Wednesday, 17 August 2011

Treatment Of Congestive Heart Failure (CHF)

Heart failure is a chronic disease that requires ongoing management. But with treatment, the signs and symptoms of heart failure and improve heart sometimes becomes stronger. Doctors sometimes can correct heart failure by treating the underlying cause. For example, repairing a heart valve or a failure to control rapid heartbeat reversal of the heart. But for most people involves the treatment of heart failure a balance in the right medicine, and in some cases, the devices help the heart beat and contract properly.

Medication

Doctors usually treat heart failure with a combination of drugs. Depending on your symptoms, you may take one or more of these substances. They include:

Converting enzyme (ACE). These drugs help people with heart failure live longer and feel better. ACE inhibitors are a type of vasodilator, a drug that dilates blood vessels to lower blood pressure, improve circulation and reduce the workload on the heart. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten).

Receptor blockers (ARBs). These substances, which include losartan (Cozaar) and valsartan (Diovan), most of the same benefits as ACE inhibitors. They can be an alternative for people who can not tolerate ACE inhibitors.

Digoxin (Lanoxin). The drug, also known as digitalis, increases the strength of heart muscle contractions. It also tends to slow the heart rate. Digoxin reduces heart failure symptoms and improves your ability to live with the disease.

Beta-blockers. This class of drugs decreases the heart rate and lowers blood pressure. Examples include carvedilol (Coreg), metoprolol (Lopressor) and bisoprolol (Zebeta). These drugs also reduce the risk of certain abnormal heart rhythms. Beta-blockers may reduce signs and symptoms of heart failure and improve cardiac function.

Diuretics. Often called diuretics diuretics make you urinate more frequently and keep fluid from building up in your body. Diuretics are prescribed for heart failure include bumetanide (Bumex) and furosemide (Lasix). The drugs also decrease fluid in the lungs, so you can breathe more easily. Because diuretics make your body lose potassium and magnesium, your doctor may prescribe supplements of these minerals. If you take diuretics, your doctor will likely monitor levels of potassium and magnesium in the blood by regular blood tests.

Aldosterone antagonists. These drugs include spironolactone (Aldactone) and eplerenone (Inspra). They are primarily potassium-sparing diuretics, but they have additional properties that help the heart work better, may reverse scarring of the heart and can help people with severe heart failure live longer. Unlike some other diuretics, spironolactone can raise the level of potassium in the blood to dangerous levels, talk to your doctor if potassium increased to a problem.

You may have to take two or more medications to treat heart failure. Your doctor also may prescribe other heart problems - such as nitrates for chest pain, a statin to lower cholesterol or blood-thinning drugs to prevent blood clots - the heart failure drug.

You may be hospitalized for several days if you have a surge in heart failure symptoms. While in the hospital, you get more medicine to help your heart pump better and relieve your symptoms. You can also get extra oxygen through a mask or small tubes inserted into the nose. If you have severe heart failure, it may be necessary to use the term oxygen long.

Surgical and medical devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments studied and used in some people include:

Coronary artery bypass grafting. If you seriously blocked arteries involved in heart failure, your doctor may recommend coronary artery bypass grafting. In this procedure, the vein of the leg, arm or chest to replace your heart stuck in the vein so that blood flow to the heart more easily.

Heart valve repair or replacement. If a defective heart valve causes heart failure, your doctor may recommend repair or replacement of the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate blood flow to the rear. Surgeons can also repair the valve by reconnecting valve leaflets or by removing tissue from the upper valve so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty). Valve replacement is done when valve repair is not possible. At surgery, valve replacement, the damaged valve is replaced with an artificial (prosthetic) valve.

Implantable cardioverter defibrillators (ICDs). An ICD is a device implanted under the skin and connected through the veins in your chest the heart with his young son. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous pace, or if your heart stops, attempts to ICD shocks it back into normal rhythm.

Cardiac resynchronization therapy (CRT) or biventricular pacing. A biventricular pacemaker sends timed electrical impulses to the two lower chambers of the heart (left and right ventricles), so they pump more effectively coordinated. As much as half of those with heart failure have problems with the electrical system of the heart because of their already weak heart muscle to beat in a disorderly manner. This inefficient muscle contraction can lead to heart failure worsens. Often, a biventricular pacemaker is combined with an ICD for people with heart failure.

The heart pump (left ventricular assist device, or LVAD). These mechanical devices are implanted in the abdomen or chest and connected to a weak heart pump to help. Doctors first used heart pumps to help keep alive the candidates for heart transplantation while waiting for a donor heart.

LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who are not eligible to participate, or heart transplant or are awaiting a new heart.

Heart transplant. Some people have such severe heart failure that surgery or medication does not help. They may need to get their diseased heart replaced with a healthy donor heart. Heart transplants can greatly improve survival and quality of life for some people with severe heart failure. But the transplant candidates often wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or therapy device and can be removed from the waiting list for transplantation.

End of life and heart failure

Although the number of treatments available for heart failure, it is possible that heart failure can worsen to the point of a heart transplant is not an option, and you may need to enter hospice care. The hospice provides special care and sick.

Palliative care allows family and friends - with the help of nurses, social workers and trained volunteers - to care and comfort of a loved one at home or in hospices. It also provides emotional, social and spiritual support for patients and their families. Although most people in palliative care to remain in their own homes, the program is available anywhere - including nursing homes and assisted living facilities. For people who stay in a hospital, specialists in end of life can offer comfort, compassion and dignity.

Although it can be extremely difficult to discuss end of life issues with family and medical team. Part of this discussion will likely involve advance directives - a general term for oral and written instructions you give concerning your medical care if you become unable to speak for yourself. If you have an implantable cardiac defibrillator (ICD) is an important consideration to discuss with your family and doctors to turn off the defibrillator so that it can not deliver shocks to your heart continue to beat.

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