Disease Management for Heart Failure (HF)

Learn about the treatment options for Heart Failure (HF):

Consult with your doctor to make the best decisions

When discussing with your doctor, you may want to use this document to help guide the conversation

When discussing with your doctor, you may want to use this document to help guide the conversation

1. Identify

During the ECG test, electrodes (sensors) that can detect the electrical activity of the heart are located in your chest and sometimes in your limbs. An ECG measures the time and duration of the electrical phases of each heartbeat, allows identify and record the presence of arrhythmias and alterations in cardiac impulse conduction.

Routine medical checkups will allow your doctor to closely monitor your health status and establish an early diagnosis of heart failure.

• Based on your treating doctor’s consideration, an echocardiogram may be performed to evaluate the size of your heart and its functioning. This test also allows to measure the ejection fraction of the left ventricle. This refers to the ability of the left ventricle to properly pump blood through the body with each heartbeat.

• Another diagnostic test is coronary angiography, which makes the blood flow through the arteries of your heart visible. Like the echocardiogram, this procedure will be requested by your doctor if considered necessary.

• An electrophysiological study (EPS) may be performed to observe the functioning of the heart’s electrical system in more detail and confirm the presence or absence of electrical abnormalities.

Left Ventricular Ejection Fraction (LVEF) is the percentage of blood that is pumped out of the heart to the body with each heartbeat. Based on the LVEF your doctor will determine how well your heart is functioning as a pump.

How is the LVEF measured?

The most common way to evaluate lVEF is through an echocardiogram. This test non invasive and done regularly in a doctor’s office or in a hospital’s diagnostic area.

The LVEF may change over time, so it is important that it is regularly assessed by your doctor.

Table of typical LVEF ranks:


The heart’s pumping capacity is



The heart’s pumping capacity is


35 % and less

The heart’s pumping capacity is


People who have a low ejection fraction (EF) of 35% or less have an increased risk of Sudden Cardiac Arrest (SCA).

A healthy heart has an LVEF between 50 % and 75 %. This indicates that the heart is pumping the blood properly and can provide enough oxygenated blood to the body and brain. Even a healthy heart doesn’t pump 100 % blood from the heart during each beat; a certain amount of blood always remains in the heart.

You can determine how quickly your heart beats by taking your pulse. If you identify that your pulse is irregular or slow, consult a doctor.

Example on how to take the pulse in the wrist. Taking care of your heart.

Flip one hand, palm up. Gently place the index and middle finger of your opposite hand in the internal part of your wrist below the base of the thumb; the position is correct if you feel your heartbeat. Count the total number of heartbeats for 1 minute, or for 30 seconds, and multiply this number by two.

Example on how to take the pulse in the neck. Taking care of your heart.

The pulse can also be found in the neck, always using the same fingers and performing the process similarly to the previous one.

2. Manage

If you have heart failure, you may be a candidate for an implantable heart device called Cardiac Resynchronization Therapy (CRT) device. It serves 3 functions:

If your doctor determines that you have heart failure, it is in progress and does not improve with the prescribed medication treatment, you may be a candidate for a CRT device.

The device is programmed with some specific parameters, which are determined by your doctor taking into account your specific condition to help correct uncoordinated (or unsynchronized) and inefficient heartbeats.

This device will allow your doctor to better control your disease and optimize your treatment to control heart failure. Current technology allows your doctor to control and adjust your pacemaker according to your specific pathology.

3. Treat

A Cardiac Resynchronization Therapy (CRT) device is implanted under the skin and delivers therapies to treat fast and irregular rhythms.

It serves 3 functions:

Delivers therapies to treat irregular, interrupted or slow heart rhythms.

Continuously monitors the heart and automatically delivers therapies to correct fast heart rhythms.

The device delivers therapies to coordinate the heart pumping and provides treatment to fast, irregular or slow heart rhythms.

The implant procedure does not require open-heart surgery and most people return to their homes in less than 24 hours.

To know more about living with a pacemaker, please download this brochure

4. Maintain

Maintaining healthy habits can help prevent heart disease and improve your quality of life.

  • Maintain a healthy diet: Eat fruits and vegetables, high-fiber foods, lean meats, fish and unsaturated fats like olive oil. Reduce alcohol and caffeine-containing beverages.
  • Exercise regularly: Try to get physical activity every day for at least half an hour.
  • Avoid harmful habits like smoking.
  • Control your blood pressure regularly: If you have high blood pressure, follow your doctor’s orders and take all prescribed medications as directed.
  • Control your cholesterol: Have your cholesterol levels checked regularly. Eat fewer high-cholesterol foods, and if necessary, take cholesterol-lowering medication as prescribed by your doctor.
  • Manage your stress levels: Reduce stress as much as possible. Practice healthy techniques for managing stress such as muscle relaxation, deep breathing, and exercise.
  • Treat sleep apnea and thyroid disorders: If you have sleep apnea or thyroid disorder, it’s important to go to the doctor to treat them properly.

Different types of medications are used to treat heart failure. Your doctor may prescribe a combination of medications (beta blockers, anticoagulants and diuretics, among others) in order to control the progression of the disease.

If your heart failure is caused by a valve that doesn’t work properly or gets worse by this situation, your doctor may consider having heart surgery to repair or replace the valve. If heart failure is severe and irreversible, the implant of a Ventricular assist device or heart transplant surgery may be considered.

Keep a close communication with your doctor to monitor your condition and check if treatments are working properly, or if you have new symptoms or side effects.

Seek help in case of an emergency. Contact your doctor or the ER right away if your heart rate is faster than usual, if you feel you’re going to faint, if you have chest pain or palpitations or if you notice shortness of breath.


When discussing with your doctor, you may want to use this document to help guide the conversation

When discussing with your doctor, you may want to use this document to help guide the conversation