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If you have heart failure, you are not alone. More than six million Americans have heart failure. Heart failure does not mean that your heart has stopped beating, it refers to a number of conditions that can affect how your heart functions.

Heart failure makes it harder for the heart to pump enough blood to meet your body’s need for oxygen. That is why most people with heart failure have trouble breathing, especially when they are active. Even small tasks like climbing stairs or grocery shopping result in fatigue and trouble breathing. Heart failure is a lifelong condition, and you play a very important role to stay well.


Heart failure with reduced ejection fraction HFrEF:

This is a condition where your heart muscle is weak to pump enough blood to meet your body oxygen requirements.

Heart failure with reduced ejection fraction HFpEF:

This is a condition where your pumping ability is normal; however, your heart cannot relax to fill with enough blood. As a result, less blood full of oxygen and nutrients is pumped out to your body.

With heart failure with preserved ejection fraction, pressure inside your heart increases and can push fluid back into the lungs and other parts of your body.


The good news is that heart failure can be managed and there are many treatment options for both heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. Proper treatment of heart failure can make you feel healthy and live a normal life.

Treatment of heart failure depends on underlying conditions. For example, if you have blockage in your heart arteries, fixing those blockages might help you to feel better.

If you have valvular problem, fixing that valve problem can make you feel better.
In general, if you have heart failure the treatment usually includes lifestyle changes, medications, cardiac rehab, and surgical procedures.

Lifestyle changes: Eat low-salt and low-fat foods. Exercise regularly. Do not smoke. If you are overweight, lose weight. Monitor your fluid intake and weight, and manage blood pressure, diabetes, and pulmonary disease.


Beta-blockers: Can slow the heart rate and lower your blood pressure and improves survival.

Angiotensin-converting enzyme inhibitors/blockers: Relax blood vessels and reduce strain on your heart and improve blood flow. Improves survival.

Angiotensin receptor/ neprilysin inhibitors: Combination drug that relaxes blood vessels and reduces sodium retention. Reducing strain on heart and lowers blood pressure. Newer medication and improves survival.

Mineralocorticoid receptor antagonist: Like spironolactone, helps to get rid of salt and water through urine. This lowers the volume of blood that the heart muscle pumps.

Nitrates and hydralazine: Nitrates and hydralazine combination have shown to improve outcomes in African American patients. It is often used if someone is allergic to angiotensin-converting enzyme inhibitors or cannot take for some reason.

Diuretics: Also called water pills. Help to keep fluid from building up in your body or lungs. Will make you urinate more often.

Most of the medications are available at very low cost except some newer ones.

Cardiac rehabilitation: This is a supervised exercise program that helps to build your strength and a healthy lifestyle. Participating in cardiac rehab program can help to make you feel better, make your heart stronger and may reduce hospitalizations.


Many people with heart failure may have the problem with the way their heart beats(arrhythmia).

Devices can be used to prevent sudden cardiac death.

Implantable cardioverter defibrillator (ICD)-battery-powered device that monitors your heart and delivers electric shock if it detects a dangerous fast heartbeat.

Cardiac resynchronization therapy (CRT)-small battery-powered device that sends electric signal to lower chambers of your heart so that they beat together in the more synchronized way.

For very late-stage heart failure, patients may need a mechanical pump called the left ventricle assist device. This is often needed in patients who need a heart transplant.


If you have a heart failure, you should follow with your doctor on regular basis and review medications and plan in detail. You should prepare your questions for the doctor to ask at each visit.

                                Shahzad Ahmed MD, FACC, FSCAI, RPVI
                           Interventional Cardiologist, Director Cardiology

Dr. Ahmed Board Certified in Interventional Cardiology, Cardiovascular Medicine, Echocardiography, Nuclear Cardiology, Vascular Ultrasound and Internal Medicine. He was Awarded Prestigious award of Fellow of American College of Cardiology (FACC) in 2019 and Fellow of Society of Cardiovascular Interventions in 2020 (FSCAI). He completed internal medicine, cardiovascular and interventional cardiology training at Drexel University College of Medicine. He was appointed Assistant Professor of Medicine at Drexel University College of medicine. Under his leadership Lower Bucks Hospital has started many new programs including same-day discharge after percutaneous coronary intervention, Venous and Pulmonary Thrombectomy, Carotid stenting and implementing the radial first approach (Cardiac Cath through arteries of hand).

Dr. Ahmed is currently accepting new patients at BMC Cardiology Practice,501 Bath Road in Bristol. For more information or to schedule an appointment, please call 215-785-5100.