Lifestyle changes, medications, and surgical procedures and devices are the main types of treatments for heart disease. Doctors recommend heart disease treatments based on what type of heart disease you have, what symptoms you experience, your age, and any other health conditions or medications you take. Treatment guidelines generally specify that safer treatments should be tried first. If first-line treatments are not effective, doctors consider those with more serious side effects or a higher risk of complications.
Many classes of medication are used to manage heart disease. It is common for people with heart disease to be prescribed drugs from multiple categories. Read more details about each medication and its potential side effects in the Treatments A-Z pages.
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Commonly called water pills, diuretics are often one of the first drugs prescribed to treat people with hypertension (high blood pressure). Diuretics are believed to reduce blood volume by ridding your body of sodium and water through urination. Common diuretics include furosemide (sold as Hydrochlorothiazide and Lasix) and spironolactone (Aldactone). Diuretics are usually safe, but they can cause dehydration if you lose too much water.
Anticoagulants — known as blood thinners — can help prevent dangerous clots from forming and causing stroke or myocardial infarction (heart attack). Drugs from several classes work in different ways as blood thinners. One of the most common blood thinners is the familiar aspirin, a nonsteroidal anti-inflammatory product sold over the counter. Other blood thinners include clopidogrel (Plavix), rivaroxaban (Xarelto), apixaban (Eliquis), dabigatran (Pradaxa), warfarin (Coumadin), and aspirin/extended-release dipyridamole (Aggrenox). Blood thinners can raise the risk of bruising and bleeding problems.
High levels of cholesterol in the blood contribute to atherosclerosis (narrowing of the arteries). Statins are believed to work by stopping the body from producing cholesterol and promoting the reabsorption of existing cholesterol. Statin medications include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor). Muscle pain and weakness are common side effects of statins.
Beta-blockers treat hypertension by relaxing blood vessels and slowing the heart rate. Beta-blockers include metoprolol (Lopressor), bisoprolol (Zebeta), and propranolol (sold under the brand names Inderal and InnoPran XL). Beta-blockers can cause fatigue and weight gain.
Angiotensin-converting enzyme (ACE) inhibitors are believed to lower blood pressure by relaxing the blood vessels. Ramipril (Altace), lisinopril (Zestril), and enalapril (Vasotec) are examples of ACE inhibitors. Common side effects of ACE inhibitors include headache, dizziness, and weakness.
Calcium channel blockers are believed to treat hypertension and chest pain by dilating the arteries and decreasing the force with which the heart pumps. Some examples are amlodipine (Norvasc), diltiazem, sold under the brand names Cardizem and Tiazac, and verapamil sold under the brand names Calan, Verelan, and Covera-HS. Calcium channel blockers can cause side effects including constipation, headache, and palpitations.
Digoxin, a digitalis drug, is used to treat heart failure and atrial fibrillation. Digitalis drugs are believed to work by increasing the force with which the heart beats and controlling irregular heart rhythms. Digoxin is often prescribed in combination with a diuretic and an ACE inhibitor. Digoxin is sold under the brand names Lanoxin and Digitek.
Nitroglycerin is used to treat or prevent angina pectoris (chest pain) due to coronary artery disease. Nitroglycerin is sold under brand names including Nitrostat, Nitro-Dur, NitroMist, and Nitrolingual Pumpspray. Nitroglycerin is a nitrate. Nitrates are believed to work by dilating arteries.
Antibiotics, such as ciprofloxacin, vancomycin, and penicillin G, may be prescribed in cases of endocarditis and other infective heart diseases caused by nonvirus microorganisms.
Corticosteroids, such as prednisone, prednisolone, and dexamethasone, are synthetic hormones that suppress immune system responses. Corticosteroids may be prescribed to control inflammation in cases of myocarditis.
Surgeries are performed to correct defects, repair damage, and regulate or replace parts of the heart that have become dysfunctional. The type of surgery used depends on the type of heart disease and your age and overall health. Read more details about each surgery in the Treatments A-Z pages.
Coronary artery bypass graft surgery (CABG, pronounced “cabbage”) is the most common heart surgery. CABG is considered in cases of severe coronary heart disease, where a waxy substance called plaque has built up in the coronary arteries. Plaque hardens and narrows the arteries and limits the amount of oxygen-rich blood that reaches the heart, causing angina (chest pain). Plaque can also rupture and form clots that can block the flow of blood, leading to a heart attack. Coronary bypass surgery restores the flow of blood to the heart by bypassing the blocked section of the coronary artery.
During CABG surgery, the surgeon will harvest one to three blood vessels from the legs, chest, or wrist for grafting. In a traditional procedure, the surgeon makes a long incision down the chest, cuts the sternum in half, and spreads the rib cage apart. The heart is then temporarily stopped while grafting surgery is performed. While the heart is stopped, blood will continue to be pumped through the body by a cardiopulmonary bypass (heart-lung) machine. When the grafts are in place, the heart is restarted, and normal blood flow is restored. The surgeon will then close the chest. In some situations, CABG surgery can be performed using newer, minimally invasive techniques such as keyhole surgery or “off-pump” procedures during which the heart is not stopped.
Angioplasty is a common nonsurgical procedure also referred to as percutaneous coronary intervention (PCI), balloon angioplasty, or coronary artery balloon dilation. Angioplasty is considered in cases of less severe coronary heart disease when CABG is not yet necessary. Angioplasty restores the flow of blood to the heart by widening narrowed sections of coronary artery. Stents are small wire mesh or fabric tubes often placed into arteries during angioplasty. Permanent stents keep the artery propped open.
The cardiologist performs angioplasty by making a small hole in your arm or groin with a needle, then inserting a thin, flexible guide wire followed by a catheter (thin tube). You may or may not need to spend one night in the hospital after undergoing angioplasty.
Angioplasty and stents do not cure the underlying coronary artery disease. Over time, the coronary arteries can become clogged again.
Pacemakers are considered standard treatment for people with many types of arrhythmia. Pacemakers can treat symptoms of arrhythmia and enable you to have a more active lifestyle. A pacemaker is a small, battery-powered device that helps your heart maintain a normal rhythm by emitting a low-level electrical signal when arrhythmia is detected. Pacemakers are usually implanted beneath the skin of the chest under the collarbone. Some types of temporary pacemakers may be worn externally on a belt. After pacemaker placement, you will likely need to spend one day in the hospital. You can expect to resume normal activities within four weeks.
An implantable cardioverter defibrillator (ICD) is a small, battery-powered device that helps control life-threatening arrhythmias and prevent sudden cardiac arrest. ICDs are considered standard treatment for people who have survived cardiac arrest. Studies show that ICDs also protect people who are at high risk of sudden cardiac arrest. ICDs are placed under the skin of the chest or abdomen during a noninvasive procedure. Some ICDs may be connected to your heart by fine wires.
The heart has four valves: mitral, tricuspid, aortic, and pulmonary. The purpose of each valve is to open enough to let blood flow through into the next heart chamber and then close to prevent the blood from flowing backward. Heart valve surgery aims to repair or replace a damaged or defective valve. The aortic and mitral valves are the most common focuses of heart valve surgery. The aortic valve is usually replaced, while the mitral valve is usually repaired. Valves may be replaced with either artificial (also known as mechanical or prosthetic) valves or biological valves made of human or animal tissue. Heart valve surgery may be performed alone or during another heart surgery such as CABG.
Ablation is a nonsurgical procedure used to correct arrhythmias. Ablation may also be referred to as catheter ablation, radiofrequency ablation, or cryoablation. Ablation targets small areas of tissue within the heart responsible for sending electrical signals that control heart rhythm. By destroying and scarring these small target areas, cardiologists can restore normal heart rhythms.
In some people with heart failure, the ventricles, or lower chambers of the heart, can no longer pump blood effectively through the heart and body. A ventricular assist device (VAD) is a mechanical system that can take over the pumping function from one or both ventricles. Blood passes through the VAD instead of through your ventricle(s). A VAD may be short term, while you recover from heart surgery or wait for a heart transplant.
A VAD may be used for the left ventricle only (LVAD), the right ventricle only (RVAD), or it may be biventricular (BIVAD). However, LVAD is the most common type of VAD. Other terms for a VAD include heart pump, ventricular assist system (VAS), or mechanical circulatory support (MCS). There are several types of VADs. Some VADs involve an external pump. The external pump may be small and portable or connected to a large console at your hospital bedside. External pumps are connected to your heart via catheters that exit your abdomen or leg. Other types of VADs are entirely internal, with the pump placed inside your chest.
A heart transplant may be an option for some people with end-stage heart failure. The heart transplant must be harvested from an organ donor who has died recently and is on life support. The donor must be a good genetic match in order to avoid organ rejection. The donor must also be a similar size and located within your geographical region. There are extensive criteria for becoming a candidate for a heart transplant in addition to the severity of your disease.
After receiving a heart transplant, you will spend several days in the intensive care unit (ICU) so that your condition can be monitored regularly. You will spend between seven and 21 days in the hospital before going home after a heart transplant. You can return to work and normal activities after approximately three months of recovery at home.
Heart transplant extends the life of people who would otherwise die of heart failure. You will need to take immunosuppressants for the rest of your life to prevent your body from rejecting the heart transplant. With rejection carefully controlled, heart transplant recipients can live longer than 10 years.
Making changes to your lifestyle can be hard, but it pays off. Stopping smoking, improving your diet, and increasing your activity level can help you feel better and lower your risk of worsening your heart disease and developing serious complications.
If you smoke, quit. Smoking raises blood pressure, damages red blood cells and blood vessels, and makes blood more likely to clot, which can cause strokes and heart attacks. Smoking actively works against any heart disease treatments and makes it more likely that heart disease will progress and worsen. Even secondhand cigarette smoke has been shown to raise the risk of heart disease.
For people with heart disease, nutrition is one of the most important ways you can control your cholesterol and blood pressure and avoid the development of serious complications in the long term. A healthy diet can also help you manage your weight and blood glucose and combat inflammation, which plays a key role in many forms of heart disease. In general, focus your diet on fresh vegetables and fruit, whole grains, legumes, fish, low-fat dairy products, and sources of healthy unsaturated fats such as nuts. Avoid saturated (animal) fats such as fatty beef, butter, and chicken skin, which can raise cholesterol and contribute to inflammation. Limit sodium intake to control your blood pressure, and eat plenty of fiber, which seems to help lower both cholesterol and blood pressure.
In addition to strengthening the heart and other muscles, exercise can help you control cholesterol and blood pressure, promote a healthy weight, improve your mood, and prevent serious complications such as diabetes and osteoporosis from developing. Any amount of exercise is more beneficial than no exercise at all. It is never too late to start being more active. Regular exercise does not necessarily mean going to the gym or playing sports. Nearly any physical activity that gets you up and moving can provide significant benefits to those with heart disease. Small lifestyle changes such as taking the stairs, parking further from the door, and taking walks during work breaks can increase the amount of exercise you get.