How is heart failure treated? 

James Ampadu, MD

Cardiology

Your heart is the most essential muscle in your body, constantly at work moving blood through your body, supplying oxygen to your mind and organs. The idea that it can fail is a scary one. But what is heart failure, exactly? Are there warning signs to watch out for? How is heart failure treated? 

Cardiologist James Ampadu, MD, spoke with us on heart failure, including how heart failure is treated, whether it is curable and more. 

What is heart failure? 

“Heart failure is when the heart is too stiff or weak to complete its job of circulating blood through the body,” said Dr. Ampadu. 

Heart failure is a long-term condition, causing increasingly significant symptoms and potentially limiting how well you live or how long.  

What are the most common symptoms of heart failure? 

“Shortness of breath is a common potential sign of heart failure, although it’s easy to mistake for other things in everyday life,” said Dr. Ampadu. “When the heart isn’t pumping effectively, fluid can build up in the lungs, causing difficulty breathing.” 

Other common symptoms of heart failure include: 

• Fatigue 

• Chest discomfort 

• Memory loss 

• Lack of appetite 

• Leg swelling 

• Weight gain 

How have treatment options for heart failure changed over time?  

“The development of new medications has helped us to improve not just survival rates for those living with heart failure but also allowed us to see big improvements in symptoms,” said Dr. Ampadu. “Cutting-edge device therapies have been shown to improve quality of life and overall survival.” 

In addition, more research trials are available for patients that suffer from heart failure. 

What are some advances in heart failure treatment options? 

“Alongside newlydeveloped medications, there are some amazing device therapies that have been shown to help heart failure patients get their lives back,” said Dr. Ampadu. 

Left ventricular assist devices, or LVADs, significantly improve the life expectancy of patients who have advanced heart failure. Newer diagnostic tests help pinpoint the cause or manner of heart failure, which means treatments can be more successfully targeted. 

How does cardiac rehab help with heart failure? 

“Cardiac rehab can help improve exercise capacity and muscle strength and lower cardiovascular disease risk ,” said Dr. Ampadu. 

Cardiac rehab is a supervised program that is a little different for every patient, designed to help improve overall health in people with heart disease. It can involve exercise training, education about how to live a lifestyle that’s easier on your heart, advice on healthy eating, and emotional support as you make big changes and face such a potentially overwhelming diagnosis. 

For many, quitting smoking will be a big part of their cardiac rehab, as smoking increases the likelihood of multiple harmful conditions, including heart disease.  

What medications might be prescribed to someone with heart failure, and how do they work? 

“There’s a list of drug therapies that have been shown to improve quality of life and survival in heart failure,” said Dr. Ampadu. “These are listed as guideline-directed medical therapies, with five classes.” 

Medications prescribed for heart failure include: 

• Beta blockers 

• Renin-angiotensin-aldosterone-system inhibitors, or RAAS inhibitors 

• Mineralocorticoid receptor antagonists 

• Sodium-glucose-co-transport inhibitors 

All these medications work by blocking the negative effects of heart failure while promoting the positive effects to strength the heart.  

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What lifestyle changes can help to improve quality of life in someone with heart failure? 

“First, weight management is a big part of building a healthy lifestyle when you’re living with heart failure,” said Dr. Ampadu. “Obesity is a chronic condition that has cascading negative effects on your overall health. Treating that condition is important for treating heart failure.” 

Healthy eating  is also a big part of giving your heart a break when it needs one the most. Patients with heart failure should avoid alcohol and sodium-heavy food.  

“We also heavily advise prioritizing plenty of genuinely restful sleep,” said Dr. Ampadu. “Sleep is something that many of us don’t think about when it comes to health, but getting enough sleep can improve not just how awake and alert you feel, but your overall health and well-being.” 

Finally, managing your blood pressure is essential. For some, lowering high blood pressure might involve no more than regularly staying active and exercising and changing their diet. Others may need medications or stronger treatments to keep their blood pressure at healthy levels. 

What is cardiac resynchronization therapy?  

“This kind of therapy is best for those who have what we call dyssynchrony in their conduction system,” said Dr. Ampadu. “Basically, your heart works best when it keeps a consistent, constant rhythm where your ventricle muscles contract at the same time. Dyssynchony, which is often seen first during an EKG, or echocardiogram, happens when your heartbeat isn’t lining up correctly.” 

Cardiac resynchronization therapy involves implanting a specific pacemaker to fix the dyssynchrony and maintain your heart’s rhythm. People who receive pacemakers often find their quality of life improves after recovery. 

What surgical treatment options can help with heart failure? 

“For those who have valvular disease associated with heart failure, there are surgical valve treatments,” said Dr. Ampadu. “There are also several devices that can be implanted to improve symptoms in patients that remain on medications.” 

Devices that may be surgically implanted as part of a heart failure treatment plan include: 

• Cardiac contractility modulation 

• Baroreflex activation therapy 

• Biventricular pacemaker 

• Defibrillators 

• And other investigational devices 

Those living with advanced heart failure, ongoing persistent symptoms or hospitalizations on medications, left ventricular assist device therapy (LVAD) and heart transplantation are surgical options. 

Can someone with heart failure live a normal life if they follow their treatment plan? 

“I love answering this question, because the answer is yes,” said Dr. Ampadu. “Someone with heart failure who follows the treatment plan will be able to live a normal, active life.”