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Inotrope Therapy Heart Failure What is heart failure? Heart failure occurs when the heart cannot pump enough blood through the body. When the heart cannot pump enough blood, there is not enough oxygen for the body to work. Usually, the loss in pumping action is a symptom of a heart problem. How serious the condition is depends on how much pumping capacity the heart has lost. Even the mildest heart failure is a serious health problem that must be treated. How common is heart failure? Approximately five million Americans have heart failure and the National Institute of Health expects that 500,000 new cases will be diagnosed this year. What causes heart failure? There are many causes of heart failure. These include coronary artery disease, heart attack, high blood pressure, irregular heart rhythms and abnormal heart valves. Other diseases such as diabetes and lung disorders can also cause heart failure. How is my heart supposed to work? Your heart has four chambers that work together to move the blood through the vessels of your body. The blood vessels and heart are all connected together in a closed system. As the heart pumps it pushes blood through the vessels to the body and back into the heart. As blood is returned from the body it enters the top chamber of the heart called the right atrium. It then passes into the right ventricle where it gets pushed into the lungs. As the blood moves through the lungs it picks up oxygen and is then returned to the heart into the left atrium. The blood must be moved through the lungs to pick up oxygen before it goes to the body so that muscles and tissues receive oxygen. The left ventricle then forces the blood into the vessels where the blood delivers oxygen to the body. Inotrope Therapy © 2015 Coram LLC | COR05010-0215 Loss of Pumping Action in Heart Failure Healthy Heart Muscle Normally, the heart pumps blood by relaxing and then contracting its chambers. When the chambers relax, blood comes in; when the chambers contract, blood is pushed out, carrying oxygen and nutrients to the rest of the body. Weakened Heart Muscle Heart failure occurs when the heart muscle loses its ability to pump. The chambers cannot relax and contract well. Less blood moves through the chambers and more blood stays in the heart. Diastole Blood from body Systole From lungs Blood pumped to body To lungs Left ventricle Right ventricle Blood from body From lungs Blood pumped to body To lungs Left ventricle Right ventricle What are the symptoms of heart failure? The most common symptoms of heart failure are: •Shortness of breath (called dyspnea) – can increase at night •Fatigue, tires easily •Fluid accumulation or swelling in arms and legs (called edema) •Weight gain •Persistent coughing •Loss of appetite •Confusion •A faster heartbeat Inotrope Therapy 2/3 How is heart failure commonly treated? Heart failure can be helped in many ways, including treating the cause of the heart failure and helping the heart pump better. Surgery may be performed to repair the heart or replace the heart through a transplant. Medications are the most common treatment for heart failure. The most common heart medications are: • Angiotensin converting enzyme inhibitors (ACE Inhibitors) –T hese medications lower blood pressure and reduce strain on the heart. • Beta blockers – These medications slow the heart rate and lower blood pressure to decrease the heart’s workload. • Digoxin –T hese medications make the heart beat stronger and pump more blood. • Diuretics – These medications are sometimes called water or fluid pills. They help reduce fluid build up in your lungs and swelling in your feet and ankles. What is an inotrope medication? Inotrope medications may be prescribed when the other medications listed fail to improve heart failure. Inotropes work to enlarge the vessels and help the heart contract harder. Both of these actions help more blood to be pumped from the heart into the body. Common inotropes used include: •Milrinone •Dobutamine •Dopamine Side effects from inotrope medications include: •Headache •Irregular heart beats •Low blood pressure Your physician, working with you and the Coram team, will focus on treating your heart failure. If you have any questions, please call your Coram clinician. Reference: National Heart, Lung, and Blood Institute website (a part of the National Institute of Health) Inotrope Therapy 3/3