Heart failure #2 : How to live with it?

I) How to treat heart failure ?

The purpose of treatment for heart failure (HF) is to improve the daily life of patients by reducing symptoms, decreasing the duration of hospitalization and slowing the progression of the disease [1]. The prescription of a drug treatment is always associated with hygienic and dietary measures involving a change in lifestyle [1].

1. Medication treatment

After having established his diagnosis, the doctor prescribes a drug treatment that will facilitate the work of the heart. The treatment can be adapted over time according to the evolution of the disease and to the patient’s reaction. The medication must be taken regularly, according to the doctor’s instructions, and throughout life.

There are 3 classes of drugs that are most used in the treatment of HF:

• Beta-blockers, which help reducing the heart rate and facilitate the contraction of the heart while reducing its oxygen requirements. [1]
• Diuretics, which work by increasing urine volume and renal salt removal. This reduces the amount of fluid in the body and thus relieves the heart [1].
• Converting enzyme inhibitors (CEIs), which lower blood pressure and thus reduce the strain on the heart [1].

Self-medication should be avoided for patients with heart failure, as some drugs that are considered harmless and available without a prescription may alter the effects of treatment for heart failure and cause side effects, thereby aggravating the disease [1]. These include anti-inflammatory drugs, aspirin, laxatives and effervescent drugs that are usually salty [1]. It is very important to ask your pharmacist or doctor for advice before taking any type of medication.  

2. Surgical treatment

In some cases of heart failure, surgery is necessary to relieve the patient.

• When heart failure is caused by a failing heart valve
• When heart failure is caused by a blockage in the coronary arteries
• When heart failure leads to desynchronization of cardiac contractions [2]
• In more severe cases, heart transplantation is considered, usually in patients under 65 years of age. It is often accompanied by numerous side effects (rejection, infections, cancers…)

II) Hygienic and dietary measures 

Heart failure is a chronic disease which unfortunately cannot be cured permanently. However, a healthy lifestyle can stabilize it when combined with regular medication. Indeed, a healthy lifestyle is essential: by combining healthy dietary measures with medication, symptoms and risks of hospitalization can be reduced, and the worsening of heart failure prevented [1].

Here are some diet and health tips to help you protect your heart:

1. Watch your diet

• Eat a healthy, balanced diet. A diet consisting of fruits, vegetables, whole grains, lean meat and low-fat milk is recommended [5]. In addition, people with HF should eat plenty of fiber to avoid constipation associated with diuretic use.
• Moderate salt and red meat consumption
• Limit your fluid intake to 1 to 2 liters per day [2].
• Avoid or reduce your caffeine intake to prevent your heart from beating too fast or irregularly [5].

2. Have a healthy lifestyle

• Excessive alcohol consumption is one of the risk factors for heart failure. It is imperative for HF patients to reduce or avoid alcohol consumption. Alcoholic beverages can interfere with the action of medications or increase the patient’s blood pressure [5].
• Quit smoking. [2].
• Control your stress and anxiety levels. [2]
• Practice appropriate regular physical activity such as swimming, cycling, walking, etc. [2]. However, these activities should be done under medical supervision and the patient should avoid overexertion [2].
• Some vaccinations are also recommended for HF patients, as they are more susceptible to suffer from respiratory infections [4]. These include vaccinations against influenza, which causes pneumonia [4].

3. Practice daily self-monitoring 

HF is a chronic disease, so it requires regular monitoring. The patient should strictly adhere to his or her treatment regimen and see his or her physician regularly. To ensure patient safety, it is important that patients are also able to identify warning signs and monitor their condition daily.

Self-monitoring consists of:

• Monitoring weight by weighing oneself at least twice a week [4].
• Assessing fatigue and shortness of breath [4].
• Look for edema in the ankles [4].
• Look for symptoms such as fever, vomiting, diarrhea, loss of appetite, cramps, etc. [4].

If you wish to know more about the disease and its causes, please click here

Sources:

[1] Heart failure treatment – Ameli – Available at: https://www.ameli.fr/assure/sante/themes/insuffisance-cardiaque/traitement

[2] HOW IS HEART FAILURE TREATED? – Vidal – Available on: https://www.vidal.fr/maladies/coeur-circulation-veines/insuffisance-cardiaque-chronique/soigner.html

[3] RISK FACTORS OF HEART FAILURE – VIDAL – Available at: https://www.vidal.fr/maladies/coeur-circulation-veines/insuffisance-cardiaque-chronique/facteurs-risque.html

[4] Heart failure: medical follow-up and daily life – Ameli – Available on: Heart failure: medical follow-up and daily life | ameli.fr | Insured

[5] Heart failure – Coeurotavc – Available on: Heart Failure | Heart and Stroke Foundation (coeuretavc.ca)

POI 0719-09/22