Heart failure living patient overview

Overview

Heart failure is a long-term condition where your heart isn't pumping blood as well as it should. This doesn't mean the heart has stopped or is about to stop, but it means the heart muscle is weak or stiff, so the body doesn't get enough oxygen and nutrients. This can cause symptoms like feeling very tired, short of breath, or having swelling in your legs and ankles.

Yes, heart failure is very common, especially in older adults. It is one of the leading reasons for hospital stays in people over 65.

Heart failure can affect people of any age, but it is most common in older adults. It is also more common in people with high blood pressure, coronary artery disease, diabetes, or a history of heart attacks. Certain factors like obesity, smoking, and a family history of heart disease can increase your risk.

Symptoms

Common symptoms

• Shortness of breath, especially during activity or when lying down
• Feeling very tired or weak (fatigue)
• Swelling in the legs, ankles, or feet (oedema)
• Rapid or irregular heartbeat
• Persistent cough or wheezing, sometimes with white or pink mucus
• Sudden weight gain from fluid buildup

Symptoms in children

• In children, heart failure may cause poor feeding, slow growth, sweating during feeding, and shortness of breath during play.

Symptoms in older adults

• In older adults, symptoms can be less obvious and may include confusion, loss of appetite, or just feeling generally unwell.

Causes

Main causes

• Coronary artery disease – narrowed arteries that reduce blood flow to the heart
• High blood pressure (hypertension) – makes the heart work harder
• Heart attack – damages the heart muscle
• Cardiomyopathy – a disease of the heart muscle
• Heart valve problems – faulty valves that put extra strain on the heart
• Infections or inflammation of the heart muscle (myocarditis)

Risk factors

• Age – risk increases with age
• Family history of heart failure or heart disease
• Obesity
• Diabetes
• Smoking
• Heavy alcohol use
• Some chemotherapy drugs or radiation therapy
• Sleep apnoea

When to see a doctor

See a doctor urgently if:

• If you have sudden or worsening shortness of breath, especially if you can’t do normal activities
• If you gain 2-3 pounds in a day or 5 pounds in a week without trying
• If you have severe swelling in your legs or belly
• If you feel faint or dizzy often

Book a routine appointment if:

• If you notice new or worsening symptoms that are not urgent
• If you have ongoing fatigue, mild swelling, or a cough
• For regular check-ups and medication reviews as advised by your healthcare team

Diagnosis

A doctor will start by asking about your symptoms, medical history, and doing a physical exam. They will listen to your heart and lungs, check for swelling, and take your blood pressure. Based on that, they will order tests to confirm the diagnosis and find the cause.

Tests that may be done

• Blood tests – to check for substances that may indicate heart failure
• Echocardiogram (echo) – an ultrasound of the heart to see how well it pumps and if valves are working
• Electrocardiogram (ECG) – records the heart’s electrical activity
• Chest X-ray – to look for fluid in the lungs or an enlarged heart
• Stress test – to see how your heart works during exercise

What to expect at your appointment

Your doctor will explain the test results and what they mean for you. They will talk about treatment options and help you create a plan to manage your condition. You may be referred to a heart specialist (cardiologist) for further care.

Treatment

Heart failure is usually a long-term condition, but it can be managed with a combination of lifestyle changes, medicines, and sometimes surgery or devices. The goal is to relieve symptoms, improve quality of life, and prevent the condition from getting worse. Treatment plans are tailored to each person.

Self-care at home

• Weigh yourself daily and keep a log – sudden weight gain may mean fluid buildup
• Reduce salt in your diet – aim for less than 2 grams per day (check with your doctor)
• Stay as active as your doctor advises – gentle walking or approved exercises can help
• Quit smoking and limit alcohol
• Manage stress – try relaxation techniques or talk to a counselor
• Keep track of your blood pressure and heart rate if advised

Medical treatments

Doctors may prescribe medicines to help your heart pump better, reduce fluid buildup, lower blood pressure, or slow a fast heart rate. These may include diuretics (water pills), ACE inhibitors, beta blockers, or other types. Your doctor will explain which ones are best for you and how to take them. Never stop or change a medicine without talking to your doctor.

When is surgery considered?

Some people with heart failure may benefit from surgery or implanted devices. For example, a pacemaker or an implantable cardioverter defibrillator (ICD) can help regulate the heartbeat. In some cases, surgery to repair or replace a heart valve is needed. A heart transplant is a last option for a very small number of people.

Living with this condition

Living with heart failure means paying attention to your body and following your treatment plan. You may need to take medicines every day, check your weight, and watch for changes. Many people still work, travel, and enjoy hobbies, but you may need to pace yourself and rest when needed.

Lifestyle tips

• Eat a heart-healthy diet – low salt, low fat, rich in fruits and vegetables
• Stay active – talk to your doctor about safe activities like walking or chair exercises
• Avoid smoking and secondhand smoke
• Limit alcohol – no more than one drink per day if at all
• Manage stress – consider meditation, deep breathing, or talking to a therapist

Diet and exercise

A low-salt diet is very important for heart failure because salt makes your body hold onto fluid. Try to cook with herbs and spices instead of salt. Limit processed foods like canned soup, chips, and fast food. For exercise, aim for gentle aerobic activity like walking or swimming for 20-30 minutes most days, but only if your doctor says it is safe. Stop if you feel very short of breath or dizzy.

Mental health and emotional wellbeing

Having heart failure can be emotionally challenging. It is common to feel anxious, depressed, or overwhelmed. You are not alone. Talk to your doctor about how you feel – they can help with counseling or support groups. Taking care of your mental health is just as important as managing your physical health.

Prevention

You cannot always prevent heart failure, especially if you have a family history or a pre-existing condition. However, you can lower your risk by controlling high blood pressure, managing diabetes, eating well, staying active, not smoking, and limiting alcohol. These steps also help keep your overall heart healthy.

Vaccines

Getting recommended vaccines, such as the flu shot every year and the pneumonia vaccine, can help prevent infections that might make heart failure worse. Ask your doctor which vaccines are right for you.

Screening programmes

If you have risk factors like high blood pressure, diabetes, or a family history of heart disease, regular check-ups with your doctor can help catch heart failure early. Your doctor may do blood tests, blood pressure checks, and listen to your heart. Early treatment can improve outcomes.

Complications

If left untreated

• Fluid buildup in the lungs (pulmonary oedema) – can cause severe breathing problems
• Kidney damage or failure
• Liver damage from fluid buildup
• Irregular heartbeats (arrhythmias) that can be dangerous
• Sudden cardiac arrest

Long-term outlook

Heart failure is a serious condition, but the outlook has improved greatly with modern treatments. Many people live many years with good quality of life. By following your treatment plan, staying active, and getting support, you can manage your symptoms and continue to do the things you enjoy. Progress in medical care means there is more hope than ever before.

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