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Overview
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.
Symptoms
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
- feeling lightheaded and fainting
Less common symptoms
Other symptoms of 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
- a fast heart rate
- a pounding, fluttering or irregular heartbeat (palpitations)
Some people with heart failure may also experience feelings of depression and anxiety.
Causes
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:
- coronary heart disease – where the arteries that supply blood to the heart become clogged up 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
- conditions affecting the heart muscle (cardiomyopathy)
- 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
Sometimes obesity, anaemia, drinking too much alcohol, an overactive thyroid or high pressure in the lungs (pulmonary hypertension) can also lead to heart failure.
Diagnosis
Tests for heart failure
Tests you may have to diagnose heart failure include:
- blood tests – to check whether there's anything in your blood that might indicate heart failure or another illness
- an electrocardiogram (ECG) – this records the electrical activity of your heart to check for problems
- an echocardiogram – a type of ultrasound scan where sound waves are used to examine your heart
- breathing tests – you may be asked to blow into a tube to check whether a lung problem is contributing to your breathlessness; common tests include spirometry and a peak flow test
- a chest X-ray – to check whether your heart's bigger than it should be, whether there's fluid in your lungs (a sign of heart failure), or whether a lung condition could be causing your symptoms
Stages of heart failure
When you're diagnosed with heart failure, your doctor will usually be able to tell you what stage it is.
The stage describes how severe your heart failure is.
It's usually given as a class from 1 to 4, with 1 being the least severe and 4 being the most severe:
- class 1 – you don't have any symptoms during normal physical activity
- class 2 – you're comfortable at rest, but normal physical activity triggers symptoms
- class 3 – you're comfortable at rest, but minor physical activity triggers symptoms
- class 4 – you're unable to carry out any physical activity without discomfort and may have symptoms even when resting
Treatment Options
Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.
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.
When To See A Doctor
See your GP if you experience persistent or gradually worsening symptoms of heart failure.
The symptoms can be caused by other, less serious conditions, so it's a good idea to get them checked out.
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