Heart Failure - Treatment - Treatment

Heart failure has no cure. But treatment can help you live a longer, more active life with fewer symptoms. Treatment depends on the type of heart failure you have and how serious it is but usually includes heart-healthy lifestyle changes and medicines. You may need a procedure or surgery for some types of serious heart failure. Because heart failure often gets worse over time, it is important for you and your caregivers to discuss your long-term treatment goals with your healthcare team. 

Your healthcare team will also treat any medical condition that caused or worsens your heart failure. 

This video describes possible treatments for heart failure, including lifestyle changes, medicines such as diuretics to get rid of excess fluid, or a heart procedure or surgery. Medical Animation Copyright © 2021 Nucleus Medical Media Inc. All rights reserved. 

Your healthcare team may include a cardiologist (a doctor who specializes in treating heart conditions), nurses, your primary care doctor, pharmacists, a dietitian, physical therapists and other members of your cardiac rehabilitation team, and social workers. 

Healthy lifestyle changes 

Your doctor may recommend these heart-healthy lifestyle changes alone or as part of a cardiac rehabilitation plan: 

  • Lower your sodium (salt) intake. Salt may make your fluid buildup worse. View our Tips To Reduce Salt and Sodium fact sheet. 
  • Aim for a healthy weight since extra weight can make your heart work harder. 
  • Get regular physical activity. Ask your doctor about how active you should be, including during daily activities, work, leisure time, sex, and exercise. Your level of activity will depend on how serious your heart failure is. Sometimes, your healthcare provider might recommend outpatient cardiac rehabilitation services to improve what level of exercise you can do and reduce your risk factors.  
  • Quit smoking. View Smoking and Your Heart for more information. For free help quitting smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848). 
  • Avoid or limit alcohol. Your doctor may recommend that you limit or stop drinking alcohol. You can find resources and support at the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Treatment Navigator. 
  • Manage contributing risk factors. Controlling some of the factors that may worsen heart failure like blood pressure, heart rhythm, and anemia will often improve heart health.  
  • Manage stress. Learning how to manage stress and cope with problems can improve your mental and physical health. Learning relaxation techniques, talking to a counselor, and finding a support group can all help. Visit Relaxation Techniques for Health to learn more about how relaxation techniques can help lower stress and anxiety. 
  • Get good-quality sleep. Sleep disorders such as sleep apnea are common in people who have heart failure. Treating your sleep disorder helps improve your sleep and may help improve your heart failure symptoms. 

Learn more about these healthy lifestyle changes in our Heart-Healthy Living Health Topic.  

Medicines 

Your doctor may prescribe medicines based on the type of heart failure you have, how serious it is, and your response to certain medicines. 

Left-sided heart failure 

The following medicines are commonly used to treat heart failure with reduced ejection fraction. 

  • Medicines to remove extra sodium and fluid from your body, including diuretics and aldosterone antagonists (such as spironolactone). These medicines lower the amount of blood that the heart must pump. Very high doses of diuretics may cause low blood pressure, kidney disease, and worsening heart failure symptoms. Side effects of aldosterone antagonists can include kidney disease and high potassium levels. 
  • Medicine to relax your blood vessels to make it easier for your heart to pump blood. Examples include angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Possible side effects include cough, low blood pressure, and short-term reduced kidney function.  
  • Medicines to slow your heart rate, such as beta blockers and ivabradine. These medicines make it easier for your heart to pump blood and can help prevent long-term heart failure from getting worse. Possible side effects include a slow or irregular heart rate, high blood pressure, and fuzzy vision or seeing bright halos. 
  • Newer medications. Two new groups of medicines approved to lower blood sugar in patients with diabetes, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide (GLP) agonists, may also reduce heart failure hospitalizations. Their use in treating heart failure is currently being studied. 
  • Digoxin to make your heart beat stronger and pump more blood. This medicine is mostly used to treat serious heart failure when other medicines do not help improve your symptoms. Side effects may include digestive problems, confusion, and vision problems. 

Currently, the main treatment for heart failure with preserved ejection fraction are diuretics. Your doctor also may prescribe blood pressure medicines to help relieve your symptoms. 

Right-sided heart failure 

If you have right-sided heart failure, your doctor may prescribe medicines to remove extra sodium and fluid from your body, and medicines to relax your blood vessels. 

Procedures and surgeries 

If your heart failure with reduced ejection fraction worsens, you may need one of the following medical devices:  

You may also need heart surgery to repair a congenital heart defect or damage to your heart. If your heart failure is life-threatening and other treatments have not worked, you may need a heart transplant. 

For people with heart failure and preserved ejection fraction, there are no currently approved devices or procedures to improve symptoms. Researchers are continuing to study possible treatments.