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Congestive Heart Failure Treatment

MEDICAL ENCYCLOPEDIA 
Congestive Heart Failure Treatment
Congestive Heart Failure
Causes and Risk Factors
Symptoms
Diagnosis
Treatment

Congestive heart failure treatment
People diagnosed with chronic heart failure (CHF) can live longer and be more active, as long as CHF is diagnosed early and treated properly. Treatment hinges on two factors, heart failure type, and level of severity. A doctor will frequently use a three-pronged attack in treating CHF, using medicines, ongoing patient care, and lifestyle adjustments. In this way, certain goals can be met:

  1. Improve quality of life, increased lifespan
  2. Reduction of symptoms
  3. Stop progress of heart failure
  4. Treat root causes of failure, like high blood pressure, artery disease

When you work with your doctor as a team, CHF can be effectively managed or even reversed. It requires open and honest communication about medications, diet, and lifestyle adjustments. Proper strategies can be implemented to reduce the negative impacts of CHF. These options follow.

Children's treatment
Age and disease type are the determining variables in treating children for CHF. In babies born with heart defects, surgery may be required. Doctors use medical therapy until the child is strong enough for an operation. With some congenital defects, transplant is the only option. Although this is also true for older children, medication can be effective in treating their CHF:

  • diuretics to eliminate excess fluid
  • ACE inhibitors to lower blood pressure
  • beta-blockers to lower blood pressure
  • meds to boost heart performance
  • a feeding tube to provide needed nutrition to the stomach

Clinical trials
Advancements in treating CHF are waiting in the wings, providing new hope for those who suffer from heart failure. Here is an abbreviated list of those under study:

Cardiac wrap surgery - When the heart weakens, it enlarges (dilates) to work harder, eventually leading to failure. Surgeons can encase the heart in a mesh bag that inhibits dilation. The bag is attached to the heart with stitches.

Enhanced external counter pulsation (EECP) - This is a noninvasive treatment whereby inflatable cuffs encircling the calves, thighs and buttocks are pressurized and deflated in sync with the heartbeat. This promotes more blood flow to the heart. It was originally used to treat heart-related chest pain.

Ventricular restoration surgery - A heart attack often results in scar tissue that forms in the muscles of the ventricles. This severely impacts the ventricle's pumping ability. Surgeons can now reshape damaged ventricle muscle and remove dangerous scar tissue.

Diet
A few changes in diet, as well as weight control can help you treat heart problems. Try first to maintain a healthy weight. Ideal body weight can reduce high blood pressure and strain on the heart. To calculate ideal body weight, learn more about body mass index BMI. Ideal weight is somewhere around a BMI of 19% to 24.9%.Check your weight each day before breakfast, after you have urinated. A sudden weight gain of 3 or so pounds may indicate fluid retention. Your treatment regimen may need to be adjusted. Keep a journal of daily weight for the doctor. Other diet suggestions follow.

Limit alcohol/fluid intake - Abuse of alcohol can weaken heart muscle, as well as potentially interacting dangerously with CHF medications.

Limit fats/cholesterol - These can promote coronary artery disease that can lead to heart failure. One should avoid foods high in sodium, trans fats, saturated fats, and cholesterol.

Restrict sodium - Salt keeps fluid in the blood vessels and increases the blood pressure,which strains the heart, and can affect breathing. Swelling may occur in the legs, ankles, and feet. Processed foods are usually high in sodium. One should limit themselves to no more than 2,000 mg of sodium daily. Avoid salt substitutes since many contain potassium chloride, which can work against your medication.

Lifestyle changes
Minor changes can go a long way in combating CHF. A doctor can determine which are best for each individual case, but here are some of the more common and beneficial changes one can make:

Exercise - Moderate exercise, such as walking, can lower the heart's workload as it conditions the rest of the body. Check also to see if the hospital has a cardiac rehabilitation program; a doctor can enroll you.

Reduce stress - Stress exacerbates heart problems, putting additional strain on the heart. Relax as much as possible.

Sleep easy - To combat shortness of breath at night, prop the head at a 45-degree angle with a pillow. Those who snore should be tested for sleep apnea, as the body may be deprived of oxygen while sleeping, causing heart strain.

Stop smoking - Smoking robs the blood of oxygen, increases heartbeat, and damages blood vessels. A doctor can recommend an effective program to quit. Those who smoke are prohibited from receiving heart transplants.

Medications
One or more may be needed to deal with adult CHF. Here is a list of the most common medications a doctor may prescribe:

Angiotensin-converting enzyme (ACE) inhibitors - Vasodilators that widen blood vessels, and suppress hormonal salt/water retention. Effects are lower blood pressure, and fewer loads on the heart. Names: enalapril, lisinopril, captopril.

Aldosterone antagonists - Diuretics that can assist the heart, extend life for CHF sufferers, and reverse heart scarring. It is important to note that these may raise potassium to dangerous levels if not monitored. Names: spironolactone, eplerenone.

Angiotensin II receptor blockers (ARBs) - Used to alleviate blood pressure, increase proper blood flow, and relieve the overworked heart, just as ACE inhibitors (see above) without the side effect of persistent coughing.

Beta-blockers - Used to lower blood pressure, slow heart rate, and improve heart function. Useful in treating abnormal heart rhythms but should never be used for brachycardia diagnoses or other types of A-V block of the impulses.

Blood thinners - May be added along with other medications to prevent blood clotting.

Digoxin, AKA Digitalis - Increases contraction strength in the heart muscle, slows heartbeat, reduces symptoms, and promotes overall well being (but should never be used for brachycardia diagnoses or other types of A-V block of the impulses).

Diuretics - Used to eliminate excess fluid in the body, especially buildup in the lungs. Promotes easier breathing. Users may require supplementation of potassium and magnesium, which are lost due to the drugs.

Nitrates – These drugs are prescribed to help alleviate chest pain.

Statins – Doctors use this class of drugs to lower cholesterol.

Prevention
By reducing risk factors such as coronary artery disease or high blood pressure, heart failure can be prevented. Lifestyle adjustment and helpful medications can increase success in this area.

Surgery
In order to treat some root causes of CHF, surgery may be necessary. Or in cases of severe heart failure, surgery and other procedures may be necessary.Surgery can correct/replace damaged valves or narrow coronary arteries, such as in the case of bypass surgery. People with severe heart failure may need an artificial heart or even a heart transplant. Here is a list of the most common procedures:

Cardiac resynchronization therapy (CRT)/ or Biventricular pacing - This procedure involves insertion of a pacemaker, designed to stimulate the ventricles of the heart with electrical pulses that make the heart function more consistently. It also re-establishes proper heart rhythm.

Heart pumps - Once used to keep transplant candidates alive while waiting for the replacement heart, these mechanical devices are increasingly used today instead of actual transplants. These Left Ventricular Assist Devices (LVADs) are implanted in the abdominal region, and can greatly extend life.

Heart transplant - When surgery and medicines can no longer aid severe heart failure, the organ must be replaced with a healthy one. Unfortunately, the wait for a donor heart can take years. The good news is that modern drug therapy and new devices may enable a candidate to be removed from the waiting list.

Implantable cardioverter defibrillators (ICDs) - This implant keeps track of heart rhythm. If the heartbeat becomes irregular, the ICD sends an electrical charge to the heart that readjusts the rhythm to normal. ICDs may be used in conjunction with a pacemaker in more severe heart failure cases.

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Tags: Congestive Heart Failure, abnormal heart rhythms, heart transplant, artificial heart, heart problems, heart failure, heart defects, heart muscle, Heart Attack, heart rhythm, heart rate, heart, angiotensin ii receptor blockers, angiotensin ii receptor, aldosterone antagonists, cardiac rehabilitation, High Blood Pressure, treatment regimen, Body Mass Index, rehabilitation
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