Heart failure

What is heart failure?

Heart failure means the heart is not pumping or filling as well as it should to meet the body’s needs. It does not mean the heart has stopped. It is a long-term condition that can often be managed well with treatment.

Symptoms

• Breathlessness on activity, lying flat or waking at night

• Swelling of the ankles, legs or abdomen

• Tiredness and reduced exercise ability

• Rapid weight gain from fluid retention

Common causes

• Coronary artery disease and previous heart attack

• Long-standing high blood pressure

• Heart valve disease

• Cardiomyopathy

• Irregular heart rhythms such as atrial fibrillation

Diagnosis

Tests may include blood tests (including natriuretic peptides), ECG, chest X-ray and echocardiography to measure how well the heart pumps (ejection fraction).

Treatment

Treatment depends on the type of heart failure and usually combines guideline-directed medicines, fluid and salt advice, management of the underlying cause, devices in selected patients, and cardiac rehabilitation. Daily weight checks help detect fluid build-up early.