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Heart Failure Treatment

The words ‘heart failure’ always sound very scary to patients, while it can be serious in a minority of people, most people only have mild symptoms of shortness of breath when lying flat or with exercise, or slight ankle swelling.

Heart failure is when your heart is unable to keep up with its workload and pump enough blood to the rest of the body. It is a chronic condition that gets worse progressively. Approximately 900,000 people in the UK suffer from heart failure.

The mainstay of treatment are diuretics (water tablets). We at The Online Surgery offer, Furosemide, Bendroflumethiazide, Spironolactone, Indapamide and Amiloride. Sometimes these are in combination form such as Co-amilofruse. In addition we can also prescribe, Beta blockers, ACE inhibitors and occasionally Digoxin for extreme cases.

Heart Failure > ACEI


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Enalapril Maleate tablets are white to off-white round flat beveled edged tablets marked with '2.5'(2.5mg), '5' (5mg), '10' (10mg) or '20' (20mg),

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Buy Lisinopril 2.5mg, 5mg, 10mg and 20mg Tablets for lowering blood pressure

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Perindopril/Coversyl

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Buy Ramipril Capsules 2.5mg, 5mg, 10mg. It is used to treat high blood pressure (hypertension) or congestive heart failure.

Heart Failure > Betablockers


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Atenolol 25mg, 50mg and 100mg tablets: It is primarily used to treat cardiovascular diseases.

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Bisoprolol Fumarate Tablets - Bisoprolol is used to cure high blood pressure and angina pectoris.

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Metoprolol

Heart Failure > Diuretics


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Amiloride

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Furosemide

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Spironolactone

Heart Failure > Inotropic drugs and treatment of AF


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Digoxin

What is Heart Failure?

Heart failure is a condition where the heart is unable to pump enough blood to the rest of the body at the right pressure. It is a chronic condition that progressively worsens with time as the heart is unable to keep up with its workload. You may have it for years before you realise it.

The body depends on the heart to pump out oxygen- and nutrient-rich blood to the body’s cells, to carry out all processes. With heart failure, the weakened heart can no longer supply the cells with enough blood, resulting in symptoms such as fatigue and shortness of breath, whereby everyday activities can become extremely taxing.

The heart makes attempts to compensate for its weakened function by enlarging, increasing in muscle mass or increasing the heart rate, to be able to increase its output. The body compensates as well, by narrowing the blood vessels and diverting blood away from less important organs. However these are only temporary fixes.

There are three main types of heart failure;

Left Ventricular Systolic Dysfunction
When the left ventricle becomes weak, and is unable to pump blood around the body.

Preserved Ejection Fraction
When the left ventricle becomes stiff, making it difficult for the heart chamber to completely fill with blood.>/p>

Diseased or Damaged Heart Valves
That slow down the functioning of the heart

It is a serious condition that cannot be cured, however many people with heart failure are able to lead a full life as long as they regularly monitor and treat the condition with prescribed medication and healthy lifestyle changes.

Long-term heart failure can lead to other serious conditions such as pulmonary oedema when fluid collects in the lungs and affects breathing, kidney disorders which affects the kidney’s ability to dispose sodium and water, increasing swelling in the body’s tissues, and more seriously it can lead to a heart attack if not managed in time.

You might have heart failure for many years before you begin to develop symptoms for it, it varies form person to person. Individually these symptoms might not cause alarm, but having multiple together are cause for concern.

Symptoms commonly associated with heart failure include;

- Unusual tiredness
- Shortness of breath, sometimes even while lying flat.
- Chronic coughing or wheezing
- Build up of fluid in body tissues – swelling in feet, ankles, legs, abdomen.
- Nausea or loss of appetite
- Confusion or impaired thinking
- Increased heart rate

As your heart grows weaker, symptoms get worse and more prominent. You begin to feel tired a lot sooner and feel breathless even while lying flat. The resultant fluid build up may also cause weight gain, frequent urination and cough that's worst at night

In most cases, heart failure doesn’t have a single cause, there are a number of conditions that can increase your chances of developing heart failure.

High Blood Pressure(Hypertension)
This puts extra strain on the heart, which can lead to it’s slowing down

Heart muscle weakness (Cardiomyopathy) / heart muscle inflammation (Myocarditis)
Cardiomyopathy and Myocarditis could come about due to a genetic predisposition, viral infections, alcohol misuse or certain medications. However heart muscle weakness leads to heart failure.

Coronary Heart Disease
This is when the arteries supplying blood to your heart become blocked due to a build up of fatty substances, leading to chest pains and heart failure.

Anaemia
The lack of red blood cells, can contribute to heart failure

Hyperthyroidism
An overactive thyroid can cause imbalances and lead to heart failure.

Most people who develop heart failure, previously have another heart condition, that has damaged or weakened the heart muscle over time, disabling it from filling or pumping blood completely.

Certain factors can increase your risk of developing heart failure;

Age
You are at a much higher risk at 65 years of age or older; ageing weakens the heart muscle.

Ethnicity
People of African origin are more likely to develop the condition than other races, and also to develop symptoms for it at a younger age.

Overweight
Excess weight puts strain on the heart, and also increases the risk of other heart diseases and Type 2 Diabetes.

Previous heart conditions
People who have previously had a heart attack are at an extremely high risk for heart failure, due to the damage and weakness caused.

Congential heart defects
Children born with a heart defect are also at risk, as their heart has to work harder over a long time period.

Early diagnosis and treatment can help manage the condition and allow the individual to live longer.

A diagnosis is made by your GP based on your medical and family history, physical exam and test results. The doctor checks if you have or previous had a condition that can cause heart failure, such as Coronary Heart Disease, High Blood Pressure or Diabetes. Symptoms are studied closely with regards to their frequency and severity.

A number of tests and exams could be recommended;

Physical exam
You doctor will listen to your heart for abnormal sounds, listen to the lungs for sounds of extra fluid and look for swelling in the ankles, legs and abdomen.

Blood tests
To test for anything in your blood that might indicate heart failure or associated conditions affecting the heart, kidney, liver etc. Your blood can be tested for BNP that is secreted if your heart is under stress.

Breathing test
You may be asked to blow into a tube to check your lung’s functioning, assessing whether a lung problem could be causing the breathlessness.

Electrocardiogram (ECG)
This records the electrical activity of your heart.

Echocardiogram
Sound waves are used to check how well your heart is pumping blood and if there are any valve defects.

Chest X ray
It takes pictures of the structures inside your chest, such as heart, lungs, and blood vessels. Can show if the heart is enlarged, or if there is fluid in the lungs.

Treatment prescribed for heart failure works to make the heart stronger, improve symptoms, reduce the risk of flare-ups and allow a longer life. In addition to necessary lifestyle changes, we can offer a combination of various treatment options and medicines to manage heart failure.

Angiotensin-converting enzyme (ACE) Inhibitors
Angiotensin-converting enzyme converts Angiotensin I to Angiotensin II, which narrows blood vessels, increasing blood pressure. ACE inhibitors work to block this process, reducing blood pressure by relaxing your blood vessels.
ACE Inhibitor medicines include Ramipril, Lisinopril, and Perindopril.

Angiotensin II Receptor Blockers (ARBs)
ARBs block angiotensin II hormone from binding with receptors in the blood vessels. When it is blocked, the blood vessels don’t constrict and narrow, reducing blood pressure.
ARBs include Candesartan, Valsartan and Losartan

Beta blockers
Beta blockers slow down your heart rate, protecting it from adrenaline or noradrenaline produced by the body. It is prescribed to treat people whose left ventricle that pumps blood around the body doesn’t function well.
These include Metoprolol, Atenolol and Bisoprolol.

Diuretics
Diuretics flush excessive fluid and salts from your body through urine, reducing blood pressure. These are often used in combination with other high blood pressure medicines.
Diuretic medicines include Bendroflumethazide, Furosemide, Amiloride, Hygroton, Indapamide and Spironolactone.

Digoxin
Derived from a plant, it can increase the strength of your heart muscle contractions and slow down the heart rate. It can help reduce hospitalisation and is recommended when no improvement is seen despite other treatments.

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