Through the efforts of the American College of Cardiology Foundation and American Heart Association, there are clearly defined guidelines for the treatment of heart failure at each of its four classes:
- Class A includes patients who are at risk of heart failure but who have no symptoms or structural heart disease.
- Class B are those patients who have structural heart disease but no signs or symptoms.
- Class C describes those patients who have symptoms – or a history of symptoms (e.g., limitations in physical activity).
- Class D includes those patients who require special interventions (e.g., pacemaker) to reduce their risk of developing additional problems or death.
In all stages of heart failure, lifestyle changes play a significant role in alleviating symptoms and reducing further damage to the heart. Some of these changes include exercising (as recommended by your doctor), reducing salt intake, limiting alcohol, quitting smoking and losing weight.
Depending upon the stage and symptoms of your heart failure, your doctor may prescribe medications to help with the following:
- Reduce strain on heart and relax vessels (e.g., ACE inhibitors or ARBs)
- Reduce fluids and salt (e.g., diuretics)
- Boost heart strength and maintain heart rhythm (e.g., digitalis, ACE inhibitors)
- Control coronary artery disease, high blood pressure, or arrhythmias (e.g., beta blockers, ACE inhibitors, calcium channel blockers or antiarrhythmics)
Procedures, Devices & Surgery
If medications aren’t effectively managing your heart failure, your doctor may suggest surgery. This aggressive approach can treat underlying problems or specific complications of heart failure.
Examples of heart failure surgeries include:
- Balloon angioplasty, stenting, or atherectomy for the treatment of coronary artery disease
- Repair or replacement of faulty heart valves, often using minimally invasive procedures
- Catheter ablation, a pacemaker, or an implantable cardioverter / defibrillator (ICD) to manage heart irregularities
- Cardiac remodeling surgery, insertion of a mechanical heart pump (including use of the newest generation of left ventricular assist devices) or an artificial heart to improve the heart’s pumping ability
- Heart transplantation for eligible patients with end-stage heart failure who cannot be helped by other treatments. If the patient is ruled a candidate for transplant, there is a waiting period for a donor heart, followed by a lifetime of care and monitoring.