Guide to Safe Use of Diuretics


Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. Heart failure is progressive and can periodically worsen causing symptoms to become severe and sometimes require hospitalization to treat.  The symptoms are often due to fluid build up in the body and appropriate use of diuretics and limiting fluid consumption can help avoid hospitalization.

This guide helps you understand how limiting how much you drink and how much salt (sodium) you take in can help prevent worsening heart failure symptoms.

 

GUIDE TO SAFE HEART FAILURE HOSPITAL DISCHARGE 

Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. Heart failure is progressive and can periodically worsen causing symptoms to become severe and sometimes require hospitalization to treat. During the hospital stay you will get medical treatment to stabilize your heart function and relieve symptoms. Typically, a stay of 4-5 days is normal but other problems or complications may lengthen your stay.  Discharge from the hospital doesn’t mean you’re completely out of the woods. You have to be very careful during the days and weeks after discharge to be sure nothing happens that will send you back to the hospital. This quick guide supplements your discharge instructions and will help you avoid readmission.

 

 

KEY POINTS

  • Used to assist severe heart failure
  • Approved for permanent use in patients who cannot get heart transplantation 
  • Approved as a bridge to help people until a donor heart is found

NEW OPTION FOR ADVANCED HEART FAILURE:  HEARTMATE 3  


FDA APPROVED HEARTMATE 3 IN 2017

The HeartMate 3 Left Ventricular Assist System (LVAS) is a heart pump system that helps the heart’s left ventricle (the main pumping chamber of the heart) deliver blood to all parts of the body. The device is used for heart failure patients whose hearts are unable to pump blood effectively. The HeartMate 3 LVAS is made up of a blood pump that is implanted inside the patient’s body and a pump controller with batteries that remains outside the patient’s body.

 

 

 

 

 

KEY POINTS

  • FDA approves new treatment of the heart disease (cardiomyopathy) caused by transthyretin mediated amyloidosis (ATTR-CM)
  • Amyloidosis is deposition of substances in the heart which interferes with normal functioning 

NEW DRUGS FOR AMYLOIDOSIS APPROVED  


NEW CLASS OF DRUGS BRINGS HOPE FOR PATIENTS WITH RARE DISEASE

On May 3, the U.S. Food and Drug Administration approved Vyndaqel (tafamidis meglumine) and Vyndamax (tafamidis) capsules for the treatment of the heart disease (cardiomyopathy) caused by transthyretin mediated amyloidosis (ATTR-CM) in adults. These are the first FDA-approved treatments for ATTR-CM. Vyndaqel and Vyndamax have the same active moiety, tafamidis, but they are not substitutable on a milligram to milligram basis and their recommended doses differ.

The efficacy of Vyndaqel and Vyndamax in treating ATTR-CM was shown in a clinical trial of 441 patients randomized to receive Vyndaqel or a placebo. After an average of 30 months, the survival rate was higher in the Vyndaqel group than in the placebo group. Vyndaqel was also shown to reduce the number of hospitalizations for cardiovascular problems.

 

WHAT IS ATTR AMYLOIDOSIS?  

ATTR is caused by the buildup of abnormal deposits of specific proteins known as amyloid in the body’s organs and tissues, interfering with their normal functioning. These protein deposits most frequently occur in the heart and the peripheral nervous system. Heart involvement can result in shortness of breath, fatigue, heart failure, loss of consciousness, abnormal heart rhythms and death. Involvement of the peripheral nervous system can result in a loss of sensation, pain, or immobility in the arms, legs, hands and feet. Amyloid deposits can also affect the kidneys, eyes, gastrointestinal tract and central nervous system.

 

 

KEY POINTS

  • Important class of medicines for heart failure
  • Usually used in people with reduce heart function 
  • Avoid in pregnancy 
  • Use with caution with kidney disease

ACE INHIBITORS 


THE FOUNDATION FOR HEART FAILURE TREATMENT

Patients with heart failure with reduced ejection fraction are usually started on one of these medications which have been repeatedly show to improve quality of life and reduce death and hospitalization for worsening heart failure. all of the medicines in this class are effective for heart failure. These medicines also share similar side effects and precautions.

 

Angiotension-Converting Enzyme (ACE) Inhibitors

Brand Name Generic Name
Aceon Perindopril
Accupril Quinapril
Altace Ramipril
Capoten Captopril
Lotensin Benazepril
Mavik Trandolapril
Monopril Fosinopril
Prinivil Lisinopril
Univasc Moexipril
Vasotec Enalapril
  Enalaprilat
Zestril Lisinopril

Warnings

  • Women who are pregnant should not take any medication in this class 
  • People who have kidney or liver problems, diabetes, or heart problems should talk to their doctor about the benefits versus risks of using ACE drugs.
  • People taking diuretics (water pills) should talk to their doctor about the risks of using ACE drugs.

Common Side Effects

  • Cough
  • Dizziness
  • Feeling tired
  • Headache
  • Problems sleeping
  • Fast heart beat

Serious Warning Signs

Call your doctor or emergency services if you have any of these signs:

  • Chest pain
  • Problems breathing or swallowing
  • Swelling in the face, eyes, lips, tongue, or legs

 

 

INITIAL HEART FAILURE BLOOD TESTS


UNDERSTANDING THE LAB WORK NEEDED TO DIAGNOSE HEART FAILURE

 Blood  is usually drawn when a patient starts developing symptoms of heart failure. The reason for lab testing is to see is any other disease are present and contributing to the failure. The other reason to assess for other conditions with bloodwork is because heart failure treatment may be more complicated depending on any other conditions a person has. Some common blood tests used in initial assessment of heart failure include: