Editing Heart (section)

===Treatment===
Diseases affecting the heart can be treated by a variety of methods including lifestyle modification, drug treatment, and surgery.

====Ischemic heart disease====
{{Main|Coronary artery disease|Coronary artery bypass surgery|Coronary stent}}Narrowings of the coronary arteries (ischemic heart disease) are treated to relieve symptoms of chest pain caused by a partially narrowed artery (angina pectoris), to minimise heart muscle damage when an artery is completely occluded ([[myocardial infarction]]), or to prevent a myocardial infarction from occurring. Medications to improve angina symptoms include [[Medical use of nitroglycerin|nitroglycerin]], [[beta blocker]]s, and calcium channel blockers, while preventative treatments include [[Antiplatelet drug|antiplatelets]] such as [[aspirin]] and [[statin]]s, lifestyle measures such as stopping smoking and weight loss, and treatment of risk factors such as high blood pressure and diabetes.<ref>{{Cite journal|last1=Authors/Task Force Members|last2=Piepoli|first2=Massimo F.|last3=Hoes|first3=Arno W.|last4=Agewall|first4=Stefan|last5=Albus|first5=Christian|last6=Brotons|first6=Carlos|last7=Catapano|first7=Alberico L.|last8=Cooney|first8=Marie-Therese|last9=Corrà|first9=Ugo|date=September 2016|title=2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)|journal=Atherosclerosis|volume=252|pages=207–274|doi=10.1016/j.atherosclerosis.2016.05.037|issn=1879-1484|pmid=27664503|url=http://orbi.ulg.ac.be/handle/2268/205776|doi-access=free|access-date=11 September 2018|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828102950/https://orbi.uliege.be/handle/2268/205776|url-status=live}}</ref>

In addition to using medications, narrowed heart arteries can be treated by expanding the narrowings or redirecting the flow of blood to bypass an obstruction. This may be performed using a [[percutaneous coronary intervention]], during which narrowings can be expanded by passing small balloon-tipped wires into the coronary arteries, inflating the balloon to expand the narrowing, and sometimes leaving behind a metal scaffold known as a stent to keep the artery open.<ref name=":0">{{Cite journal|last1=Kolh|first1=Philippe|last2=Windecker|first2=Stephan|last3=Alfonso|first3=Fernando|last4=Collet|first4=Jean-Philippe|last5=Cremer|first5=Jochen|last6=Falk|first6=Volkmar|last7=Filippatos|first7=Gerasimos|last8=Hamm|first8=Christian|last9=Head|first9=Stuart J.|date=October 2014|title=2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)|journal=European Journal of Cardio-Thoracic Surgery|volume=46|issue=4|pages=517–592|doi=10.1093/ejcts/ezu366|issn=1873-734X|pmid=25173601|doi-access=free}}</ref>

If the narrowings in coronary arteries are unsuitable for treatment with a percutaneous coronary intervention, open surgery may be required. A [[Coronary artery bypass surgery|coronary artery bypass graft]] can be performed, whereby a blood vessel from another part of the body (the [[Great saphenous vein|saphenous vein]], [[radial artery]], or [[Internal thoracic artery|internal mammary artery]]) is used to redirect blood from a point before the narrowing (typically the [[aorta]]) to a point beyond the obstruction.<ref name=":0" />{{sfn|Davidson's|2010|pp=585–588, 614–623}}

==== Valvular heart disease ====
{{Main|Artificial heart valve}}Diseased heart valves that have become abnormally narrow or abnormally leaky may require surgery. This is traditionally performed as an open surgical procedure to replace the damaged heart valve with a tissue or metallic [[Artificial heart valve|prosthetic valve]]. In some circumstances, the [[Tricuspid valve|tricuspid]] or [[Mitral valve|mitral]] valves can be repaired [[Mitral valve repair|surgically]], avoiding the need for a valve replacement. Heart valves can also be treated percutaneously, using techniques that share many similarities with percutaneous coronary intervention. [[Transcatheter Aortic Valve Replacement|Transcatheter aortic valve replacement]] is increasingly used for patients consider very high risk for open valve replacement.<ref name=":4">{{Cite journal|last1=Vahanian|first1=Alec|last2=Alfieri|first2=Ottavio|last3=Andreotti|first3=Felicita|last4=Antunes|first4=Manuel J.|last5=Barón-Esquivias|first5=Gonzalo|last6=Baumgartner|first6=Helmut|last7=Borger|first7=Michael Andrew|last8=Carrel|first8=Thierry P.|last9=De Bonis|first9=Michele|date=October 2012|title=Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)|journal=European Journal of Cardio-Thoracic Surgery|volume=42|issue=4|pages=S1–44|doi=10.1093/ejcts/ezs455|issn=1873-734X|pmid=22922698|doi-access=free}}</ref>

==== Cardiac arrhythmias ====
{{Main|Heart arrhythmia|Radiofrequency ablation|Artificial cardiac pacemaker}}Abnormal heart rhythms ([[Heart arrhythmia|arrhythmias]]) can be treated using antiarrhythmic drugs. These may work by manipulating the flow of electrolytes across the cell membrane (such as [[calcium channel blocker]]s, [[sodium channel blocker]]s, [[amiodarone]], or [[digoxin]]), or modify the autonomic nervous system's effect on the heart ([[beta blocker]]s and [[atropine]]). In some arrhythmias such as atrial fibrillation which increase the risk of stroke, this risk can be reduced using anticoagulants such as [[warfarin]] or [[novel oral anticoagulants]].<ref name=":3">{{Cite journal|last1=Kirchhof|first1=Paulus|last2=Benussi|first2=Stefano|last3=Kotecha|first3=Dipak|last4=Ahlsson|first4=Anders|last5=Atar|first5=Dan|last6=Casadei|first6=Barbara|last7=Castella|first7=Manuel|last8=Diener|first8=Hans-Christoph|last9=Heidbuchel|first9=Hein|date=November 2016|title=2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS|journal=Europace|volume=18|issue=11|pages=1609–1678|doi=10.1093/europace/euw295|issn=1532-2092|pmid=27567465|doi-access=free}}</ref>

If medications fail to control an arrhythmia, another treatment option may be [[catheter ablation]]. In these procedures, wires are passed from a [[Femoral vein|vein]] or [[Femoral artery|artery]] in the leg to the heart to find the abnormal area of tissue that is causing the arrhythmia. The abnormal tissue can be intentionally damaged, or ablated, by [[Radiofrequency ablation|heating]] or [[Cryoablation|freezing]] to prevent further heart rhythm disturbances. Whilst the majority of arrhythmias can be treated using minimally invasive catheter techniques, some arrhythmias (particularly [[atrial fibrillation]]) can also be treated using open or [[Thoracoscopy|thoracoscopic]] surgery, either at the time of other cardiac surgery or as a standalone procedure. A [[cardioversion]], whereby an electric shock is used to stun the heart out of an abnormal rhythm, may also be used.

Cardiac devices in the form of [[Artificial cardiac pacemaker|pacemakers]] or [[Defibrillation|implantable defibrillators]] may also be required to treat arrhythmias. Pacemakers, comprising a small battery powered generator implanted under the skin and one or more leads that extend to the heart, are most commonly used to treat abnormally [[Bradycardia|slow heart rhythms]].<ref name=":1">{{Cite journal|last1=European Society of Cardiology (ESC)|last2=European Heart Rhythm Association (EHRA)|last3=Brignole|first3=Michele|last4=Auricchio|first4=Angelo|last5=Baron-Esquivias|first5=Gonzalo|last6=Bordachar|first6=Pierre|last7=Boriani|first7=Giuseppe|last8=Breithardt|first8=Ole-A.|last9=Cleland|first9=John|date=August 2013|title=2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)|journal=Europace|volume=15|issue=8|pages=1070–1118|doi=10.1093/europace/eut206|issn=1532-2092|pmid=23801827|doi-access=free}}</ref> Implantable defibrillators are used to treat serious life-threatening rapid heart rhythms. These devices monitor the heart, and if dangerous heart racing is detected can automatically deliver a shock to restore the heart to a normal rhythm. Implantable defibrillators are most commonly used in patients with heart failure, [[Cardiomyopathy|cardiomyopathies]], or inherited arrhythmia syndromes.

==== Heart failure ====
{{Main|Heart failure}}As well as addressing the underlying cause for a patient's heart failure (most commonly [[Coronary artery disease|ischemic heart disease]] or [[hypertension]]), the mainstay of heart failure treatment is with medication. These include drugs to prevent fluid from accumulating in the lungs by increasing the amount of urine a patient produces ([[diuretic]]s), and drugs that attempt to preserve the pumping function of the heart ([[beta blocker]]s, [[ACE inhibitor]]s and [[Antimineralocorticoid|mineralocorticoid receptor antagonists]]).<ref name=":2">{{Cite journal|last1=Ponikowski|first1=Piotr|last2=Voors|first2=Adriaan A.|last3=Anker|first3=Stefan D.|last4=Bueno|first4=Héctor|last5=Cleland|first5=John G.F.|last6=Coats|first6=Andrew J.S.|last7=Falk|first7=Volkmar|last8=González-Juanatey|first8=José Ramón|last9=Harjola|first9=Veli-Pekka|date=August 2016|title=2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC|journal=European Journal of Heart Failure|volume=18|issue=8|pages=891–975|doi=10.1002/ejhf.592|issn=1879-0844|pmid=27207191|hdl=2434/427148|s2cid=221675744|url=https://orbi.uliege.be/bitstream/2268/205777/1/2016%20ESC%20Guidelines%20for%20the%20diagnosis%20and%20treatment%20of%20acute%20and%20chronic%20heart%20failure.pdf|access-date=24 September 2019|archive-date=14 June 2020|archive-url=https://web.archive.org/web/20200614214934/https://orbi.uliege.be/bitstream/2268/205777/1/2016%20ESC%20Guidelines%20for%20the%20diagnosis%20and%20treatment%20of%20acute%20and%20chronic%20heart%20failure.pdf|url-status=live}}</ref>

In some patients with heart failure, a specialised pacemaker known as [[Cardiac resynchronization therapy|cardiac resynchronisation therapy]] can be used to improve the heart's pumping efficiency.<ref name=":1" /> These devices are frequently combined with a defibrillator. In very severe cases of heart failure, a small pump called a [[ventricular assist device]] may be implanted which supplements the heart's own pumping ability. In the most severe cases, a [[Heart transplantation|cardiac transplant]] may be considered.<ref name=":2" />