Heart failure: Everything you need to know

What is heart failure?

Heart failure is a serious condition in which the heart is failing to pump oxygen-rich blood around the body at the correct pressure level, caused by the heart muscle becoming too weak. There are different types of heart failure that a person can suffer from, caused by different areas of the heart muscle itself.

Heart failure could be caused by a condition such as coronary heart disease, or brought on as the result of a previous condition, for example there might be lasting weakness after experiencing a heart attack. The risk of developing heart failure increases with age and also if you maintain a poor or sedentary lifestyle.

What are the symptoms of heart failure?

If you have heart failure you may experience a range of symptoms including:

• Tiredness
• Weakness
• Breathlessness
• Swelling in feet and legs
• A reduction in your ability to exercise

If you have any suspicions that you are experiencing heart failure, you should consult with a medical professional immediately.

What causes heart failure?

Heart failure can be brought on by various conditions including:

Coronary heart disease

Coronary heart disease, or coronary artery disease, is a condition where arteries and blood vessels that bring blood to the heart get clogged with fatty substances. This restricts blood flow to the heart and can cause issues like angina or a heart attack depending on the severity.

High blood pressure

High blood pressure is where it takes a higher force than is considered ‘normal’ to pump blood around your body. The extra force required by the heart can cause the heart to become strained and over time this could lead to heart failure.

Heart rhythm problems

Your heart works by beating at a regular rhythm to keep the blood flowing continually around the body. Some people experience heart rhythm problems where the heart beats irregularly, causing blood to be pumped slower or faster depending on the type of arrhythmia they have.

With regular medication and monitoring, people with heart rhythm problems can lead a normal, healthy life.

Congenital heart disease

Some people are born with a defect in their heart that prevents the organ from working normally.

The risk of being born with congenital heart disease is increased under certain situations including if the child has Down’s syndrome, if the mother smokes or drinks during pregnancy, if the mother has poorly controlled type 1 or type 2 diabetes, or if the baby inherits a chromosome defect.

How is heart failure diagnosed?

If you suspect you may have heart failure, you should speak to a medical professional as soon as possible. They will be able to run a series of tests to investigate your symptoms and make a diagnosis.

Initially, your specialist may ask you about your medical history and ask you if heart disease runs in your family. You are also likely to be given a physical examination where your specialist will listen to your heart.

Beyond this, your specialist may order tests including:

• Blood tests – to check whether there is anything in your blood that is an indicator of heart failure
• Ultrasound scan – where an ultrasound scan uses soundwaves to examine your heart
• ECG – Also know as an electrocardiogram, this machine records the electrical activity of your heart and can check for abnormalities. You may also be asked to undergo a cardiac stress test (stress ECG) to examine how your heart performs under stress
• X-ray – Your specialist will be able to see the size of your heart and check if it is larger than it should be. They can also examine for fluid on your lungs or check for other lung conditions that may be causing problems
• Breathing tests – To check whether a lung problem is causing your symptoms – for this you may be asked to breathe into a tube to assess why you may have a shortness of breath

What are the stages of heart failure?

Most commonly, the severity of heart failure is described by class, and often as NYHA class. This stands for New York Heart Association (the organisation who devised it). Below are the different classes and what they mean:

• Class 1 - a patient has structural or functional heart disease on a scan but with no symptoms
• Class 2 - patients have generally mild symptoms of heart failure and modest limitations of physical activity
• Class 3 - there is significant limitation of physical activity although comfortable at rest
• Class 4 -  there are symptoms of heart failure at rest or very minor physical activity such as getting dressed

The higher the NYHA class, the worse the prognosis. All classes of heart failure need assessment and treatment.

What is the difference between heart failure and heart attack?

A heart attack means that there is a sudden blockage of blood flow to the heart muscle, usually because of a blood clot in a coronary artery. The blockage of blood flow means that the heart muscle doesn’t receive oxygen, and therefore starts to die – causing central chest pain and often irreparable damage to the heart muscle. It is a medical emergency.

Heart failure is the condition that occurs when the heart muscle is not pumping properly. Therefore, a heart attack is one of the most common causes of heart failure.

How can heart failure be prevented?

The most effective way to prevent heart failure is to prevent heart damage being done in the first place. If you already have heart failure, there are various lifestyle changes as well as treatments that can be used to manage symptoms.

Your specialist will discuss risk factors for a heart attack with you once heart failure is diagnosed and your lifestyle or trigger factors should be addressed and modified where necessary.

Your specialist will look at how best to control your blood pressure. They may ask you about you diet or refer you to a dietician so that you can make necessary changes to your diet to ensure it is healthy and balanced. Along with this, regular exercise is important. You may be asked what exercise you already do and together you will come up with a plan to ensure this is suitable for your health.

If you drink regularly, you may be asked to limit the amount of alcohol you consume. You’ll be advised to refrain from taking drugs.

How can heart failure be managed?

Heart failure is a serious condition. After you have been assessed by a consultant cardiologist who is a dedicated heart failure specialist, you should take steps to ensure you follow any guidance given to you to live as long and healthy life as possible.

Medication

It is important that if you are prescribed any medication, you take the dose at the recommended times. If you struggle to remember, you can purchase inexpensive pill organisers to help you organise pills to be taken at set dates and times, or set reminders on electronic devices so you are alerted at the correct times to take your tablets.

Diet and exercise

A healthy diet can help to improve your symptoms. Keeping active is very important too. As a heart patient, loved ones may encourage you to ‘take it easy’ but it is important to keep your body as used to activity as possible so you don’t lose stamina or strength. If you have been given any rehabilitation exercises, set aside time to do them and slowly build up your tolerance. As always though, do take a break when you need to but ensure any exercises recommended get done.

Careful monitoring

If you feel any symptoms worsening it is important to keep a note of them and speak to a health professional as soon as possible. With a heart condition, the earlier problems are caught, the better. If in doubt, seek medical advice. It may save your life.

Pay attention to salt and fluids

Fluid retention is often a key sign of heart failure and preventing this as much as possible is important. If your specialist has asked you to limit your intake of fluid, stick to these limits. It may even be helpful to weigh yourself regularly to keep an eye on weight gain which may be due to fluid retention. Similarly, limiting your intake of salt can also help with this too. Don’t add extra salt to your cooking and pay attention to supermarket labels so you understand what foods contain high levels of salt so you can swap them for healthy alternatives.

Get specialist advice

If you have been diagnosed with heart failure or are worried you may be suffering with the condition, it’s crucial to seek the advice of a specialist. Our consultant cardiologists are highly experienced at helping people to manage their heart problems. Call or book online today to meet with one of our experts and they’ll build a personalised treatment plan to help you manage your heart failure as best you can.