Heart failure

Heart failure means that the heart is not able to pump blood around the body properly. It usually happens because the heart has become too weak or stiff.

It's sometimes called ‘congestive’ cardiac failure, although this name isn't widely used today.

Heart failure means that your heart needs some extra support to help it work better. It can occur at any age, but commonly occurs in older people.

Heart failure is a long-term condition that tends to get slowly worse with time. It can't usually be cured, but the symptoms can often be controlled for many years.

Symptoms of heart failure

Are mainly:

■ Feeling breathless, at rest, or after activity, and is sometimes worse when lying down.

■ Feeling generally tired and finding exercise exhausting.

■ Swollen ankles and legs, often less in the morning, and worse later in the day.

Symptoms can sometimes develop quite quickly (acute heart failure) or gradually over weeks or months (chronic heart failure).

Other less common symptoms

Can include:

■ A persistent cough, which can be worse at night

■ Wheezing

■ A bloated abdomen

■ Loss of appetite ■ Weight loss or gain

■ Feeling confused

■ Palpitations or an irregular and sometimes fast heart rate

■ Feeling dizzy or faint

■ Depression or anxiety

When to get medical advice

You should see your GP if you experience persistent or gradually worsening symptoms of heart failure.

The symptoms can sometimes be caused by other, less serious conditions, so it is important to get them checked out.

Normally upon having symptoms of heart failure, your GP will ask you to describe them and will then perform a physical examination. If they suspect heart failure, you maybe referred to a specialist for further tests.

If your symptoms are severe or suddenly appear, then you should seek urgent medical assistance, or an ambulance if very severe, as you may need treatment in Hospital.

Tests for heart failure

Tests you may need, to diagnose heart failure include:

■ Blood tests – to detect whether heart failure is the problem, or another illness.

■ An electrocardiogram (ECG) – this records the electrical activity of your heart.

■ An echocardiogram – is a type of ultrasound scan where sound waves are used to examine your heart.

■ Breathing tests – you may be asked to blow into a tube to check whether a lung problem is contributing to your breathlessness; common tests include spirometry and a peak flow test.

■ A chest X-ray – to check the size of your heart, to check for enlargement, also there may be fluid in your lungs (also a sign of heart failure), to check whether a lung condition could be causing your symptoms.

The British Heart Foundation has a website, where you can read more about this.

Stages of heart failure

When you're diagnosed with heart failure, your doctor will usually be able to tell you what stage it is.

The stage describes how severe your heart failure is. It's usually given as a class from 1 to 4, with 1 being the least severe and 4 being the most severe:

■ class I – you have no symptoms during normal physical activity

■ class II – you are comfortable at rest, but normal physical activity triggers symptoms

■ class III – you are comfortable at rest, but a little physical activity triggers symptoms

■ class IV – you are unable to carry out any physical activity without discomfort and you may have symptoms even when at rest

Knowing at which stage your heart failure is, will aid the doctors to decide which course of treatment to follow.

The main course of action is to ensure that you follow a healthy lifestyle, and to take the correct medication prescribed for you. Sometimes a device is needed to control the rhythm of your heart; this can be implanted into your chest. Sometimes an operation is needed. There are many combinations of treatment and these usually need to be followed for the rest of your life.

Lifestyle changes

If you have been diagnosed with heart failure, there are some healthy life style changes that can help relieve your symptoms and reduce your risk of becoming even more seriously ill.

It is often recommended to

■ Follow a healthy diet

■ Stop smoking

■ Moderate alcohol intake ■ Reduce your salt intake ■ Exercise regularly With heart failure, it is very important to look after your own health and wellbeing, and to seek support as and when it is needed.

You may be given an opportunity to attend a rehabilitation programme. This teaches you the best course of action, as in exercise, re-education, relaxation and emotional support.