Heart failure requires periodic monitoring by your health care provider. The goals of treatment include reduction of the cardiac workload, control of symptoms, and improvement of heart function. Any underlying disorders and precipitating factors should be treated, if possible
One frequent recommendation in heart failure is to decrease both the amount of dietary sodium (salt in your food) and your intake of fluids.
Specific therapies for right-sided heart failure depend on the cause of the heart failure and may include the following:
Medications that reduce your heart's workload include angiotensin converting enzyme (ACE) inhibitors (such as captopril or enalapril), angiotensin receptor blockers (such as losartan or candesartan), and vasodilators such as hydralazine and long-acting nitrates. Beta-blockers (such as metoprolol or carvedilol) or other medications, given in small doses, may benefit some patients.
To reduce fluid accumulation you may need to take diuretics (water pills) such as loop diuretics (furosemide or bumetanide) for moderate to severe symptoms, or thiazide diuretics (hydrochlorothiazide, chlorthalidone and chlorothiazide) for mild symptoms, or a diuretic combination. Potassium-sparing diuretics (spironolactone, triamterene) are frequently used as well to prevent excessive potassium losses.
Digitalis may be prescribed to increase the muscle contraction of the heart and help the heart pumping function during atrial fibrillation (a common arrhythmia in right-sided heart failure).
Daily aspirin is appropriate when the underlying cause of heart failure is atherosclerotic heart disease.
If your symptoms are severe, unstable or don't improve with initial treatment, you may need hospitalization. Bed rest, reduced physical activity and intravenous medications help minimize the heart's workload.
Long-term recommendations may include:
Severe heart failure that doesn't respond to these therapies may require heart transplantation.
