HEART FAILURE TREATMENT OPTIONS

1) Lifestyle modifications. These are steps you can take to help improve your health.

• Restricting sodium intake to less than 2 grams per day
• Limiting fluid intake (including jello, soup, and ice cream) to about 8 cups per day
• Giving up smoking
• Limiting or eliminating alcohol intake
• Getting moderate exercise, such as walking, swimming, or biking

2) Medications

Angiotensin converting enzymes inhibitors (ACE-I) drugs are the cornerstone of heart failure therapy. They help to decrease the amount of work the heart has to do by opening the blood vessels more widely to allow more blood flow from the heart to the rest of the body. They also help to prevent further damage of the heart muscle. These drugs have been shown to improve cardiac function and clinical status, improve quality of life, reduce hospitalizations, and prolong life. Some ACE-1 drugs are:

• Captopril (Capoten®)
• Enalapril (Vasotec®)
• Lisinopril (Zestril®, Prinivil®)
• Ramipril (Altace®)

Beta Blockers help to decrease the amount of work the heart has to do by decreasing the heart rate and helping the heart pump more strongly. They can help block the negative effects of certain neurohormones, substances in the body that can weaken the heart. Beta Blockers that have been studied in large clinical trials are:

• Carvedilol (Coreg®)
• Metoprolol (Toprol XL®)
• Bisoprolol (Zebeta®)

Diuretics help rid the body of excess fluid. Commonly used ones are:

• Furosemide (Lasix®)
• Bumetanide (Bumexe®)
• Metolazone (Zaroxolyn®, Mykrox®)
• Hydrochlorothiazide (Esidrix®, HydroDIURIL®)

Spironolactone (Aldactone®) This mild diuretic, which preserves blood potassium and blocks the neurohormone aldosterone, has also been shown to prolong life in advanced heart failure.

Digoxin (Lanoxin®) helps the heart to contract more strongly so that it can pump blood to the body more efficiently. This drug can slow the heart rate, which can decrease the amount of work the heart has to do.

Vasodilators help open (dilate) blood vessels to allow blood to flow more easily. Commonly used vasodilators are:

• Hydralazine (Apresoline®)
• Nitrates (Isordil®, IMDUR®, ISMO®, Sorbitrate®, Nitroglycerin)
• Intravenous (I.V. ) Nitroglycerin
• I.V. Nitroprusside (Nipride®) 

Inotropes help the heart to contract more strongly in patients with severe, decompensated heart failure. Commonly used inotropes are:

• I.V. Dopamine (Dopacard®)
• I.V. Dobutamine (Dobutrex®)
• I.V. Milrinone (Inocor®)