Treatment depends on the cause of heart failure, which type you have, the severity of your symptoms (classification), and how well your body is able to compensate.

Treatment of heart failure that is caused by a filling problem (diastolic heart failure) may differ from treatment of heart failure that is caused by a pumping problem (systolic heart failure). Identifying the type of heart failure you have will help guide proper treatment.

Sometimes, heart failure can be fixed if an underlying problem can be corrected, such as through heart valve replacement surgery or treatment to correct hyperthyroidism.

If heart failure develops shortly after a heart attack, it can sometimes be reversed with coronary artery bypass surgery or angioplasty, medicine, and cardiac rehabilitation.

Initial treatment

The goal of treatment for early stage heart failure is to relieve symptoms and prevent additional heart damage. You will probably take a diuretic first to reduce blood pressure and fluid buildup. Next, your doctor will probably prescribe one or more other medicines, including an ACE inhibitor. This medicine reduces the heart's workload, lowers blood pressure, and reduces fluid retention and swelling.

You may also take a beta-blocker medicine. These drugs can keep heart failure from getting worse and, in some cases, will improve your heart function and prolong life.² Some people can't take beta-blockers because of their side effects.

Lifestyle recommendations include the following:

• Watch your fluid intake.
• Eat less sodium.
• Exercise under the direction of your doctor.
• Lose weight if you are overweight.
• Stop smoking, because smoking increases your risk of heart disease and makes it more difficult to exercise. For more information, see the topic Quitting Tobacco Use.
• Avoid overuse of alcohol. For more information, see the topic Alcohol Abuse and Dependence.
• Control your high blood pressure. Exercising, limiting alcohol intake, and controlling stress will help keep your blood pressure in a healthy range too. For more information, see the topic High Blood Pressure (Hypertension).
• Control your diabetes.

Your doctor will also need to treat the underlying cause of your heart failure. You may need to take additional medicine for coronary artery disease, high blood pressure, diabetes, or an abnormal heart rhythm (arrhythmia).

Ongoing treatment

Although some causes of heart failure are reversible, in most cases heart failure cannot be cured. Most likely you will have to take medicine for the rest of your life. Ongoing treatment is aimed at decreasing the progression of the disease and preventing complications and hospital stays. Treatment should also improve symptoms and help you live longer.

ACE inhibitor medicines are the cornerstone of treatment for most people with heart failure. These drugs prolong life and reduce symptoms.²

If you have continued swelling, you may need to take a diuretic medicine, such as furosemide (Lasix) or bumetanide (Bumex). If you have moderate to severe heart failure, you may need to take the diuretic spironolactone (Aldactone), which has properties that can prevent heart failure from getting worse in addition to improving your symptoms.⁵