This year doctors will diagnose 670,000 Americans with heart failure. Also known as congestive heart failure, it is one of the biggest challenges we face in all of medicine. Heart failure is the single most common reason for hospitalizations in people over 60-65 years old, costing the nation an estimated $40 billion a year in related health costs. Despite these statistics, the medical field is making progress – a diagnosis today offers more hope than it did just a few years ago. With a multi-pronged approach to treatment, you can manage your symptoms and be much more active and productive than heart failure patients of the recent past. What is Heart Failure? Many people assume heart failure is when the heart simply stops beating. In reality, heart failure occurs when your heart muscle fails to pump enough blood through the body, causing other organs to come under stress and fail to function properly too. Heart failure is a progressive, chronic disease, with early symptoms surfacing as shortness of breath, leg swelling, fatigue, and difficulty doing normal activities like walking up the stairs. Rapid weight gain can also be an early sign your body is retaining too much fluid as a result of organs receiving less blood. As an example, kidneys may not receive enough blood flow and they may not be able to get rid of the excess water taken in. This leads to fluid build-up in the body. There are a number of conditions that cause heart failure. The usual suspects are coronary artery disease (when the arteries that supply blood to the heart become narrowed), untreated high blood pressure, diabetes, abnormal heart rhythms (arrhythmias), and viral infection of the heart. Although rare, genetics or unknown causes can also play a role in the development of heart failure. The First Line of Intervention: Medication The first line of medical intervention is medication. There are several classes of drugs that can successfully treat heart failure symptoms. Physicians usually prescribe a combination of these drugs to address a patient’s particular condition and symptoms. For example, I might prescribe diuretics, pills that help the body get rid of excess fluid, to a patient suffering from leg swelling. In addition, I would use other drugs to further decrease the heart’s workload for the same patient. The use of these medications has to be carefully monitored and adjusted based on the patient’s age, kidney function, symptoms of heart failure, and stage of heart failure. As a doctor, I try to focus on treating the condition’s underlying causes in a patient, such as high blood pressure or diabetes. The goal with a drug therapy regimen is to treat both the symptoms and the cause, thus stemming heart failure’s progression and decreasing the symptoms. In this way, treating heart failure needs a holistic approach, and I recommend patients take time to understand how their treatment regimen is supposed to work. Lifestyle Changes Are Crucial Medication can reduce your symptoms, but making lifestyle changes can slow the disease’s development and help you live a full life with heart failure. Quitting smoking, controlling salt and water intake, decreasing cholesterol and saturated fats from your diet are some of the most obvious ways to give your condition a chance to improve. I also encourage patients to maintain a healthy weight and exercise routine. Moderate exercise under medical supervision can significantly improve or at least maintain your condition. For many patients, participating in a cardiac rehabilitation program, or a medically supervised program designed to coach and educate you on proper exercise and diet, can be the best and safest way to start making these changes become a routine. Getting enough rest can help your body stay healthy and also manage stress, another factor in heart failure. Patients with heart failure should also be careful to avoid respiratory infections like the flu or pneumonia. I recommend flu and pneumonia vaccinations for heart failure patients. Surgical Procedures to Treat Heart Failure For some patients, lifestyle changes and medications won’t be enough to give the heart a second chance. But many of the surgical procedures and medical devices available are very effective in treating heart failure and in extending a patient’s lifespan. There are several kinds of devices that doctors can surgically place to help the heart function properly. One such device is an implantable cardioverter defibrillator (ICD). Often used when a patient experiences irregular heartbeats, the ICD can deliver a shock or pace the heart to stop abnormal heart beat rhythms that could otherwise take a patient’s life. Cardiac resynchronization therapy (CRT) is a strategy that uses an implantable pacemaker (combined with an ICD at times) to help your heart beat more efficiently. Pulmonary artery (PA) pressure monitoring is another innovation used to track and treat heart failure. Inserted through a vein, usually in the leg, and then delivered to a lung artery, this device actually monitors pressure in the vessel that moves blood from your lung to your heart. Instead of looking at a patient’s symptoms later in the heart failure course, the doctor gets an understanding of exactly what's happening to an at risk patient while he or she is at home and can help determine when changes in your treatment plan need to be made. Studies of the PA pressure sensor device show a large reduction in the amount of times patients have to go back to the hospital for complications. In the most severe cases, a physician would discuss the possibility of a heart transplant. Physicians typically recommend heart transplants in the last stage of heart failure when medical treatments and less invasive procedures have not been enough. A patient will usually wait several months for a matching heart to be identified, and the outlook for patients that have received a heart transplant is good for years after the surgery. For patients who cannot wait for a transplant, the left ventricular assist device (LVAD) is sometimes used as patients wait for a heart transplant. It is an internal, battery powered mechanical pump that assists a weak heart in pumping blood around the body. This “bridge to transplant” can help a patient make it to his or her transplant successfully. More recently, these devices have been made so durable that patients who cannot receive a transplant can live many years using the LVAD with good quality of life. Heart Failure: Not the End The goal for any heart failure patient is to increase your lifespan and improve your quality of life with this condition. Although the wide spectrum of treatment options and lifestyle changes may seem overwhelming, progress has been made in treating heart failure. These strategies offer patients hope that we can slow the progression enough for them to have many productive years to come.