Medicines for systolic heart failure

Heart failure can be caused by either diminished force of contraction of each heartbeat (systolic heart failure) or inability of the heart to fully relax and fill up with blood between heartbeats (diastolic heart failure). Most people with heart failure have systolic heart failure. However, many have a combination of systolic and diastolic heart failure. Your doctor will take into account whether you have systolic heart failure, diastolic heart failure, or both in deciding which types of medicines to use.

The three main classes of medicines for systolic heart failure are:

  • Diuretics.
  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Beta-blockers.

If you have systolic heart failure, your doctor will aim to treat you with all three of these medicines. The combination of medicines will remove excess fluid from your body (diuretics), improve the efficiency of your heart in pumping blood (ACE inhibitors and beta-blockers), and reduce ongoing damage to your heart.

If you continue to have symptoms after taking medicines from each of these classes, or if you are not able to tolerate any of them, your doctor might consider treating you with other medicines that increase the force of contraction of the heart (digoxin) or with vasodilators, which can lower the blood pressure your heart has to beat against.

If you are very seriously ill from systolic heart failure, your doctor may need to admit you to an intensive care unit to receive intravenous medicine such as dobutamine to help increase the force of your heart's contractions.



Author: Robin Parks, MSLast Updated: September 1, 2006
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology

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