Heart failure living in adults

Overview

Heart failure is a long-term condition where your heart does not pump blood as well as it should. This means your body does not get enough oxygen and nutrients to work properly. It does not mean your heart has stopped working or is about to stop. With proper care, many people with heart failure live full, active lives.

Yes, heart failure is common, affecting millions of people worldwide. It becomes more common with age, but it can affect younger people too, especially if they have other health problems.

Heart failure can affect any adult, but it is more common in people over 65, and those with high blood pressure, coronary artery disease, diabetes, or a history of heart attack. It also affects people who smoke, are overweight, or have a family history of heart disease.

Symptoms

Common symptoms

• Shortness of breath, especially when lying down or doing light activity
• Feeling very tired or weak
• Swollen ankles, legs, or belly (from fluid buildup)
• Rapid weight gain (2-3 pounds in a day or 5 pounds in a week) from fluid
• Persistent cough or wheezing, especially at night
• Loss of appetite or feeling sick

Symptoms in children

• Heart failure in children is rare and usually caused by a heart defect present at birth or a problem with the heart muscle.
• Symptoms may include poor feeding, slow weight gain, fast breathing, excessive sweating, or being unusually tired.

Symptoms in older adults

• Symptoms can be less obvious and may be mistaken for normal aging.
• Older adults may notice confusion, reduced ability to walk or do daily tasks, increased drowsiness, or frequent falls.

Causes

Main causes

• Coronary artery disease (narrowing of the arteries that supply blood to the heart)
• High blood pressure over many years
• Heart attack that damages the heart muscle
• Damaged heart valves
• Cardiomyopathy (disease of the heart muscle, often due to infections, alcohol, or genetics)

Risk factors

• Older age
• Being overweight or obese
• Diabetes
• Smoking
• Heavy alcohol or drug use
• Family history of heart failure
• Some cancer treatments (chemotherapy or radiation)

When to see a doctor

See a doctor urgently if:

• If you have severe shortness of breath that does not get better with rest
• If you have chest pain or feel like you might faint
• If you cough up pink or foamy mucus

Book a routine appointment if:

• If you have new or worsening swelling, fatigue, or weight gain
• If you notice any symptoms that do not improve with your current treatment
• If you need help managing your blood pressure, diabetes, or other conditions

Diagnosis

Your doctor will take a detailed history, listen to your heart and lungs, and use a stethoscope to check for extra sounds or fluid. They may refer you to a heart specialist for further tests.

Tests that may be done

• Blood tests (to check for heart strain or fluid balance)
• Electrocardiogram (ECG) - a simple test of the heart's electrical activity
• Chest X-ray to look for fluid in the lungs or an enlarged heart
• Echocardiogram (ultrasound of the heart) to see how well your heart pumps

What to expect at your appointment

Diagnosis often takes time and may involve several visits. You will be asked about your symptoms, lifestyle, and medical history. Tests are painless and routine. Once diagnosed, your healthcare team will work with you to create a personal treatment plan.

Treatment

Heart failure is usually treated with a combination of lifestyle changes, medicines, and sometimes medical devices or surgery. Treatment aims to relieve symptoms, slow the condition, and improve your quality of life. Your plan will be tailored to your specific needs.

Self-care at home

• Weigh yourself every day and tell your doctor if you gain more than 2-3 pounds overnight or 5 pounds in a week.
• Take your medicines exactly as prescribed, even if you feel well.
• Limit salt (sodium) in your diet – aim for less than 2000 mg per day.
• Stay as active as your doctor advises – walking or light exercise can help.
• Stop smoking and limit alcohol.

Medical treatments

Medicines are the cornerstone of heart failure treatment. They help reduce fluid buildup, lower blood pressure, and make the heart pump more efficiently. Common types include water pills (diuretics), ACE inhibitors, beta blockers, and mineralocorticoid receptor antagonists. Some people may benefit from devices like a pacemaker or an implantable defibrillator. In advanced cases, a heart transplant may be considered. Always follow your doctor's advice about which treatments are right for you.

When is surgery considered?

Surgery may be used if heart failure is caused by a blocked artery (bypass surgery) or a damaged valve (valve repair or replacement). These procedures can improve heart function and symptoms.

Living with this condition

Living with heart failure means learning to manage your energy. Plan activities, rest when tired, and pace yourself. Keep a daily log of your weight and symptoms, and share it with your healthcare team. Always carry a list of your medicines and doses in your wallet.

Lifestyle tips

• Quit smoking – it worsens heart failure.
• Limit alcohol to no more than 1-2 drinks per week, or avoid it entirely if your doctor advises.
• Manage stress – try deep breathing, meditation, or talking to a friend.
• Get enough sleep – aim for 7-8 hours a night.

Diet and exercise

A heart-healthy diet includes plenty of fruits, vegetables, whole grains, lean protein, and healthy fats. Avoid high-salt processed foods like chips, canned soups, and frozen meals. Work with a dietitian if needed. For exercise, ask your doctor what is safe. Walking, cycling, or swimming can be good options. Start slowly and stop if you feel breathless or dizzy.

Mental health and emotional wellbeing

Heart failure can cause anxiety, depression, or feelings of loss. It is normal to feel overwhelmed at times. Talk to your doctor about how you are feeling – they can refer you to a counsellor or support group. Remember, you are not alone, and getting help is a sign of strength.

Prevention

You can reduce your risk by controlling high blood pressure, diabetes, and cholesterol. Eating a healthy diet, staying active, not smoking, and limiting alcohol also help. If you already have heart disease, following your treatment plan can prevent it from leading to heart failure.

Vaccines

Get the flu vaccine every year and ask your doctor about the pneumococcal vaccine. Infections like the flu can put extra strain on your heart and make heart failure worse.

Screening programmes

If you have risk factors like high blood pressure or a family history of heart disease, have regular check-ups to catch problems early. Your doctor may recommend an ECG or other tests even if you have no symptoms.

Complications

If left untreated

• Fluid buildup in the lungs causing severe breathing problems
• Kidney damage or failure due to poor blood flow
• Irregular heart rhythms that can lead to stroke or sudden cardiac arrest
• Liver damage from fluid backup

Long-term outlook

Heart failure is a serious condition, but many people live many years with it if they follow their treatment and lifestyle changes. New medicines and devices are being developed all the time. Your outlook depends on how well you manage the condition and how much your heart is damaged. With good care, you can still enjoy time with loved ones, do hobbies, and have a good quality of life.

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