________________________________
Ref: Heal Thy Heart written by Prof: Dr. Muhammad Hafizullah
Life style modifications:
Regardless of cause of failure and severity of symptoms, there are certain rules to follow for every one. Diet and lifestyle modifications are important in managing the symptoms.
Limit Fluid intake. Excessive fluid puts extra load on heart and can make it harder for the already weakened heart to pump. Monitoring fluid intake can reduce complications and hospitalization. All foods that melt such as ice cream, gelatin, or frozen ice treats and foods that contain a lot of liquid such as soup are considered liquids. To relieve thirst without taking extra water, chewing gum or rinsing mouth with water and spitting it out can be tried.
Limit sodium intake: When a patient has heart failure, one need to eat less sodium, a component of salt, Excessive sodium leads to retention of water that makes it harder for the weakened heart to pump and leads to worsening of heart failure. Fluid may build up in the lungs – making it harder to breath. It may accumulate in feet, ankles, legs, and abdomen. Sodium intake should be limited to less than 2 g (2000 mg) per day and keeping track of sodium intake is the surest way of evaluating diet. Processed and restaurant food are high in sodium. Remember, food can be tasty and still be low in sodium.
Exercise: Exercise is very important for people with heart failure. If the patient is not already active, he should be encouraged to start an exercise program. Prescribed exercise is often part of a cardiac rehabilitation program.
Weight: Heart is entrusted with the responsibility of supplying nutrition in the form of blood to all parts of body. Losing weight can favourable lessen the load on heart. Over weight patients should be very strongly urged to lose weight.
Smoking: Smoking increases the risk of heart disease and makes it more difficult to exercise.
High blood pressure: Exercising, limiting salt intake, and controlling stress can help keep blood pressure in a healthy range.
2. Drugs: We are lucky that we have a host of drugs available, to not only control the complaints associated with heart failure but also favourably effect the eventual outcome. Added medications may be used depending on how well the patient tolerates the prescribed medications:
· Diuretics: Water tablets form the corner stone of heart failure treatment. The body is over loaded with extra fluid and the only way to get ride of this is through increased urine output. The drug has to be used very carefully because excessive use can lead to loss of salts and water leading to dehydration. Supplements of potassium are required on a regular basis to compensate for the loss. Some diuretics have special Potassium retaining effect and the combination of a loop diuretic and potassium sparing diuretic makes a logical choice. Renal function may dictate the type of diuretic to be used.
· ACE inhibitors: ACE inhibitors have been a wonderful addition in the armamentarium of anti-failure drugs. They have been proven to reduce death rate and improve symptoms in patients with mild, moderate or severe heart failure. Their efficacy has been established in patients with poor heart function but no obvious evidence of heart failure. This medication reduces the heart’s workload, lowers blood pressure, and optimizes heart function. Every patient with heart failure should benefit from ACE inhibitors. Some patients develop intractable cough with ACE inhibitors, they can benefit from the new class of drugs called Angiotensin receptor inhibitors.
· Beta Blockers: Beta blockers have revolutionized the management of heart failure patients. The research one the use of Beta blockers in heart failure, has shown that Beta blockers prevent worsening heart failure and in some cases improve heart function. However, some patients are not able to take them because of their side effects.
· Additional medications for coronary artery disease (CAD), high blood pressure, diabetes, infection or inflammation of the heart muscle (such as myocarditis), thyroid problems, heart valve problems, and abnormal heart rhythms (arrhythmias) may be required.
3. Definitive treatment:
In some cases, heart failure can be reversed when the underlying problem can be corrected, such as heart valve replacement surgery and treatment for hyperthyroidism. Sometimes heart failure develops shortly after a heart attack; heart failure can sometimes be reversed in these cases when treatments such as coronary artery bypass surgery or angioplasty, medication, and cardiac rehabilitation improve blood flow.
4. New treatment options:
Recent research has focused on developing devices that can help cardiac failure.
· Cardiac resynchronization therapy: Biventricular pacemakers can synchronize the rhythm of the heart’s chambers (cardiac resynchronization). Cardiac resynchronization is typically used for people with heart failure who also have certain problems with their heart’s electrical system. A recent study suggests that cardiac resynchronization may offer improvements in heart function, exercise capacity, and quality of life beyond that seen with medications alone in these people.
· In some cases when standard medical treatment does not help worsening symptoms of heart failure, other measures are considered. These include heart transplant, artificial hearts, and left ventricular assist devices (LVADs) – mechanical pumping devices that are implanted into the chest. However, these options are only for a very small number of people.
Heart failure is a life long malady and it demands understanding and commitment by the patient. Patient’s attitude and level of participation in the treatment can strongly effect the treatment outcome. Making the required changes in life style and complying with dietary restrictions can have a positive impact on the eventual prognosis. Taking the medications as directed, controlling the diet, and getting regular exercise are key lifestyle changes to control heart failure symptoms and preventing worsening of heart failure.
___________________________________________________
Ref: Heal Thy Heart written by Prof: Dr. Muhammad Hafizullah
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