Congestive heart failure treatment

In order to diagnose congestive heart failure³⁹, your healthcare provider will review your medical history, listen to your symptoms, and perform a physical examination. This examination may include using a stethoscope to listen to your lungs for signs of congestion and detect abnormal heart sounds that may suggest the presence of heart failure.

Your provider will likely check for the presence of risk factors, such as high blood pressure, coronary artery disease, and diabetes. He or she may also examine the veins in your neck and check for a buildup of fluid in your abdomen and legs.

After performing a physical exam, your healthcare provider may also order the following tests:

• Blood tests: Your provider may take a blood sample to look for signs of diseases that affect the heart. He or she may also check for the presence of a chemical called N-terminal pro-B type natriuretic peptide (NT-proBNP) if your diagnosis isn’t certain after other tests.
• Chest X-ray⁴⁰: X-ray images help show the condition of your lungs and heart. Your provider or a radiologist can also use an X-ray to diagnose conditions other than heart failure that may contribute to your signs and symptoms.
• Electrocardiogram⁴¹ (ECG): This test measures the electrical activity, rate, and regularity of your heartbeat through electrodes attached to your skin. It helps your provider diagnose heart rhythm problems and damage to your heart.
• Echocardiogram: An echocardiogram⁴² uses ultrasound (high-frequency sound waves) to produce a video image of your heart. This can help specialists see the size and shape of your heart, along with any abnormalities that may be present. An echocardiogram measures your ejection fraction, an important measurement of how well your heart is pumping that is used to help classify heart failure and guide treatment.
• Stress test: Stress tests measure the health of your heart by how it responds to exertion. You may be asked to walk on a treadmill while attached to an ECG machine, or you may receive a drug intravenously that stimulates your heart similar to the way exercise does. Stress tests can sometimes also be done while wearing a mask that measures the ability of your heart and lungs to take in oxygen and expel carbon dioxide.
• Cardiac computerized tomography (CT) scan: A cardiac CT scan⁴³ uses an X-ray tube inside a machine that rotates around your body to collect images of your heart and chest.
• Magnetic resonance imaging (MRI): A cardiac MRI⁴⁴ produces a magnetic field that aligns atomic particles in some of your cells. Radio waves are broadcast toward these aligned particles, producing signals that create images of your heart.
• Coronary angiogram⁴⁵: In this test, a thin, flexible tube (called a catheter) is inserted into a blood vessel in your groin or arm and guided through the aorta into your coronary arteries. This test uses an injectable contrast dye to spot any blockage that may disrupt the flow of blood through the coronary arteries on an X-ray.
• Myocardial biopsy: In this test, a small, flexible biopsy cord is inserted into a vein in your neck or groin, and small pieces of the heart muscle are taken. This test may be used to diagnose certain types of heart muscle diseases that cause heart failure.

Congestive heart failure medications

Your healthcare provider may suggest medication in treating congestive heart failure.

Congestive heart failure prognosis

In one study⁴⁶, the factors determining the prognosis in 100 patients with recent-onset CHF were evaluated. The study determined that the survival rates at the 1, 3, 5, and 10-year markers in the entire group were 78.5%, 59.8%, 50.4%, and 14.7%, respectively.

The study found no correlations between age, sex, heart rate and cardiothoracic ratio, and the cumulative survival rate. However, it was determined that the prognosis of patients with congestive heart failure caused by underlying coronary artery disease or primary cardiomyopathy was poor compared to the prognosis of patients with other types of heart disease.

The study concluded that its results suggest that functional status, underlying heart disease, left ventricular stroke work, and the presence of ventricular tachycardia⁴⁷ provide important information regarding the long-term prognosis in patients with congestive heart failure.

Congestive heart failure treatment

There are a number of ways to treat congestive heart failure, many of which are dependent on the severity of your symptoms.

It is best practice to make healthy lifestyle choices in order to prevent developing heart failure in the first place. If you do have heart failure, however, your lifestyle choices can also help you to manage your signs and symptoms.

In some more severe cases of heart failure, medications and medical procedures may be necessary.

Congestive heart failure prevention

CHF can be prevented⁴⁸ with a combination of healthy lifestyle choices. The best way to avoid developing congestive heart failure is to avoid the conditions that contribute to it (or if these conditions do develop, to carefully manage them).

The following can help prevent the development of congestive heart failure:

• Stop smoking: Smoking is a major factor contributing to the arterial damage that can cause heart failure. Secondhand smoke can also cause damage that can lead to CHF.
• Eat a heart-healthy diet: The foods that help you are those containing little saturated fat, trans fat, sugar, and sodium. The best foods are fruits and vegetables, low-fat dairy, lean protein such as skinless chicken, and “good” fats such as those found in olive oil, fish, and avocado.
• Maintain a healthy weight: Along with diet, being physically active helps achieve weight goals and is great for your heart.
• Closely follow treatment programs: If you have another type of heart disease or a related condition, it’s important that you receive ongoing care and adhere to prescribed medications.

Ventricular assist device

A ventricular assist device⁴⁹, or VAD (also known as a mechanical circulatory support device), is an implantable mechanical pump that helps pump blood from the ventricles (lower chambers of the heart) to the rest of the body. This device is used in people who have weakened hearts or heart failure.

A VAD may be implanted while you wait for a heart transplant or for your heart to become strong enough to pump sufficient blood on its own. Implantation of a VAD may also be recommended as a long-term treatment option if you have heart failure and you’re not a good candidate for a heart transplant.

Ventricular assist devices support the lower left heart chamber (left ventricular assist device, or LVAD), the lower right heart chamber (right ventricular assist device, or RVAD), or both lower heart chambers (biventricular assist device, or BIVAD).

While implantation of a ventricular assist device has serious risks and often requires open-heart surgery, the device can be lifesaving if you have severe heart failure.

If a VAD is not sufficient for helping your condition, your healthcare provider may consider using a total artificial heart⁵⁰ as a treatment option. This device replaces the two lower ventricles. A total artificial heart is generally only considered in people with severe heart failure whose conditions haven’t improved with other treatments.

Heart transplant

A heart transplant⁵¹ replaces the patient’s heart with a donor heart. The patient’s original heart is removed and replaced with a donor heart that is attached to his or her heart’s original structures. In patients with congenital heart disease, the lungs and heart may be simultaneously transplanted.

A heart transplant may be required for several reasons. The procedure is most commonly required when one or both ventricles aren’t functioning properly and severe heart failure is present. Patients who underwent the Fontan procedure⁵² as a child may need a heart transplant when the blood flow through the venous system is slow and the veins are congested, as this can lead to swelling, fluid accumulation, and protein loss.

As with any condition, it is important that you weigh all your options and discuss possible treatments with your healthcare provider extensively. Asking him or her any questions you may have will help you to make the most informed decision about what is best for you.