Congestive Heart Failure

Treatment

At Mayo Clinic, doctors trained in heart care (cardiologists) and cardiologists with advanced training in heart failure (heart failure cardiologists) treat people who have congestive heart failure. Mayo Clinic cardiac surgeons have extensive experience in all types of surgery to treat heart failure and other heart diseases. Surgeons perform minimally-invasive heart surgery, implant ventricular assist devices (VADs) and perform heart transplants.

Congestive heart failure treatment can significantly improve your symptoms and help your weakened heart work as efficiently as possible. Doctors treat some people by correcting the underlying cause of the condition, such as controlling a fast heart rhythm, opening blocked arteries or repairing or replacing diseased valves. Heart failure specialists also treat conditions that may aggravate your underlying heart problems, such as sleep apnea, thyroid problems, anemia and other blood abnormalities.

Congestive heart failure treatment at Mayo Clinic may include surgery, medical devices, medications and lifestyle changes.

• Surgery
• Heart valve repair or replacement. Cardiologists may recommend heart valve repair or replacement surgery to treat an underlying condition that led to congestive heart failure. Heart valve surgery may relieve your symptoms and improve your quality of life.
• Coronary bypass surgery. Cardiologists may recommend coronary bypass surgery to treat your congestive heart failure if your disease results from severely narrowed coronary arteries.
• Heart transplant. Some people who have severe congestive heart failure may need a heart transplant.
• Myectomy. In a myectomy, the surgeon removes part of the overgrown septal muscle in your heart to decrease the blockage that occurs in hypertrophic cardiomyopathy. Surgeons may perform myectomy when medication no longer relieves your symptoms.

• Medical devices


Ventricular assist device

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• Ventricular assist device (VAD). When your weakened heart needs help pumping blood, surgeons may implant a VAD into your abdomen and attach it to your heart. These mechanical heart pumps can be used either as a "bridge" to heart transplant or as permanent therapy for people who aren't candidates for a transplant. Mayo Clinic offers VADs to many people who may have no other options.


Cardiac resynchronization therapy device

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• Cardiac resynchronization therapy (CRT) device (biventricular cardiac pacemaker). A cardiac resynchronization therapy device (biventricular cardiac heart pacemaker) sends specifically timed electrical impulses to your heart's lower chambers. CRTs are suitable for people who have moderate to severe congestive heart failure and abnormal electrical conduction in the heart.
• Internal cardiac defibrillator (ICD). Doctors implant ICDs under the skin to monitor and treat fast or abnormal heart rhythms (arrhythmias), which occur in some people who have heart failure. The ICD sends electrical signals to your heart if it detects a high or abnormal rhythm to shock your heart into beating more slowly and pumping more effectively.

• Medications. Doctors usually treat people who have congestive heart failure with medications proven to relieve symptoms and increase survival in people who have heart failure. Your doctor may also prescribe medications to lower blood pressure, improve circulation and prevent blocked arteries or blood thinners to prevent blood clots.

Several types of drugs may help treat your heart failure if you have reduced blood flow pumping out of your heart's main pumping chamber (left ventricle).

• Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors lower blood pressure, improve blood flow and decrease your heart's workload.
• Angiotensin II (A-II) receptor blockers. These drugs provide several benefits of ACE inhibitors without the potential side effect of a persistent cough.
• Beta blockers. Beta blockers slow the heart rate, lower blood pressure and lessen the risk of some abnormal heart rhythms.
• Digoxin. Also known as digitalis, digoxin increases the strength of heart contractions and tends to slow your heartbeat.
• Diuretics. Diuretics prevent fluid from collecting in your body and decrease fluid in your lungs, making breathing easier.
• Nesiritide. Nesiritide, which is given through a vein (intravenously), is a synthetic version of B-type natriuretic peptide (BNP), a hormone that occurs naturally in your body.
• Aldosterone antagonists. These medications may help your heart work better, reverse scarring of the heart and help prolong your life if you have severe congestive heart failure.
• Inotropes. These are intravenous medications used in severe heart failure patients to improve heart pumping function and maintain blood pressure.

Sometimes congestive heart failure becomes severe enough to require hospitalization and monitoring for a few days. While you're in the hospital, you may take medications that quickly help your heart pump better and relieve your symptoms. You may also receive supplemental oxygen. People who have severe congestive heart failure that doesn't improve with treatment may need supplemental oxygen on a long-term basis.

• Lifestyle changes. Lifestyle changes often can relieve symptoms of congestive heart failure and prevent your disease from worsening. Some changes you can make include:
• Avoiding or limiting alcohol to one drink two or three times a week
• Avoiding or limiting caffeine
• Eating a low-fat, low-sodium diet
• Exercising by yourself or in a structured cardiac rehabilitation program
• Maintaining a healthy weight or losing weight if you're overweight
• Quitting smoking
• Reducing stress