Heart Failure Treatment Options

The Barnes-Jewish & Washington University Heart & Vascular Center has a renowned program dedicated to the treatment of heart failure. Our cardiologists and cardiac surgeons provide innovative medical and surgical solutions.

Treatment for heart failure often depends on the cause of heart failure, how far the symptoms have progressed and a patient’s overall health and strength. The early symptoms of heart failure can often be controlled with diet, proper medication and lifestyle changes. Sometimes heart failure can be reversed when other problems are fixed, such as hyperthyroidism or diabetes.

As the stages of heart failure advance, treatment becomes more aggressive.

The American College of Cardiology (ACC) and the American Heart Association (AHA) have identified the following stages of heart failure.


Patient Description

Stage A: High risk for developing heart failure

  • Hypertension

  • Coronary artery disease

  • Diabetes mellitus

  • Obesity and metabolic syndrome

  • Patient using cardiotoxins

  • Family history of cardiomyopathy

Stage B: Asymptomatic heart failure

  • Previous myocardial infarction

  • Left ventricularremodeling, including left ventricular hypertrophy

  • Asymptomatic valvular disease

Stage C: Symptomatic heart failure

  • Known structural heart disease

  • Shortness of breath and fatigue

  • Reduced exercise tolerance

Stage D: Refractory end-stage heart failure

  • Marked symptoms at rest despite maximal medical therapy (e.g., those who are recurrently hospitalized or cannot be safely discharged from the hospital without specialized interventions)

Hunt SA, et al. Circulation 2009.

When more aggressive treatment options are needed, options include:


  • ACE inhibitors

  • angiotensin receptor blockers (ARB)

  • beta-blockers

  • aldosterone blockers

  • hydralazine/nitrates

  • diuretics

  • digoxin

  • inotropic drugs


  • implantable cardioverter defibrillators (ICD)

  • cardiac resynchronization (CRT) 

  • biventricular pacemakers

  • intra-aortic balloon pump 


The Heart Failure Society of America (HFSA) provides a set of educational modules designed to help patients better manage their heart failure symptoms. Visit HFSA’s Educational Module page to explore this series of patient education guides.

To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call [Dynamic_Phone_Number].

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#14 in the Nation
by U.S. News & World Report

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