- Eliminate The Cause : This is the most important step. If the blood pressure is high, it should be controlled.If there are blockage in the coronary arteries, angioplasty or bypass surgery may be required as per the case. Likewise, valve surgery may be required for a patient with severe valve disease. Supplementation of Vitamin B12 or iron for their deficiency may help correcting symptoms and signs of heart failure.
- Fluid Restriction : For most patients with heart failure, total daily intake of liquids is restricted to 1.25 to 2 litres. Extra amount of liquids puts extra load on already weakened heart.
- Heart Healthy Food : Daily use of salt should be restricted to less than 4-5 gm. This can be achieved by using less than usual salt in cooking and avoiding additional table salt. Avoid oily, salty, junk food. Make proper use of green vegetables and fruits.
- Physical Activities : Generally, a person should not do strenuous labour, should not lift weights and should not do the work which requires strength and power. Although, it is utmost required to take a regular walk and exercise as per suggestion of the doctor.
- Medicines : Medicines like, Digitalis, Diuretics, Beta Blockers, ACE Inhibitors, etc. add to the efficiency of the heart and not only improve symptoms of heart failure but also improves survival.
- Surgery (Surgical Ventricular Restoration ) : This procedure, in which weak part of heart is cut and its normal conical shape is restored, had generated good interests before 10 years. Though this surgery was risky, tern results are not very encouraging, medical world has lost much of the interest in it.
- Pacemaker (Cardiac Resynchronization Therapy) : When a specific reason for weakening of the heart is not found, it is considered as dilated cardiomyopathy. If LVEF does not improve beyond 30% – 35% and patient remains symptomatic even after the best medical care and if ECG of this patient shows a specific abnormality, this treatment is offered.
This device is implanted in the upper part of the chest through an incision of 2 inches under local anaesthesia. This device having 40-70 gm of weight and one-third the size of an Apple phone is a wonderful invention of science. Basically, it is a battery (source of energy). Three wires from it are passed to different chambers of the heart and muscles of the heart are given periodic stimuli of electrical impulses. Because of this, all the muscles of heart experience contraction simultaneously in a well planned manner, so the efficiency of heart increases.
When applied to properly selected patients with heart failure, this device helps to improve the efficiency of the weak heart, which in turn improves the symptoms and increases the longevity of life.
- Heart Transplant : Patients with severe refractory heart failure have to get repeatedly admitted to ICU with serious breathing problems and low blood pressure. These strengthening medicines. Heart transplant is the last resort for these very serious patients. There are many challenges involved which include receiving heart from a donor, keeping the patient alive till that time, etc. in running a heart transplant program.
‘Heart may get weakened, but mind shouldn’t’- is the mantra for a patient. Then only best solutions can be sought and implemented.