Heart Failure
What it means, what causes it, and how it is treated
Heart failure does not mean the heart has stopped working — it means the heart is not pumping as efficiently as it should. It is a serious long-term condition affecting around 900,000 people in the UK, and can significantly affect quality of life if not well managed.
What is heart failure?
In heart failure, the heart muscle is weakened or stiffened and cannot pump blood around the body as effectively as normal. This means that the body's organs and tissues may not receive enough oxygen and nutrients, and fluid can build up in the lungs and legs. Heart failure can affect the left side of the heart, the right side, or both.
What causes heart failure?
The most common causes of heart failure in the UK are coronary artery disease (narrowed arteries that supply the heart), high blood pressure, and previous heart attacks. Other causes include certain heart rhythm disorders, heart valve disease, viral infections affecting the heart muscle (cardiomyopathy), alcohol abuse, and some chemotherapy drugs. Sometimes no clear cause can be identified.
Symptoms to look out for
Symptoms of heart failure include breathlessness during everyday activities or at rest, swollen ankles, legs or abdomen, persistent tiredness and fatigue, a persistent cough (sometimes with pink or white mucus), and difficulty lying flat in bed without feeling breathless. Symptoms often develop gradually but can sometimes come on suddenly. Any sudden worsening of symptoms should be assessed urgently.
How is heart failure treated?
Treatment for heart failure aims to relieve symptoms, slow disease progression, and reduce the risk of hospitalisation and death. It typically involves a combination of medications, lifestyle changes, and in some cases devices such as pacemakers or implantable defibrillators. Monitoring your own weight daily is an important part of self-management — a sudden weight gain of more than 2 kilograms in two days is a sign of fluid build-up and should be reported to your healthcare team promptly.
Managing heart failure day to day
Living with heart failure requires ongoing attention to diet, fluid intake, physical activity and medication. Reducing salt intake, limiting alcohol, stopping smoking, and attending all follow-up appointments are essential. Cardiac rehabilitation programmes — a series of supervised exercise and education sessions — have been shown to significantly improve outcomes and quality of life. Your heart failure nurse specialist is a key source of support and advice. Always keep a list of your medications and dosages, and never stop any heart medication without speaking to your doctor first. Information in this article has been prepared following careful evaluation of national and international clinical guidelines.