How to Manage Heart Failure? Tips For Better Quality of Life
Image of hands holding a heart

Heart failure (HF) is a condition in which structural and functional defects occur in the heart muscles, leading to reduced filling or the ejection of blood. It can occur congenitally or due to any defect in heart valves, greater vessels, pericardium (outermost heart muscle), and endocardium (innermost heart muscles). Its common symptoms are difficulty breathing, fatigue, dizziness, swelling in feet, abdominal fluid, etc.

In this article, we will explore HF classification, its various treatment options available, and tips for better quality of life.

NYHA Classification of Heart Failure

According to New York Heart Association, there are four classes of HF [1]:

  • Class I: Physical activity is not restricted because of heart failure, and typical physical exercise does not bring on any symptoms.

  • Class II: HF patients are able to participate in most daily activities but have mild restrictions while engaging in more strenuous activities.

  • Class III: Patients with HF have significant activity limits; they feel well while resting, but any extra effort triggers symptoms.

  • Class IV: Patients with HF exhibit persistent symptoms at rest or during little physical exertion.

What are the treatment options for HF?

1.    Medications:

Medications are the first line treatment for heart failure. These drugs help manage the symptoms and progression of the disease:

  • ACE inhibitors: Block an enzyme that narrows blood vessels, reducing strain on the heart.

  • ARBs, or Angiotensin II Receptor Blockers: They help improve blood flow and reduce fluid retention.

  • Beta-blockers: They work by slowing down the heart rate and reducing its workload, helping to improve overall cardiac function.

  • Diuretics: Body swelling and ankle edema are the common symptoms of HF. Diuretics help remove extra fluid from the body by passing more urine.

  • Aldosterone antagonists: These drugs block the action of "aldosterone hormone" and reduce fluid buildup in the body.

  • Digitalis (Digoxin): This medicine is sometimes given to people who need extra help keeping their heartbeat steady or making their muscles contract harder.

  • Hydralazine and Isosorbide dinitrate: It is another choice for people who can't take ACE inhibitors or ARBs because of side effects or other reasons.

  • Ivabradine: It is a relatively new drug that is used to lower your normal heart rate when other treatments may not be enough.

2.    Medical Implantable Devices:

Now, different medical gadgets are used to treat heart failure:

  • Pacemakers: These devices help your heart beat regularly. If your heartbeat is too slow, doctors may implant an artificial pacemaker in your heart.

  • Implantable Cardioverter-Defibrillator (ICD): This device is especially helpful for people who are at risk of HF. It is put under the skin and helps keep people from dying suddenly from HF.

  • Cardiac Resynchronization Therapy (CRT): In CRT, a device is implanted that controls the valves of the heartbeat. Patients with heart failure and abnormal electrical activity are most likely to get this treatment, which helps the heart pump better. By making the ventricles contract simultaneously, CRT can relieve symptoms and improve the way the heart works as a whole.

  • Ventricular Assist Devices (VADs): This device helps the heart pump blood vigorously. VADs can help people who can't get a transplant in the long run.

  • Remote Monitoring Systems: With these systems, doctors can monitor a patient's heart activity, symptoms, and vital signs from a distance. Patients with heart failure can send information to their healthcare team using gadgets like gauges they wear or monitors they keep at home. This technology makes it possible to notice changes in a person's health early and act on them immediately. This cuts down on hospital stays and improves general care [2].

So far, the only FDA-approved remote monitoring system for HF patients is Cardio-Microelectro-mechanical (CardioMEMS™; Abbott, Sylmar, CA, USA).

3.    Surgical Interventions:

The type of surgery used to treat HF depends on what causes it.

  • Heart Valve Repair or Replacement: Faulty heart valves that don't open or close properly can cause heart failure. When broken heart valves are fixed or replaced by surgery, normal blood flow can be restored, and symptoms can be relieved. In most cases, valve repair is preferred because it keeps the patient's tissue. If a valve is badly damaged, it may need to be replaced with a mechanical or biological valve.

  • Coronary Artery Bypass Grafting (CABG): This surgery involves rerouting blood flow around coronary arteries that are blocked or narrowed so that the heart muscle gets more blood. CABG can help relieve symptoms and improve the way the heart works by improving blood flow.

  • Heart Transplant: A heart transplant may be considered for people with end-stage heart disease that other treatments can't help.

4.    Stem Cell Therapy:

During SCT for HF, healthy stem cells are injected into the broken heart muscle to help it heal and grow back [3].

Even though this treatment is still being tested, researchers and private medical clinics are looking into how it might help heart failure patients' hearts work better and ease their symptoms. SCT is being offered by some private medical practices as an alternative treatment option for HF.

Lifestyle Modifications for HF

Changes to a person's way of life are crucial to treating heart failure and improving life.

  • Eat a healthy diet: Adopt a heart-healthy diet that reduces sodium and saturated fat intake. This means cutting back on processed foods, fast food, and high-fat meats like bacon or sausage. Instead, opt for fresh fruits and vegetables, lean proteins like fish or chicken breast, whole grains, and low-fat dairy products.

  • Regular exercise tailored to the individual's condition: Mild to moderate physical exercises help make the heart muscles stronger and thus enhance cardiac function.

  • Weight management: It is also essential as excess weight can put strain on the heart.

  • Smoking cessation: It is paramount for anyone with heart failure as smoking damages blood vessels and increases the risk of further complications such as coronary artery disease.

  • Limiting alcohol intake: It is equally important since excessive alcohol consumption can weaken the heart muscle and worsen symptoms of heart failure.

  • Managing stress and mental health: Techniques such as relaxation exercises, mindfulness practices, therapy sessions, or joining support groups can all contribute positively towards emotional well-being.

  • Monitoring Symptoms: Patients should pay close attention to their symptoms, such as shortness of breath, tiredness, and swelling. Changes in these signs can tell a lot about how heart failure is going and how well the treatment plan is working.

  • Adherence to Medication and Treatment Plans: It is very important to take recommended medications and follow treatment plans exactly. Medications help control symptoms and stop the heart function from getting worse. Changes to your habits and help from your doctor can lead to better results and a better quality of life.

Conclusion

Heart failure is a painful illness that needs to be handled as soon as possible. To treat HF well, you should take your medicine as prescribed, avoid HF risk factors and causes, and make changes to your food choices. Heart failure patients must keep an eye on their weight every day. Sudden weight gain can be a sign of fluid buildup, which is a typical sign of heart failure that is getting worse. A quick weight gain of a few pounds could be a sign that the heart isn't pumping as well as it should.

References

  1. Classes and stages of heart failure. www.heart.org. (2023, July 27). https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/classes-of-heart-failure
  2. Hindricks, G., Taborsky, M., Glikson, M., Heinrich, U., Schumacher, B., Katz, A., Brachmann, J., Lewalter, T., Goette, A., Block, M., Kautzner, J., Sack, S., Husser, D., Piorkowski, C., Søgaard, P., & IN-TIME study group* (2014). Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomized controlled trial. Lancet (London, England), 384(9943), 583–590. https://doi.org/10.1016/S0140-6736(14)61176-4
  3. Rheault-Henry, M., White, I., Grover, D., & Atoui, R. (2021). Stem cell therapy for heart failure: Medical breakthrough, or dead end?. World journal of stem cells, 13(4), 236–259. https://doi.org/10.4252/wjsc.v13.i4.236