Dr. Chauncey W. Crandall, M.D. ischief of the Cardiac Transplant Program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla.. He practices interventional, vascular, and transplant cardiology. Dr. Crandall received his post-graduate training at Yale University School of Medicine, where he also completed three years of research in the Cardiovascular Surgery Division. Dr. Crandall regularly lectures nationally and internationally on preventive cardiology, cardiology healthcare of the elderly, healing, interventional cardiology, and heart transplants. Known as the “Christian physician,” Dr. Crandall has been heralded for his values and message of hope to all his heart patients. Dr. Crandall is author of Dr. Crandall’s Heart Health Report newsletter.

Dr. Chauncey W. Crandall, M.D.

Drug Treatments for Heart Failure

Thursday, 17 Apr 2014 04:18 PM

By Dr. Crandall

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Heart failure treatment often requires several drugs, and it is of utmost importance that you take each exactly as directed. Make sure you have detailed, written instructions for each, along with what to watch for so you can alert your doctor to any adverse side effects.
 
Here are a few of the drugs your doctor might suggest:
 
• Diuretics. Years ago, diuretics were the only treatment we had to treat heart failure. They eliminated the body’s excess fluid but did nothing to improve the heart function. Diuretics are still a mainstay of heart failure treatment, but they now are used in combination with other medications that strengthen the heart.
 
• Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors). These drugs were the “game-changer” that transformed heart failure from a condition that had to be lived with to one that was actually reversible. ACE inhibitors not only relieve symptoms but also actually strengthen the heart by blocking the effects of angiotensin II, a hormone the kidneys produce. Inhibiting this hormone causes blood vessels to relax, which lowers blood pressure, meaning that the heart doesn’t have to work so hard.
 
• Beta-Blockers. This class of drugs usually is given in conjunction with ACE inhibitors. They work by lowering blood pressure and pulse rate, which improves the heart’s ability to relax. This, over time, improves the heart’s pumping ability. Beta-blockers also assist in a favorable remodeling of the heart back to its normal state.
 
• Digoxin. This drug strengthens the force of the heart’s contractions, which helps restore a steady heartbeat and reverses heart failure.
 
• Vasodilators/Nitrates. These are another type of drug family that treats heart failure by relaxing the blood vessels so the blood can flow forward more easily. Usually, they are prescribed for people who can’t take ACE inhibitors.
 
Successful heart failure treatment restores the body’s harmony. Think of your body as an orchestra. When a key member of the orchestra (the heart) begins to falter, the rest of the orchestra has to work harder to compensate. This throws everything out of sync, and before long all you have is a jumble of noise instead of music. The conductor (your doctor) steps in to restore order. Then, with all the musicians in sync again, harmony is restored.
 
Fortunately, nowadays, we have more ways than ever to restore harmony. If you have heart failure, expect to be taking at least two different types of drugs, and usually more.

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