Treatment: How is heart failure treated?

The goals of treating heart failure include the following:

• Decrease the likelihood of disease progression, thereby decreasing the risk of death and the need for hospitalization
• Lessen symptoms
• Improve quality of life

How to decrease the likelihood of disease progression if you have heart failure

• Keep your blood pressure low. In heart failure, the release of hormones cause the blood vessels to constrict or tighten. The heart must work hard to pump blood through the constricted vessels. It is important to keep your blood pressure as low as possible, so that your heart can pump effectively without extra stress.
• Schedule regular visits with your heart failure doctor or nurse to monitor your progress
• Monitor symptoms.
• Check for changes in your fluid status (daily weights and checking for swelling).
• Schedule regular follow-up visits with your special team of doctors and nurses. If you have questions, write them down and bring them to your appointment. Call your doctor if you have urgent questions. (Click here to find a doctor who treats heart failure)
• Notify all your doctors about your heart failure, medications and any restrictions. Check with your heart failure doctor about any new medications prescribed by another doctor.
• Keep good records and bring them with you to each doctor visit.
• Decrease risk of further heart damage
  • Stop smoking.
  • Reach and maintain your healthy weight.
  • Control high blood pressure, high blood cholesterol and diabetes.
  • Exercise regularly.
  • Do not drink alcohol.
  • Have surgery or other procedures to treat your heart failure or what may have caused it .

What to bring to your doctor visit:

• Medication list
• Daily weights
• List of symptoms - what they are, when they occur, how long they last, and what relieves them
• Test and lab results
• Records from all doctor or emergency room visits
• Questions

How to lessen symptoms of heart failure

• Maintain fluid balance
• Decrease sodium (salt) in your diet .
  Sodium is found naturally in many foods we eat. It is also added for flavoring (known as salt!) or to preserve food (make it last longer). If you follow a low-sodium diet, you should have less fluid retention, less swelling and breathe easier. See Nutritional Guidelines for Heart Failure.*
• Weigh yourself daily.
  Weigh yourself each morning, in similar clothing, after urinating, but before eating, and on the same scale. Record your weight in a diary or calendar. If you gain two pounds in one day or five pounds in one week, call your doctor. Your doctor may want to adjust your medications. See Monitoring Your Health When You Have Heart Failure. *
• Learn what your "dry" or "ideal" weight is.
  This is your weight without extra water (fluid). Your goal is to keep your weight within four pounds of your dry weight.
• Your doctor may also ask you to:
  • drink or eat less fluids
  • keep a record of the amount of fluids you drink or eat and your urine output. Re member, the more fluid you carry in your blood vessels, the harder the heart must work to pump excess fluid through the body. A 2000 mg sodium diet and limiting fluid intake to less than 2 liters per day will help decrease the workload of your heart and prevent symptoms from recurring.
• Monitor your symptoms. Call your doctor:
  • if new symptoms occur
  • if your symptoms worsen

  Do NOT wait for your symptoms to become so severe that you need to seek emergency treatment. See When to Call the Doctor about Your Heart Failure Symptoms.

• Take your medications as prescribed.
  • Medications are used to improve your heart’s ability to pump blood, decrease stress on your heart, decrease the progression of heart failure (ventricular remodeling) and prevent fluid retention.
  • Many heart failure medications are used to decrease the release of harmful hormones. These drugs will cause your blood vessels to dilate or relax (thereby lowering your blood pressure).
  • Common medications for heart failure
    • ACE-inhibitors
    • beta-blockers
    • digoxin
    • diuretics
    • anticoagulants (blood thinners), if needed
  • Other medications are used to treat any associated problems, such as controlling abnormal heart rhythms, hypertension and high cholesterol.
  • Medications you should avoid if you have heart failure
    • non-steroidal anti-inflammatory drugs
    • most antiarrhythmic agents
    • most calcium antagonists
    • some nutritional supplements and growth hormone therapies
    • antacids that contain sodium (salt)
    • decongestants (they make your heart work harder)

    If you are taking any of these medications, discuss this with your doctor.

  • Check the drug search to find out more about your medications. It is important to know:
    • the names of your medications
    • what they are for
    • how often and at what times to take them.
  • Keep a list of your medications and bring them to each of your doctor visits.
  • Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively.
• Improve the heart's function through:

• surgery
• biventricular pacemaker

How to improve your quality of life

• Eat a healthy diet
• Eat less than 2,000 milligrams (2 grams) of sodium each day.
• Eat foods high in fiber and potassium. See potassium guidelines for heart failure.*
• Reach and maintain a healthy weight (you may need to fewer calories per day).
• Limit foods high in fat, cholesterol and sugar.
• Manage your fluids
• Weigh yourself daily.
  Keep your weight within four pounds (two pounds lower or higher) than your dry weight.
• Limit fluid intake to 2 liters or less per day.
• Be creative in managing your thirst.
• See Monitoring Your Health When You Have Heart Failure . *
• Exercise regularly
  A regular cardiovascular exercise program, prescribed by your doctor, will help improve symptoms, strength and your sense of well-being. It may also decrease heart failure progression. See Heart Failure Exercise Guidelines.
• Avoid heavy exercise or activities
  Activities, such as pushing or pulling heavy objects, shoveling, or strenuous occupations, may worsen heart failure and its symptoms.
• Prevent respiratory infections
  Ask your doctor about flu and pneumonia vaccines.
• Take your medications as prescribed
  Do not stop taking them without first contacting your doctor.
• Get emotional or psychological support – if you need it

Heart failure can be difficult for your whole family. If you have questions, ask your doctor or nurse. If you need emotional support, social workers, psychologists, clergy and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.

Heart Failure Management Program

You may benefit from a heart failure disease management program. As part of this program, doctors and nurses provide frequent contact with you (through office visits, telephone calls or home monitoring) to alleviate symptoms, prevent symptoms from recurring and decrease the need for emergency care or hospitalization. In this program, emphasis is placed on increasing your knowledge of heart failure and helping you self-manage your condition. Ask your doctor about Heart Failure Management Programs he or she may be affiliated with. At the Cleveland Clinic, call 216-444-4604.

*a new browser window will open with this link.

If you need more information, click here to contact us , chat online with a nurse or call the Heart and Vascular Institute Resource & Information Nurse at 216/445-9288 or toll-free at 866/289-6911. We would be happy to help you.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/06