Treatments and drugs

By Mayo Clinic Staff

Heart disease treatments vary. You may need lifestyle changes, medications, surgery or other medical procedures as part of your treatment.

Cardiovascular disease treatments

The goal in treating diseases of your arteries (cardiovascular disease) is often to open narrowed arteries that cause your symptoms. Depending on how severe the blockages in your arteries are, treatment may include:

  • Lifestyle changes. Whether your heart disease is mild or severe, it's likely your doctor will recommend lifestyle changes as part of your treatment. Lifestyle changes include eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking, and limiting how much alcohol you drink.
  • Medications. If lifestyle changes alone aren't enough, your doctor may prescribe medications to control your heart disease. These could include medications to lower your blood pressure, such as diuretics, angiotensin-converting enzyme (ACE) inhibitors or beta blockers; blood thinning medications, such as daily aspirin therapy; or cholesterol-lowering medications, such as statins or fibrates.
  • Medical procedures or surgery. If medications aren't enough, it's possible your doctor will recommend specific procedures or surgery to clear the blockages in your heart. A common procedure is coronary angioplasty, which is performed by placing a catheter in an artery in your arm or groin and threading a small balloon to your blocked artery and inflating it to reopen the artery. A small metal coil called a stent is often placed in the artery during angioplasty. The stent helps keep the artery open.

    Sometimes a more invasive procedure, coronary artery bypass surgery, is necessary. In this procedure, a vein from another part of your body — usually your leg — is used to bypass the blocked section of the artery.

Heart arrhythmia treatments

Depending on the seriousness of your condition, your doctor may simply recommend maneuvers or medications to correct your irregular heartbeat. It's also possible you'll need a medical device or surgery if your condition is more serious.

  • Vagal maneuvers. You may be able to stop some heart arrhythmias by using particular maneuvers, which include holding your breath and straining, dunking your face in ice water, or coughing. Your doctor may be able to recommend other maneuvers to slow a fast heartbeat. These maneuvers affect the nervous system that controls your heartbeat (vagal nerves), often causing your heart rate to slow. Don't attempt any maneuvers without talking to your doctor first.
  • Medications. People who have a rapid heartbeat may respond well to anti-arrhythmic medications. Though they don't cure the problem, they can reduce episodes of your heart beating rapidly or slow down the heart when an episode occurs. It's important to take any anti-arrhythmic medication exactly as directed by your doctor in order to avoid complications.
  • Medical procedures. Two common procedures to treat heart arrhythmias are cardioversion and ablation. In cardioversion, an electrical shock is used to reset your heart to its regular rhythm. Usually this is done with paddles placed on the chest that can deliver an electrical shock in a monitored setting. You're given medication to sedate you during the procedure, so there's no pain. In ablation, one or more catheters are threaded through your blood vessels to your inner heart. They're positioned on areas of your heart identified by your doctor as causing your arrhythmia. Electrodes at the catheter tips destroy (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.
  • Pacemakers or implantable cardioverter-defibrillators (ICDs). In some cases, your doctor may recommend having a pacemaker or ICD implanted to regulate your heartbeat. Pacemakers emit electrical impulses to quicken your heartbeat if it becomes too slow, and ICDs can correct a rapid or chaotic heartbeat using a similar type of electrical impulse as is used in cardioversion. The surgery to implant each device is relatively minor and usually requires only a few days of recovery.
  • Surgery. For severe heart arrhythmias, or for those with an underlying cause such as a heart defect, surgery may be an option. Because the surgeries to correct heart arrhythmias are open-heart procedures that sometimes require several months for recovery, surgery is often a last-resort treatment option.

Heart defect treatments

Some heart defects are minor and don't require treatment, while others may require regular checkups, medications or even surgery. Depending on what heart defect you have and how severe it is, your treatment could include:

  • Medications. Some mild congenital heart defects, especially those found later in childhood or adulthood, can be treated with medications that help the heart work more efficiently.
  • Special procedures using catheters. Some people now have their congenital heart defects repaired using catheterization techniques, which allow the repair to be done without surgically opening the chest and heart. In procedures that can be done using catheterization, the doctor inserts a thin tube (catheter) into a leg vein and guides it to the heart with the help of X-ray images. Once the catheter is positioned at the site of the defect, tiny tools are threaded through the catheter to the heart to repair the defect.
  • Open-heart surgery. In some cases, your doctor may perform open-heart surgery to try to repair your heart defect. These surgeries are major medical procedures and sometimes require a long recovery time. It's possible you'll need multiple surgeries over several years to treat the defect.
  • Heart transplant. If a serious heart defect can't be repaired, a heart transplant may be an option.

Cardiomyopathy treatments

Treatment for cardiomyopathy varies, depending on what type of cardiomyopathy you have and how serious it is. Treatments can include:

  • Medications. Your doctor may prescribe medications that can improve your heart's pumping ability, such as ACE inhibitors or angiotensin II receptor blockers. Beta blockers, which make your heart beat more slowly and less forcefully, help reduce the strain.
  • Medical devices. If you have dilated cardiomyopathy, treatment may include a special pacemaker that coordinates the contractions between the left and right ventricles of your heart, improving the heart's pumping ability. If you're at risk of serious arrhythmias, an implantable cardioverter-defibrillator (ICD) may be an option. ICDs are small devices implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.
  • Heart transplant. If you have severe cardiomyopathy and medications can't control your symptoms, a heart transplant may be necessary.

Heart infection treatments

The first treatment for heart infections such as pericarditis, endocarditis or myocarditis is often medications, which may include:

  • Antibiotics. If your condition is caused by bacteria, your doctor will prescribe antibiotics. Antibiotics are given by an intravenous (IV) line for two to six weeks, depending on how severe the infection is.
  • Medications to regulate your heartbeat. If the infection has affected your heartbeat, your doctor may prescribe medications such as angiotensin-converting enzyme (ACE) inhibitors or beta blockers to help normalize your heartbeat.

If your heart infection is severe and damages your heart, you may need surgery to repair the damaged portion of your heart.

Valvular heart disease treatments

Although treatments for valvular heart disease can vary depending on what valve is affected and how severe your condition is, treatment options generally include:

  • Medications. It's possible your valvular heart disease, if mild, can be managed with medications. Commonly prescribed medications for valvular heart disease include medications to open your blood vessels (vasodilators), medications to lower your cholesterol (statins), medications that reduce water retention (diuretics) and blood-thinning medications (anticoagulants).
  • Balloon valvuloplasty. This procedure is sometimes used as a treatment for valve stenosis. During this procedure, your doctor threads a small tube through a vein in your leg and up to your heart. An uninflated balloon is placed through the opening of the narrowed pulmonary valve. Your doctor then inflates the balloon, opening up the narrowed pulmonary valve and increasing the area available for blood flow.
  • Valve repair or replacement. If your condition is severe, you may need surgery to correct it. Your doctor may be able to repair the valve. If the valve can't be repaired, it may be replaced with a valve that's made of synthetic materials.
Jan. 16, 2013