preparing for heart failure testing

Overview

Heart failure is a long-term condition where the heart does not pump blood as well as it should. This does not mean the heart has stopped working — it means the heart needs support to work better. Testing helps doctors understand how well your heart is working and decide the best care for you.

Yes. Heart failure affects millions of people worldwide. In the UK, it is more common as people get older.

Heart failure can affect people of any age, but it is most common in older adults. You may be more at risk if you have high blood pressure, diabetes, or have had a heart attack.

Symptoms

Common symptoms

• Shortness of breath, especially during activity or when lying down
• Feeling very tired or weak
• Swelling in the ankles, legs, feet, or belly
• Rapid weight gain from extra fluid
• Needing to urinate often at night
• Persistent cough or wheezing

Symptoms in children

• Difficulty feeding or poor appetite
• Slow growth or weight gain
• Breathlessness during feeding or play
• Unusual tiredness or sleepiness

Symptoms in older adults

• Confusion or difficulty thinking clearly
• Reduced mobility or balance
• Swelling in the legs or feet
• Shortness of breath with everyday tasks

Causes

Main causes

• A previous heart attack that damaged the heart muscle
• High blood pressure over many years
• Disease of the heart muscle, called cardiomyopathy
• Problems with heart valves
• Sometimes the cause is unknown

Risk factors

• High blood pressure
• Diabetes
• Obesity or being overweight
• Smoking
• Older age
• Family history of heart failure

When to see a doctor

See a doctor urgently if:

• If you have any emergency symptoms, call your local emergency number right away.
• If you notice sudden weight gain or severe breathlessness, seek same-day medical advice.

Book a routine appointment if:

• Make an appointment with your GP if you have new or worsening breathlessness, swelling, or tiredness that affects your daily life.

Diagnosis

Your doctor will ask about your symptoms, examine you, and may arrange tests. Tests help show how well your heart pumps and whether fluid is building up in your body.

Tests that may be done

• Blood tests, including a peptide test (BNP or NT-proBNP)
• Electrocardiogram (ECG), which records the heart's electrical activity
• Echocardiogram, an ultrasound that creates a picture of your heart
• Chest X-ray to look at the size of the heart and fluid in the lungs
• Exercise tests to see how your heart responds to activity
• More advanced scans, such as an MRI, if needed

What to expect at your appointment

Most heart failure tests are painless and done while you rest. An echocardiogram uses sound waves to create a picture of your heart. You may be asked to change into a gown. You can usually go home the same day. Your doctor will explain the results and what they mean.

Treatment

Treatment for heart failure aims to reduce symptoms, slow the condition, and improve quality of life. It often includes a combination of medications, lifestyle changes, and regular monitoring.

Self-care at home

• Take your medicines exactly as prescribed
• Weigh yourself every day and keep a record
• Follow your doctor's advice about fluids and salt
• Keep all follow-up appointments
• Seek help early if symptoms change

Medical treatments

Doctors may prescribe medicines to help the heart pump better, remove extra fluid, and relax blood vessels. In some cases, devices like a pacemaker or defibrillator may be recommended, or surgery if needed. Always discuss your options with your heart team.

When is surgery considered?

Surgery may be considered if a heart valve problem is causing heart failure, or if you need a device to support your heart. Your specialist will explain the benefits and risks.

Living with this condition

Living with heart failure means being aware of your body and managing your daily routines. You may need to plan activities, rest when needed, and track your symptoms.

Lifestyle tips

• Quit smoking and avoid alcohol, or limit it as advised
• Stay as active as you safely can, following your doctor's advice
• Weigh yourself each morning and contact your care team if you gain weight quickly
• Reduce salt in your diet to help manage fluid
• Get enough sleep and manage stress

Diet and exercise

Your doctor or dietitian may suggest a heart-healthy diet with less salt. Regular gentle exercise, such as walking, can improve strength and energy. Always check with your care team before starting new exercise.

Mental health and emotional wellbeing

Living with heart failure can be stressful and sometimes lead to anxiety or depression. It is important to talk about your feelings with your care team. If you ever feel in crisis, please contact a crisis support line or go to your nearest emergency department.

Prevention

You cannot always prevent heart failure, but you can lower your risk by controlling blood pressure, diabetes, maintaining a healthy weight, not smoking, and staying active.

Vaccines

Talk to your healthcare provider about flu, pneumonia, and COVID-19 vaccines, as infections can make heart failure worse.

Screening programmes

If you have a family history or risk factors, ask your doctor about regular heart checks.

Complications

If left untreated

• Breathlessness and fatigue may get worse
• Fluid can build up in the lungs, legs, or abdomen
• Irregular heart rhythms may develop
• Heart function may decline more quickly

Long-term outlook

With early testing and good care, many people with heart failure lead active, fulfilling lives. The future continues to improve with better treatments. Your heart team will help you find ways to live well with the condition.

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