Congestive heart failure (CHF), or simply heart failure, occurs when the heart can’t pump blood as effectively as it should, leading to a buildup of fluid in the body. Though there is currently no cure, several treatment options are available to help manage the condition and improve quality of life.

Treatment Overview

The approach to treating CHF depends on the cause, severity, and overall health of the individual. A care team, often including a cardiologist, will customize a plan that may involve medications, therapies, procedures, or surgery.

Medications

1. ACE Inhibitors and ARBs
 These drugs help lower blood pressure and reduce the heart’s workload. Common ACE inhibitors include lisinopril and enalapril, while losartan and valsartan are typical ARBs. ARBs may be preferred for those who experience side effects like coughing from ACE inhibitors.

2. ARNIs (e.g., Entresto)
 This combination of drugs helps widen blood vessels and reduces strain on the heart. Side effects may include low blood pressure or kidney function changes.

3. Beta-Blockers
 Medications like carvedilol or metoprolol slow the heart rate, helping the heart work more efficiently.

4. I(f) Channel Blockers
 Ivabradine is used when beta-blockers alone aren’t enough to control heart rate. It can help reduce symptoms like fatigue and breathlessness.

5. SGLT-2 Inhibitors
 Originally used for diabetes, drugs like empagliflozin and dapagliflozin now also help improve heart failure symptoms and outcomes.

6. Hydralazine and Isosorbide Dinitrate
 These drugs help widen blood vessels and may be especially effective in people of African descent.

7. Diuretics
 Also known as water pills, these help reduce fluid buildup. Common ones include furosemide and hydrochlorothiazide.

Other supportive medications may include:

  • Blood thinners (if there’s a risk of clots)
  • Cholesterol-lowering drugs
  • Digoxin (to strengthen the heartbeat)
  • Potassium supplements
  • Oxygen therapy

Therapies

Cardiac rehabilitation programs include supervised exercise, nutritional counseling, and education on medication adherence. These can improve function and slow disease progression.

Procedures and Devices

  • Pacemakers and CRT devices help the heart chambers beat in sync.
  • Implantable defibrillators (ICDs) prevent dangerous heart rhythms.
  • LVADs (mechanical heart pumps) support heart function in severe cases.
  • Surgical options like valve repair or bypass surgery may be needed.
  • Heart transplants are reserved for end-stage heart failure when other treatments fail.

Lifestyle Management

You can support your treatment plan by:

  • Eating a low-sodium, heart-healthy diet
  • Staying physically active under guidance
  • Avoiding smoking and limiting alcohol
  • Monitoring weight to detect fluid retention early
  • Managing stress and getting adequate rest

Outlook

While CHF is a serious condition, many people live for years with the disease when it is properly managed. Following your treatment plan, staying in regular contact with your healthcare provider, and making healthy lifestyle choices can significantly improve your prognosis.