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.
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 so 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.
