Heart failure

What is heart failure?

Heart failure doesn’t mean your heart has stopped working. 

It’s when your heart can’t pump blood around your body properly — usually because it’s become stiffer or weaker. Symptoms can start suddenly or increase steadily over time.  When symptoms have been going on for a longer period of time, this is known as chronic heart failure.

Being over 75, having heart disease, high blood pressure, or type 1 or type 2 diabetes increases your heart failure risk.

Heart failure symptoms

Common symptoms of heart failure are:

• being short of breath — when you’re resting and moving, or when you’re lying flat
• feeling tired (fatigue)
• swollen feet, stomach, or ankles — because your body is retaining excess water (fluid retention)
• being unable to lie completely flat – because it makes you feel breathless

Less common symptoms include feeling dizzy, having a cough, or having a fast heartbeat.

If your symptoms are serious, or they happen suddenly, it’s best to call 999, so you can get help quickly.

What causes heart failure?

Several different things can cause heart failure. But it often happens because of another health condition that’s causing your heart to pump less efficiently like:

• a heart attack — when blood isn’t able to reach your heart muscle
• coronary heart disease (CHD) — fatty substances build up in the arteries that supply blood to your heart
• cardiomyopathy — a disease of the heart muscle
• an arrhythmia — when your heart isn’t beating as it should 
• a congenital heart defect — a heart condition you’re born with, affecting the structure of your heart
• high blood pressure (hypertension)
• an under or overactive thyroid

Drinking too much alcohol or binge drinking can sometimes also lead to heart failure. That’s because it raises your blood pressure. It can also lead to heart failure by weakening your heart muscles in the long term (cardiomyopathy).

How is heart failure diagnosed?

If you have symptoms that keep happening or are getting worse, you should see a GP. They might do tests to help diagnose the problem, like:

• blood tests — people with heart failure have higher levels of a hormone called brain natriuretic peptide (BNP)
• an electrocardiogram (ECG) — an electrical recording of your heart’s rhythm
• an echocardiogram (echo) — an ultrasound scan of your heart
• an x-ray — of your heart and lungs 
• breathing tests — when you blow down a tube to test your lungs

Can heart failure be treated?

Heart failure can’t usually be cured, but some treatments might help slow your symptoms down and add years to your life, like:

• lifestyle changes — like stopping smoking and eating a balanced diet
• cardiac rehabilitation – a personalised exercise and education programme offered by hospitals
• medication — to help your symptoms
• having a pacemaker fitted  — a device that helps your heart beat at a healthy rhythm
• having an implantable cardioverter-defibrillator (ICD) fitted — a device that stops your heart from beating at a dangerous rhythm

If you’ve had a heart attack or have heart failure, you should speak to your GP or consultant before you start a new exercise routine.

Can you prevent heart failure?

Maintaining a healthy lifestyle can reduce your heart failure risk, like:

• regular exercise — aim for 150 minutes of moderate activity or 75 minutes of vigorous activity a week
• eating a diet full of fruit, vegetables, beans and pulses, oily fish, nuts and seeds, and whole grains — like a Mediterranean diet 
• maintaining a healthy weight
• reduce your alcohol intake — if you do choose to drink, try not to drink more than 1 a day and avoid binge drinking 
• stopping smoking — after a few weeks of no smoking, your inflammation levels become lower 
• limiting the amount of salt in your diet
• stress management strategies, such as mindfulness, yoga, meditation and tai chi