If the cause of heart failure is either an acquired or inherited abnormality of the valves or other structures, surgical correction can return the heart to a normal or near normal functional state. As well as correcting underlying causes we must also address precipitating factors for heart failure. Many of these may be easily corrected such as excess salt intake causing fluid retention, anemia often due to blood loss from the gut and an overactive thyroid gland. The mainstay of drug treatment for heart failure is digoxin which has been available for over 200 years. It increase the force of the pump and also can control a rapid and irregular heart action.
Diuretics increase the loss of salt and water through the kidneys.
This reduces the congestion and excess fluid in the lungs improving shortness of breath, the most prominent and limiting manifestation of heart failure. Drugs that dilate blood vessels lower resistant to blood flow and decrease the heart's workload. When all of the he preceding measures are unsuccessful and heart failure becomes intractable, heart transplantation is considered, but this option will always be limited by the supply of suitable donor organs. At The Montreal General Hospital we have embarked on project involving the wrapping of a piece of back muscle around the heart and electrically stimulating it, a form of cardiac assist. However, this procedure is still in an experimental stage.