What is heart failure?
Heart failure is a condition in which the heart cannot pump blood as well as the body needs. It does not mean the heart has stopped; it means the heart is working less effectively. It usually develops gradually and can be managed with medicines, lifestyle changes, devices and, in selected patients, surgery.
What causes it?
Heart failure is usually the end result of another heart problem. Common causes include:
- Coronary artery disease and previous heart attacks
- Long-standing high blood pressure (hypertension)
- Heart valve disease
- Cardiomyopathy (disease of the heart muscle)
- Heart rhythm problems such as atrial fibrillation
- Myocarditis (inflammation of the heart muscle)
- Congenital heart defects
- Excess alcohol, diabetes and some medications
Symptoms
- Breathlessness, especially on exertion or when lying flat
- Persistent tiredness and reduced exercise capacity
- Swelling of the ankles, feet or abdomen
- Rapid weight gain from fluid build-up
- A cough that is worse at night
- Palpitations or a fast heart rate
When to seek emergency care
Call your local emergency services immediately if you have sudden severe breathlessness at rest, chest pain, fainting, or new confusion. These can be signs of a deteriorating situation that needs urgent treatment.
How is it diagnosed?
Your doctor will take a history, examine you, and usually arrange an electrocardiogram (ECG), an echocardiogram (ultrasound of the heart), blood tests and a chest X-ray. These help find the cause and guide treatment.
Treatment
Treatment is tailored to the cause and stage. It commonly includes medicines that remove excess fluid and protect the heart, control of blood pressure and rhythm, and lifestyle changes such as limiting salt, keeping active within your limits and stopping smoking. Some patients benefit from a pacemaker or a defibrillator, and a few are offered heart failure surgery. Treatment works best when medicines are taken exactly as prescribed and follow-up visits are kept.
Living with heart failure
Weigh yourself daily and tell your team about sudden weight gain, take medicines regularly, stay up to date with vaccinations, and learn your own warning signs so you can act early. Many people live active lives for years with well-managed heart failure.
Related: coronary artery disease · hypertension · cardiomyopathy