Patient Education
Heart Failure

Heart Disease and Failure

The two most common heart problems in the American population are coronary artery disease (the buildup of plaque in the arteries of the heart) and idiopathic cardiomyopathy (disease of the heart muscle without a known cause). As the heart problem gets worse, the heart grows weaker and is less able to pump oxygen-rich blood to the rest of the body. Because the heart must work harder to pump blood through the body, it tries to make up for this extra work by becoming enlarged. In time, the heart works so hard to pump blood that it may simply wear out as it is overcome by disease and unable to meet even the smallest pumping demands.

You may experience symptoms such as shortness of breath and fatigue with almost any exertion, and sometimes these symptoms may even be experienced while at rest. Swelling of the feet, legs, and abdomen are frequently seen and add to the discomfort of heart failure.

How to Treat Heart Disease and Failure

Several options are available to your doctor in treating your heart.

The first option is medical therapy with drugs. In some instances, medicines alone can be used to treat heart failure.

If your doctor feels it is necessary, there are also several other procedures that can be performed:

• Coronary artery bypass involves using blood vessels from other places in your body to "bypass" the blockages in your coronary arteries, which can help restore blood flow to your heart muscle.
• Angioplasty is a nonsurgical treatment designed to open clogged arteries.
• Diseased heart valves can cause heart failure. They can be repaired and this oftentimes improves heart function dramatically. Other times, the valve must be removed and replaced with a prosthetic, or artificial, valve made of metal or plastic.
• Cardiac size reduction involves removing a piece of living but weak heart muscle from an enlarged heart to reduce the size of the heart, allowing the remaining heart muscle to pump more efficiently and vigorously.
• Pacemakers are used to treat a heart that beats too slowly. In addition, the Food and Drug Administration has recently approved advanced pacemakers that make both of the heart's pumping chambers beat in perfect rhythm. Sometimes the natural pacemaker of the heart becomes diseased and does not keep the heart beating regularly.

At this time, there are mechanical devices that can also be surgically implanted to help improve heart function. When the above therapies fail, transplantation becomes the only option. Heart transplantation is reserved only for patients with the most advanced forms of heart disease, who have no other available options. The best treatment for your heart failure will depend on your medical history, health status, and your personal situation. Together, you and your doctors can figure out which treatment is best for you.