Hello, my name is doctor Randall starling on the section head for heart failure at the site Alan Arnold Miller family heart and vascular institute I’d like to talk to you today about treatments for heart failure in address some of the commonly asked questions that we hear from our patients heart failure can be frightening but it doesn’t mean your heart has stopped working heart failure results when muscles of the heart are weaker than normal or the lower chambers of the heart cannot relax and fill with blood like they normally do. Basically the heart isn’t pumping blood effectively, therefore, the heart works harder to do its job pumping blood to your organs and tissues and putting the muscle under quite a bit of stress over time the heart muscles weaken and or Stephan. Heart failure frequently results from past heart attacks untreated high blood pressure diabetes sleep disorders such as sleep apnea abnormal heart valves and various forms of heart muscle disease essentially wear and tear on the heart muscle weakens it and causes heart failure. The good news heart failure can be managed and there are many many options for patients who were diagnosed with this condition first let’s identify the two types of heart failure systolic heart failure is when the left ventricle heart muscle doesn’t contract with enough force so less blood is pumped throughout the body it is generally associated with an enlarged we cart diastolic heart failure is when the heart contracts normally but the ventricles do not relax or our staff so less blood enters the heart. To determine the best treatment for you a doctor will perform a test called ejection fraction referred to as E. F. this test measures how well your heart pumps with each beat E. F.
can be measured in your doctor’s office with an echocardiogram which is an ultrasound of the heart an MRI scan of the heart a nuclear stress test or cardiac catheterization a normal heart pumps a little more than half the heart’s blood volume with each beat and the F. is over fifty percent. Any off of thirty-five to forty percent may confirm a diagnosis of systolic heart failure. Someone with diastolic heart failure can have a completely normal EF. Meanwhile, an E. F. of less than thirty-five percent is a red flag for potential sudden cardiac arrest which is loss of heart function due to a life-threatening abnormal heart rhythm, of course, these are worst-case scenarios you should have your E. F. measured when you were first diagnosed with a heart condition and again as needed your doctor will recommend how often to get your E. F. checked. Your E. R. for ejection fraction can go up and down based upon your heart condition and therapies that your doctor prescribes. Aside from these tasks how will you know if you have heart failure there are some signs to look for they include shortness of breath persistent coughing or wheezing swelling which can occur in the feet the legs ankles or the abdomen or weight gain for taken difficulty carrying out everyday activities like shopping or climbing stairs lack of appetite or nausea confusion or impaired thinking and an increased heart rate if you experience one or more of these symptoms see a doctor as for therapies Cleveland Clinic physicians medically manage heart failure patients with state of the art medications that help slow the disease’s progression keep patients out of the hospital and reduce mortality we’re continually researching new drugs and treatment options generally doctors will use a combination of medications to address heart failure. The most common of these include angiotensin-converting enzyme inhibitors or ace inhibitors which widen blood vessels and lower blood pressure to improve blood flow to the heart doesn’t have to work so
hard. Angiotensin two receptor blockers or A. R. bees are an alternative for those patients who cannot tolerate ace inhibitors digoxin also referred to as digitalis increases the strength of heart muscle contractions and reduces heart failure symptoms beta-blockers slow heart rate and reduce blood pressure they can also reduce some abnormal heart rhythms beta-blockers importantly can help strengthen the heart diuretics can prevent water from collecting in the body. Another important component of treatment for heart failure includes a cardiac defibrillator and pacemakers your doctor will carefully review your case and advise whether these devices should be considered. The decision is generally made after medications have been prescribed finally there are numerous surgical procedures that can help patients with heart failure that your doctor will consider for very advanced heart failure cardiac transplant or left ventricular assist device might be an option that your doctor recommends there are stem cell trials at the Cleveland Clinic for heart failure patients within large targets and reduced ejection fraction or
systolic heart failure our hope is that stem cell therapies will improve the aft or heart muscle pumping strength and improve symptoms now you may be wondering whether you should get genetic testing for heart failure if the condition runs in the family approximately one in five patients with heart failure have a positive family history of heart failure that’s why doctors take time to gather a detailed family history so they can make an informed decision about necessary screenings which typically include a physical exam an electrocardiogram and an echocardiogram or alter sound. If you were diagnosed with heart failure you can get better and improve your quality of life there is no cure but the condition can be managed very effectively take your medications as directed and see your doctor regularly often causes identified they can be treated and make a huge difference make important lifestyle changes such as exercising reducing salt in your diet managing stress treating depression quitting smoking managing bad cholesterol in maintaining a healthy blood pressure these healthy behaviors in combination with treatments recommended by your doctor can improve your symptoms and help your heart work more efficiently thank you.