Heart failure

Your doctor may consider prescribing the following medications:

ACE inhibitors such as captopril and enalapril -- these medications open up blood vessels and decrease the work load of the heart. These have become an important part of treatment
Diuretics -- there are several types including thiazide, loop diuretics, and potassium-sparing diuretics; they help rid your body of fluid and sodium.
Digitalis glycosides -- increase the ability of the heart muscle to contract properly; prevent heart rhythm disturbances
Angiotensin receptor blockers (ARBs) such as losartan and candesartan which, like ACE inhibitors, reduce the workload of the heart; this class of drug is especially important for those who cannot tolerate ACE inhibitors
Beta-blockers -- this is particularly useful for those with a history of coronary artery disease

Sometimes, hospitalization is required for acute CHF. Hospitalized patients may receive oxygen and intravenous medications such as vasodilators and diuretics.

The heart's ability to pump blood can be directly increased by medications called inotropic agents. These include dobutamine and milrinone, which are given intravenously.

Unstable patients receiving several medications usually need also hemodynamic monitoring with Swan-Ganz catheterization.

Severe cases of CHF require more drastic measures. For example, excess fluid can be removed through dialysis, and circulatory assistance can be provided by implanted devices such as the intra-aortic balloon pump (IABP) and the left ventricular assist device (LVAD). These devices can be life-saving, but they are not permanent solutions. Patients who become dependent on circulatory support will need a heart transplant.

Expectations (prognosis):

Heart failure is a serious disorder that carries a reduced life expectancy. Many forms of heart failure can be controlled with medication, lifestyle change, and correction of any underlying disorder. Heart failure is usually a chronic illness, and it may worsen with infection or other physical stressors.

Complications:

Pulmonary edema
Total failure of the heart to function (circulatory collapse)
Arrhythmias including lethal arrhythmias

Possible side effects of medications include:

Low blood pressure (hypotension)
Light-headedness and fainting
Lupus reaction
Headache
Gastrointestinal upset (such as nausea, heartburn, diarrhea)
Cough
Muscle cramps
Digitalis toxicity

Calling your health care provider:

Call your health care provider if weakness, increased cough or sputum production, sudden weight gain or swelling, or other new or unexplained symptoms develop.

Go to the emergency room or call the local emergency number (such as 911) if you experience severe crushing chest pain, fainting, or rapid and irregular heartbeat (particularly if other symptoms accompany a rapid and irregular heartbeat).