2.5 Heart failure review

Heart failure means that your heart is not pumping blood around your body as effectively as it should. 

Having heart failure doesn’t mean that your heart has stopped working, but that your heart needs some support to help it work better.

To diagnose heart failure, your doctor will ask you questions about your medical history, talk about your symptom(s) and do a physical examination. This will include checking your heart rate and rhythm, taking your blood pressure, and checking if you have fluid in your lungs, legs and other parts of your body. In most cases you will also have further tests to confirm the diagnosis and guide how your symptoms are controlled.

You may hear your doctor talk about the ‘ejection fraction’ of your heart. This refers to the amount of blood that is pushed out of your left ventricle every time your heart beats. It’s usually expressed as a percentage – over 50% is considered normal.

Some people with heart failure have a normal ejection fraction, so ejection fraction is used alongside other tests to help diagnose heart failure.

There are lots of reasons why you may develop heart failure. It can be sudden or it can happen slowly over months or even years.

The most common causes are:

• A heart attack – this can cause long-term damage to your heart, which can affect how well the heart can pump.
• High blood pressure – this can put extra strain on the heart, which over time can lead to heart failure.
• Cardiomyopathy – a disease of the heart muscle. There are different types which can either be inherited or caused by other things, such as viral infections.

Heart failure can also be caused by:

• Damaged or diseased heart valves
• An abnormal heart rhythm (arrhythmia)
• Congenital heart conditions – heart problems that you’re born with
• A viral infection affecting the heart muscle
• Excessive alcohol consumption
• Anaemia – a lack of oxygen carrying haemoglobin or red blood cells in your blood

The main symptoms are:

• Shortness of breath when you are being active or at rest.
• Swollen feet, ankles, stomach and around the lower back area.
• Feeling unusually tired or weak.

Symptoms occur because your heart is not able to pump blood around the body efficiently. This can lead to a build-up of fluid that backs up into the lungs, which causes breathlessness. Also because the heart is not pumping properly it can cause fluid retention, leading to swelling in your legs, ankles, feet or in the small of your back or abdomen.

You may also feel extremely tired because your heart is not able to deliver enough blood and oxygen to the muscles in your body.

While there isn’t a cure for heart failure at the moment, the treatments available help to control symptoms leading many people to live full and active lives.

Your doctor is likely to prescribe drugs that will help to improve your symptoms, keep you as well as possible, help prevent your condition from getting worse and help to improve your life expectancy.

Some people with heart failure will benefit from a pacemaker or ICD, which help to improve the pumping action of your heart. Your doctor will talk to you about these treatments if they are the right option for you.

If you have a home blood pressure monitor you can use this to record your reading. You can purchase these from most pharmacies or alternatively source online. Alternatively you can visit our health check room at the surgery and ask to use our machine. You could also check your weight at the same time if you do not have scales at home.

Alongside taking your medicines as prescribed, making changes to your lifestyle can also help to keep your condition as stable as possible so you can continue to do the things you enjoy.

Such changes may include:

• Weighing yourself regularly – sudden weight gain may suggest too much fluid is building up in your body.
• Watching the amount of fluid you have each day.
• Controlling your blood pressure to reduce the strain on your heart.
• Cutting down on salt – too much salt in your diet can make your body hold on to water.
• Stopping smoking – this is the single most important thing you can do to live longer.
• Limiting how much alcohol you drink to ensure your symptoms aren’t made worse and to help keep your heart healthy.
• Keeping active – this can help improve your energy, stamina and fitness. Regular physical activity can also help you to improve or cope with your symptoms.
• Keeping to a healthy weight, which will help to prevent your heart from working too hard.

It’s normal to feel low or sad from time to time. You may feel down about your symptoms and your limitations, or feel that you have a lack of control over your life.

Some people find it very difficult to live with the uncertainty of having heart failure. But learning about your condition and being involved in making decisions about your treatment will all help you to feel more in control and may help to relieve anxiety. It’s also important to discuss your worries with your family and close friends.

Stress affects different people in different ways. People who don’t manage their stress well may turn to unhealthy habits such as smoking, drinking alcohol, or snacking on unhealthy foods. Knowing what triggers the stress can help you to tackle the problem.

Finding healthy ways of coping with stress and learning to relax can help you manage your heart failure.