Heart failure

Heart failure means the heart is unable to pump blood around the body properly. This usually happens because the heart has become too weak or stiff. It can occur at any age, but is most common in older people.

Symptoms of heart failure 

Heart failure doesn't mean your heart has stopped working – it just needs some support to help it work better. Heart failure is a long-term condition that tends to get gradually worse over time. It can't usually be cured but the symptoms can often be controlled for many years.

The symptoms of heart failure can vary from person to person. They may start suddenly or develop gradually over weeks or months.

Main symptoms 

The most common symptoms of heart failure are:

  • breathlessness – this may occur after activity or at rest; it may be worse when you're lying down, and you may wake up at night needing to catch your breath
  • fatigue – you may feel tired most of the time and find exercise exhausting
  • swollen ankles and legs – this is caused by a build-up of fluid (oedema); it may be better in the morning and get worse later in the day

Less common symptoms 

Other non-specific symptoms of more severe heart failure can include:

  • a persistent cough, which may be worse at night
  • wheezing
  • a bloated tummy
  • loss of appetite
  • weight gain or weight loss
  • confusion
  • dizziness and fainting
  • a fast heart rate
  • a pounding, fluttering or irregular heartbeat (palpitations)

Some people with heart failure may also experience feelings of depression and anxiety.

When to get medical advice 

See your GP if you experience persistent or gradually worsening symptoms of heart failure.

Call 999 for an ambulance or go to your emergency department as soon as possible if you have sudden or very severe symptoms.

A number of tests can be used to help check how well your heart is working, including blood tests, an electrocardiogram (ECG) and an echocardiogram (a heart scan).

Causes of heart failure 

Heart failure is often the result of a number of problems affecting the heart at the same time.

Conditions that can lead to heart failure include:

  • arteries becoming clogged with fatty substances(atherosclerosis), which may cause angina or a heart attack
  • high blood pressure – this can put extra strain on the heart, which over time can lead to heart failure
  • cardiomyopathy – conditions affecting the heart muscle
  • heart rhythm problems (arrhythmias) – such as atrial fibrillation
  • damage or other problems with the heart valves
  • congenital heart disease – birth defects that affect the normal workings of the heart
  • things that cause your heart to work harder than normal, for example,  anaemia, kidney failure or an overactive thyroid
  • being very overweight
  • alcohol and harmful drugs such as cocaine

Sometimes high pressure in the lungs because of chronic lung disease (pulmonary hypertension) can also lead to heart failure.

Treatments for heart failure 

Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.

Common treatments include:

  • lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
  • medication – a range of medicines can help; many people need to take two or three different types
  • devices implanted in your chest – these can help control your heart rhythm
  • surgery – such as valve surgery a bypass operation or a heart transplant

Treatment will usually be needed for life.

A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.

Reducing your risk of heart failure 

Some things you can do to reduce your risk of developing heart failure include:

  • stop smoking
  • keep your blood pressure down
  • reduce your cholesterol (fat) level
  • lose weight if you need to
  • eat a healthy diet
  • keep active
  • stop drinking or reducing your alcohol intake
  • cut your salt intake

Living with heart failure 

If you have heart failure, it's important to look after your own health and wellbeing, with support from those involved in your care.

Some of the main things you'll be advised to do include:

Take your medication 

It's very important that you take any prescribed medication, even if you begin to feel better. Some medicines are designed to protect or heal your heart. If you don't take them, they can't help.

Check with your pharmacist, practice nurse and GP if you plan to take any over-the-counter remedies, such as painkillers or nutritional supplements. These can sometimes interfere with your medication.

Have a healthy diet 

A healthy, balanced diet can help improve your symptoms and general health.

Exercise regularly 

Regular physical activity can also help improve your symptoms and general health.

You may find exercise very difficult if you have heart failure, particularly if it's severe. Try to do whatever you can without overexerting yourself, and make sure you rest often.

You may be advised to get involved in a cardiac rehabilitation programme, which will usually involve specialised exercise classes for people with heart conditions.

Stop smoking 

If you smoke, stopping smoking can improve your overall health and reduce your risk of many other health problems.

There is free specialist advice available to help you quit smoking. Stop smoking support services, through GP practices and community pharmacies, are available across Northern Ireland.

Limit the amount of alcohol you drink 

You can usually continue to drink alcohol if you have heart failure, but it's advisable not to exceed the recommended limits of more than 14 alcohol units a week.

If your heart failure is directly related to drinking alcohol, you may be advised to stop entirely.

Get vaccinated  

Heart failure can put a significant strain on your body and mean that you're more vulnerable to infections.

Everyone with heart failure is encouraged to have the annual flu jab and the one-off pneumococcal vaccination.

The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was reviewed October 2017

This page is due for review November 2019

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