Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stiff. It's sometimes called congestive heart failure, although this name is not widely used now. Heart failure does not mean your heart has stopped working. It means it needs some support to help it work better. It can occur at any age, but is most common in older people. Heart failure is a long-term condition that tends to get gradually worse over time. It cannot usually be cured, but the symptoms can often be controlled for many years. The main symptoms of heart failure are: Some people also experience other symptoms, such as a persistent cough, a fast heart rate and
dizziness. Symptoms can develop quickly [acute heart failure] or gradually over weeks or months [chronic heart failure]. See a GP if you experience persistent or gradually worsening symptoms of heart failure. Call 999 for an ambulance or go to your nearest A&E 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 ECG and an echocardiogram. Find out more about how heart failure is diagnosed 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: Sometimes obesity, anaemia, drinking too much alcohol, an
overactive thyroid or high pressure in the lungs [pulmonary hypertension] can also lead to 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.Symptoms of heart failure
When to get medical advice
Causes of heart failure
Treatments for heart failure
How you're treated will depend on what is causing your heart failure.
Common treatments include:
- lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
- medicine – a range of medicines can help; many people need to take 2 or 3 different types
- devices implanted in your chest – these can help control your heart rhythm
- surgery – such as 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.
Outlook for heart failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities you're able to do and is often eventually fatal.
But it's very difficult to tell how the condition will progress on an individual basis.
It's very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
Information:
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our guide to care and support explains your options and where you can get support.
Page last reviewed: 19 May 2022
Next review due: 19 May 2025
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Heart Health
March 14, 2022
The earliest symptoms of heart failure are often very subtle, but it's dangerous to ignore them.
It's an unfortunate truth that your body slows down in your sixth and seventh decades. Climbing a flight of stairs that you once took two at a time can now feel as daunting as scaling Mount Everest. While some degree of vitality loss can be attributed to natural aging, fatigue and breathlessness may also be signals that your heart is not functioning as well as it should. "There is a general tendency for people to ignore heart failure symptoms and attribute them to just getting older. Therefore, it was very important for us to create an easy way to identify those symptoms," says Dr. Mandeep R. Mehra, medical director of the Heart and Vascular Center at Harvard-affiliated Brigham and Women's Hospital.
FACES of heart failure
Heart failure occurs when something damages the heart muscle or reduces the heart's ability to pump effectively. Most often, the damage stems from coronary artery disease or heart attack. But faulty heart valves, longstanding high blood pressure, or genetic disease may also be to blame. No matter what the cause, the failing heart can no longer pump well enough to keep up with the body's demand for oxygen-rich blood.
To help both doctors and patients quickly spot a possible combination of heart failure symptoms, the Heart Failure Society of America [www.HFSA.org] developed a handy tool that goes by the acronym FACES.
F = Fatigue. When the heart can't pump enough oxygen-rich blood to meet the body's energy needs, a general feeling of tiredness or fatigue sets in.
A = Activity limitation. People with heart failure are often unable to do their normal activities because they become easily tired and short of breath.
C = Congestion. Fluid buildup in the lungs can result in coughing, wheezing, and breathing difficulty.
E = Edema or ankle swelling. When the heart doesn't have enough pumping power to force used blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs, and abdomen. Excess fluid can also cause rapid weight gain.
S = Shortness of breath. Fluid in the lungs makes it more difficult for carbon dioxide in used blood to be exchanged for fresh oxygen. It may also be harder to breathe when lying down because gravity allows fluid from below the lungs to travel up the torso.
By themselves, these five warning signs do not confirm a diagnosis of heart failure, but they do convey a sense of urgency to seek medical advice, says Dr. Mehra.
Further testing
In addition to the physical exam, doctors have two other important tools to spot the presence of heart failure. The first is an echocardiogram [often called an echo], which is a simple, noninvasive test that uses ultrasound to create images of your heart while it beats. If the echo shows a lower-than-normal percentage of blood leaving the heart when the left ventricle contracts, there is a strong possibility of heart muscle damage. Other findings that point to heart failure include abnormal thickening and ballooning of the heart wall and malfunctioning heart valves.
The next step in identifying early-onset heart failure is to look for biomarkers in the blood, such as B-type natriuretic peptide, which is released when the heart is under stress. "I call these compounds 'tears from the heart' because they show that the heart is crying for help," says Dr. Mehra. Once the initial diagnosis is confirmed, further testing may be needed to figure out what's causing the heart's dysfunction and determine the best treatment approach.
Drugs to avoid when you have heart failure
People with heart failure often take multiple medications. However, several commonly used prescription drugs, over-the-counter medicines, and supplements can interact dangerously to intensify heart failure symptoms. To be on the safe side, make sure all of your medical providers have a complete list of all the medicines you take. Particular compounds to watch out for include these:
- Nonsteroidal anti-inflammatory drugs [NSAIDs]. This class of widely used painkillers, which includes ibuprofen [Advil, Motrin], can worsen heart failure symptoms by causing the body to retain sodium and fluid.
- Heartburn medicines and cold remedies. These over-the-counter aids often contain high amounts of sodium, which can trigger fluid overload.
- Herbal remedies. Many so-called natural supplements contain substances such as ephedra, St. John's wort, ginseng, hawthorn, black cohosh, and green tea. All can react badly with several common heart medications.
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