Treatment for Congestive Heart Failure: What Each Stage Requires

Heart failure affects millions of people across the United States and is a leading cause of death for men and women. Chances are that you or someone you know has been diagnosed with heart failure. It’s scary, but there are many forms of treatment for congestive heart failure, which work to slow the progression and take care of your heart. It varies by your symptoms and how progressed the disease is.

Heart Failure Stages

Over time, your heart can sustain damage. This may be because of diseases such as coronary artery disease, high blood pressure, or diabetes. Lifestyle habits, including smoking, eating a high-fat diet, getting little to no exercise, and being obese, also cause your heart to weaken.

When your heart muscle is weak, it can’t pump enough blood and oxygen through your body. Your heart still works — just not as well as it needs to. This can leave you feeling short of breath, even when still, and tired. You may also have weight gain and swelling.

At a physical exam, your doctor will classify heart failure at a certain stage based on your symptoms, explains the American Heart Association.

• Stage A: There’s no evidence of heart disease or symptoms, but the individual has risk factors for developing heart failure.
• Stage B: The patient shows minimal evidence of heart disease, with some mild symptoms and minor limitations during regular activities.
• Stage C: There are signs of moderately severe heart disease. The person has express limitations during regular activities and is only comfortable when resting.
• Stage D: Severe heart disease is present, and the person is limited in performing daily activities. Symptoms are experienced even when at rest.

Treatment by Stage

You doctor will recommend treatment for congestive heart failure based on what stage of the disease you’re in. No matter your classification, lifestyle changes — such as diet, exercise, quitting smoking, and weight management — are essential to slowing progression to the next stage. The American Academy of Family Physicians has published guidelines from multiple medical organizations to manage heart failure.

Stage A

This is the best time to start making lifestyle changes to lower your risk. You may have high blood pressure, high cholesterol, or diabetes. Keep these conditions under control with diet and medications to protect your heart.

This stage is also a wake-up call to stop smoking and start exercising. If you’re significantly overweight, consider talking with your doctor or a nutritionist to develop a diet and exercise plan that fits with your preferences and schedule. The goal is to make changes that you can stick with over time — not to make yourself miserable with a series of crash diets. Limiting salt in your diet is also paramount for people with early signs of heart disease.

Stage B

At this stage, your heart has sustained some damage, but you still have an opportunity to strengthen the muscle and prevent further problems. Manage chronic conditions with a healthy lifestyle, and talk to your doctor about whether you need medication. ACE inhibitors and beta blockers are commonly prescribed medications at this stage. Medications for heart disease help lower blood pressure to try to reduce your heart’s workload.

Stage C

Heart damage is more severe at this stage. People with stage C heart failure should continue the recommendations for stages A and B, while also adding in diuretics if they experience swelling. You may also need more aggressive lifestyle modifications at this point, such as eating a low-salt diet and restricting fluid intake.

Your doctor may also talk to you about surgery to correct blockages and a pacemaker or other implantable device. The goal of treatment is to slow the progression toward stage D.

Stage D

This is the final and most serious stage of heart failure. The heart has sustained severe damage and struggles to sufficiently pump blood throughout your body. If your heart has trouble contracting properly, called reduced ejection fraction, you will likely need an implantable device to help your heart pump. You may also need to consider a heart transplant during stage D.

Heart failure is scary, but you have the ability to preserve your heart’s function by following a heart-healthy lifestyle. If you’re unsure where to begin, talk with your primary care physician or see a nutritionist. Personal trainers are also good resources to help you get active and tailor exercise to your abilities and interests.