What to expect if you’ve been diagnosed with heart failure

Hearing the words “heart failure” can be scary and overwhelming. While it is a serious chronic condition, thanks to a combination of lifestyle changes and treatment, many people can manage their symptoms and enjoy a full life.

Here is what you can expect if you’ve recently been diagnosed with heart failure, and the medications your doctor may prescribe to treat it.

What exactly is heart failure?

A normal functioning heart pumps oxygen- and nutrient-rich blood through the arteries and circulatory system to all parts of the body. If you have heart failure, your heart muscle isn’t strong enough to pump properly, preventing it from being able to circulate enough blood to organs and tissues.

Heart failure is a chronic, progressive disorder that left untreated gets worse over time. In the beginning stages of heart failure, the heart tries to compensate for its inability to meet the body’s needs:

1. The heart will stretch to contract more strongly so that it can pump more blood.
2. The blood vessels will become narrower to keep up blood pressure.

While these changes may help initially, they ultimately cause the heart to become enlarged and make heart failure worse. It’s at this point when most people start to feel symptoms like shortness of breath, fatigue, rapid weight gain, cough, and swelling of or pain in the abdomen.

Causes of heart failure

Chronic conditions like high blood pressure, heart disease, obesity, diabetes, and atherosclerotic CVD (cholesterol buildup within the blood vessels) raise the risk of developing heart failure. Less common causes of heart failure include family history, substance abuse, arrhythmia, myocarditis, autoimmune disease, thyroid disease, and other endocrine or nutritional causes.

You can also develop heart failure after an injury or illness damages your heart, such as a heart attack or blood clot in your lungs.

Lifestyle changes to treat heart failure

According to the American Heart Association (AHA), making changes to your diet, exercise, and other aspects of your life can slow the progression of heart failure and help improve daily life. These include:

• Quitting smoking
• Losing weight
• Tracking daily fluid intake (because of fluid retention and the extra strain that puts on the heart)
• Limiting alcohol and caffeine
• Eating heart-healthy foods such as whole grains, fruits and vegetables, and low-fat dairy products
• Being physically active
• Managing stress
• Making sure you get enough sleep

The AHA also recommends keeping track of your symptoms and monitoring your blood pressure so that you can have a better grasp of whether your condition is improving or getting worse.

Medications prescribed to treat heart failure

“Patients are often prescribed many new medications following a diagnosis of heart failure,” said Rachel Kozinski, a registered pharmacist with Express Scripts^® Pharmacy. “And patients may have questions or feel overwhelmed. It’s helpful to understand why they are being prescribed each medication and the role they play in their heart failure regimen.”

There are three different ways that medications help treat heart failure, said Kozinski, and each of these strategies has the end goal of preventing the heart from being overworked. They include:

1. Lowering blood pressure to decrease the strain on the heart. This can be accomplished with medications such as ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), angiotensin receptor and neprilysin inhibitors (ARNI), and mineralocorticoid receptor agonists (MRA).
2. Managing heart rate to ensure the heart beats more efficiently, doesn’t tire itself out, and preserves its health. This can be accomplished with beta blockers or I(f) (“funny”) channel inhibitors.
3. Eliminating extra fluid the body doesn’t need so that the heart has less blood to pump through the body and less resistance to pump against. This can be accomplished with loop diuretics and thiazide diuretics.

It’s important to work with your healthcare team to understand all of the different medications that you’re taking, why you’re taking them, and when and how often to take them. These medications need to be taken exactly as directed to get the best results.

The Express Scripts® Pharmacy mobile app makes it easy for you to keep track of all of your medications. You can schedule automatic refills, make payments, check order status, and set up dose reminders to take your medications.

If lifestyle modifications and medication aren’t enough, your healthcare team may discuss other options, like bypass surgery or an implantable pacemaker or defibrillator.

Managing the risk of medication side effects

As with any medication, you may experience side effects if you’re prescribed medication to treat heart failure. Some common side effects include:

• Dizziness
• Low blood pressure
• Slowed heart rate
• Changes in kidney function
• Increased or decreased potassium and other electrolyte levels
• Headache
• Nausea or digestive problems
• Wheezing or coughing
• Breast enlargement/sensitivity
• Skin rashes, hives, or sensitivity to light

“Your prescriber will need to monitor your electrolyte levels and kidney function via blood testing, as well as monitor your blood pressure and heart rate, to make sure your medication is working properly and the medication isn’t making your condition worse,” said Kozinski.

In some cases, side effects will decrease over time as your body gets used to the medication. However, if side effects become troublesome, your doctor or pharmacist may be able to adjust your medication dosage to help you manage them better.

Heart failure medications also have the potential to interact with other medications that you’re taking, causing potentially dangerous side effects. Before you take any new medication for heart failure, let your doctor or pharmacist know about all of the medications that you’re currently taking, including over-the-counter medications, vitamins, and supplements.

Lean on your pharmacist for support

It can feel overwhelming to start a new medication. If your health benefits include Express Scripts^® Pharmacy, we have pharmacists with special training and knowledge of cardiovascular conditions, including heart failure, who are available to you 24/7. They’re ready to answer all of your questions about your medications and any side effects you’re experiencing.