There is no curative treatment for heart failure. All attempts to manage the disease involve following recommendations concerning diet, exercise and other habits to alleviate symptoms, reduce disease progression and improve their quality of life, accompanied by a drug treatment.
Suprimir completamente el consumo de tabaco o de alcohol, sea cual sea la causa del fallo cardíaco.
Si es necesario, perder peso.
Mantener una vida activa y evitar el sedentarismo. Se debe practicar un ejercicio físico adecuado a las capacidades de la persona y su estado cardíaco. Las actividades recomendadas más frecuentes son caminar, nadar o pasear en bicicleta. Es importante evitar aquellos ejercicios que supongan grandes esfuerzos y evitar las horas del día de más calor, humedad o frío.
Es recomendable seguir una alimentación equilibrada y suprimir o evitar la cafeína, así como moderar el consumo de grasas y sal porque provoca retención de líquidos.
Dormir al menos 7-8 horas. Es muy importante descansar.
Your cardiologist will prescribe the correct drugs and doses to take; they may later modify these instructions as the condition develops.
Diuretics. This group of drugs helps the kidneys expel excess sodium and water, i.e., they help eliminate any accumulated fluids. They usually take effect 2–3 hours after administration when taken orally. Patients normally take them first thing in the morning and then, if necessary, another dose at midday. You should not take them at night to avoid interrupting your sleep.
Angiotensin-Converting Enzyme Inhibitors (ACEIs). These drugs stop the body from creating a substance called angiotensin that causes the blood vessels to contract and therefore produce high blood pressure. ACEIs have been proven to reduce the hospitalisation period for heart failure and increase patient survival.
Beta-blockers. Beta-blockers reduce heart rate and blood pressure so the heart is under less strain. This group of drugs have also been shown to reduce the hospitalisation period and increase patient survival.
Vasodilators. These drugs dilate or relax blood vessel walls so blood can circulate more easily; this reduces the strain on the heart.
Digitalis-based drugs. Digitalis-based drugs strengthen the heart’s pumping action and increase its ability to contract, thus eradicating the irregular rhythm.
Some patients with advanced heart failure, and who meet certain criteria, can benefit from having some different devices implanted:
Triple chamber pacemaker. A special pacemaker that can “resynchronise” the heart’s electrical and mechanical activity.
Implantable cardioverter defibrillator (ICD). Some patients have malignant heart arrhythmias that can cause death. This special pacemaker applies a small electric shock to the heart and prevents sudden death.
Revascularización del vaso con la implantación de un muelle (stent coronario);
Procedimiento quirúrgico, en el cual se realizan puentes entre la arteria aorta y las arterias coronarias, de forma que se reconectan vasos para evitar la obstrucción.
If the heart failure is caused by valvular heart disease, then they can be repaired surgically or replaced with artificial valves.
Heart transplant. In very specific cases, the final therapeutic option may be a heart transplant. This option is only performed in highly specialised centres and requires a complex post-op monitoring protocol.
Ventricular assist device. As occurs with heart transplants, only in certain cases and based on the cardiologist’s expert opinion, these devices equipped with a small motor are implanted in the heart so they can help pump blood to the rest of the body.
Coronary catheterisation involves accessing the coronary arteries, which supply blood to the heart muscle, to perform certain procedures using special catheters. The catheterisation may be performed for diagnostic or therapeutic reasons; in the latter case, stents (cylindrical metal meshes) are implanted in the arteries to keep them open.
- Right heart catheterisation. Consists of accessing the heart through a vein, normally either the jugular (neck), femoral (groin) or basilic vein (arm). It is performed under local anaesthetic, so you may notice a pin prick when this is administered. The catheter is used to access the right heart chambers, to measure their pressures, and the main pulmonary artery and its principal branches, to obtain information about the pressures in the right heart chambers and the lung. The procedure is also used to calculate the resistance the heart must overcome to function properly.
- Left heart catheterisation. Consists of accessing the left heart chambers by means of an artery, usually the radial or femoral artery, in the wrist and groin respectively. This type of catheterisation is used to measure the pressures in the left-hand chambers and the difference between them, or to perform a coronary artery catheterisation.