Medical treatment for a sudden flare-up of heart failure
When you arrive at a hospital or emergency room in the middle of a sudden flare-up of heart failure, your doctor will first try to stabilize your condition. The doctor will immediately prescribe drugs such as diuretics, nitrates, and/or morphine (see table below) to help you breathe more easily and to control your pain or anxiety. These drugs should quickly relieve your symptoms.
Your doctor may also order an oxygen mask that fits over your nose and mouth. The oxygen helps make sure that your heart and the rest of your body are receiving plenty of oxygen. After your condition is stabilized, your doctor will try to determine what caused your flare-up and whether your heart has been damaged.
First treatments of a sudden heart failure flare-up Treatment
What does it do?
Diuretic Removes extra salts and fluid from your body Nitrate Dilates blood vessels and decreases fluid buildup in the lungs Morphine Reduces pain and anxiety Oxygen Increases oxygen levels in your blood Some flare-ups of heart failure are worse than others. Sometimes your doctor will need to use more aggressive treatments to stabilize your condition. Even flare-ups that appear to be mild can take several days to control.
For these acute flare-ups, your doctor may put you in a hospital intensive care unit (ICU) where hospital staff can closely monitor your condition. In the ICU, if you are having a very severe acute flare-up, your doctor may need to place a tube into your windpipe to help you breathe more easily. You may also need other, more invasive treatments. In general, they must be given to you over the course of several days to work well.
Treatment of more severe acute flare-ups Treatment
What does it do?
Pressor Constricts blood vessels and increases blood pressure Inotrope Increases the strength of heart contractions Positive pressure ventilation A machine that increases the pressure of air inside your lungs and the oxygen levels in your blood Determining the cause
After your condition has been stabilized, your doctor will try to find the cause of your flare-up and treat it. The cause may be easy to recognize. For example, you may have eaten a salty meal the night before that caused your body to retain extra water and make your symptoms worse. Or, the cause can be more difficult to find. Your doctor may order exams, such as a stress test, EKG/ECG, or echocardiogram, that will give more specific information about the function of your heart.
Your doctor will be most interested in finding out whether you have coronary artery disease (CAD). If your doctor believes that your CAD caused your acute flare-up, you may need an angioplasty or coronary artery bypass graft (CABG) surgery as soon as possible. These procedures may help prevent future complications such as a heart attack (myocardial infarction) or another acute flare-up.
Your doctor may also review the drugs that you are taking. A quick change will be made to your drug treatment if your doctor finds that interactions between your medicines caused the flare-up.
Adjusting your regimen
The last step of treating an acute flare-up is probably the hardest. Sometimes an acute flare-up will not affect your heart too much and therefore will not change your heart failure very much. At other times a flare-up will affect your heart and change your heart failure significantly. Your doctor may need to adjust your drug treatment to better control your heart failure symptoms and keep them under control.
Changes in your treatment may be as simple as adjusting your dosage of diuretics or angiotensin-converting enzyme (ACE) inhibitors. Your doctor may also decide to prescribe additional drugs such as digoxin or a diuretic, such as spironolactone, to fight your heart failure.
Rehabilitation
Depending on how you were affected by your acute flare-up, your doctor may recommend that you go from the hospital to a rehabilitation facility. Staff at these institutions are specially trained to support people with heart failure. The staff can also design special programs that will help you manage the dietary and lifestyle changes that you need to control heart failure.
| Author: | Douglas Dana Robin Parks, MS | Last Updated: October 23, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
 | ||
| |