Heart Failure

Heart failure means the heart is not pumping or filling as well as it should, so it cannot fully meet the body’s needs. It does not mean the heart has stopped. With the right diagnosis, medicines and self-care, many people feel better and live longer.

What is heart failure?

Heart failure can follow a heart attack or coronary artery disease, long-standing high blood pressure, heart valve disease, diseases of the heart muscle (cardiomyopathy) or heart rhythm problems. It is often described by the ejection fraction, the percentage of blood pumped out with each beat: heart failure with reduced, mildly reduced or preserved ejection fraction. The type guides treatment.

Symptoms

breathlessness on exertion, or when lying flat
waking at night feeling breathless
swelling of the ankles, legs or abdomen
tiredness and reduced ability to exercise
rapid weight gain from fluid build-up

Sudden or severe breathlessness is an emergency: call 1122.

COMPLETE Heart Failure Guide | Symptoms | Tests | Treatment - Urdu/Hindi

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Tests

Tests your cardiologist may arrange include an ECG, a natriuretic peptide blood test (BNP or NT-proBNP), an echocardiogram (ultrasound of the heart), and blood tests such as kidney function and blood count. Further tests, such as coronary angiography, may be needed to find the cause.

Treatment

For heart failure with reduced ejection fraction, guidelines recommend a combination of medicines shown to improve survival and reduce hospital admissions: an ACE inhibitor or ARNI, a beta-blocker, a mineralocorticoid receptor antagonist and an SGLT2 inhibitor. They are started and adjusted carefully. Diuretics (water tablets) relieve fluid build-up. Treating the underlying cause is equally important, and some patients may be referred for device therapy.

Living well with heart failure

weigh yourself every morning and report a sudden weight gain over a few days
take your medicines every day as prescribed
avoid excess salt, and follow the fluid advice given to you
stay active within your limits
keep vaccinations up to date, including the flu vaccine
avoid painkillers such as ibuprofen unless your doctor advises them
attend regular follow-up

Questions patients ask

Is heart failure the same as a heart attack?

No. A heart attack is caused by a blocked heart artery. Heart failure is a condition in which the heart does not pump or fill well, and it can be one of the consequences of a heart attack.

Can heart failure improve?

For many people, symptoms and heart function improve with treatment, especially when the cause is treated and medicines are optimised.

Should I stop eating salt completely?

Avoid excessive salt. Very strict restriction is not necessary for everyone, so follow the advice given for your situation.

References

McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599–3726. doi.org/10.1093/eurheartj/ehab368 (opens in a new tab)
McDonagh TA, et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023;44:3627–3639. doi.org/10.1093/eurheartj/ehad195 (opens in a new tab)

This page is general information about the condition or procedure, not personal medical advice. Whether a test or treatment is right for you is decided at your consultation. Medical disclaimer.

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