Heart failure

Heart failure refers to the condition when the heart is unable to pump blood around the body as well as it should. This can lead to oxygen deprivation to the rest of the body, and abnormal back pressure developing within blood vessels of the body, causing a number of problems.

There are two types of heart failure:

1. Systolic dysfunction (also known as systolic heart failure) occurs when the heart muscle is weakened and doesn’t have enough force to pump oxygen-rich blood throughout the body.

2. Diastolic dysfunction (also known as diastolic heart failure) occurs when the heart contracts normally, but the ventricles cannot relax or are stiff, making it hard for enough blood to enter the heart as it fills.

What causes heart failure?

Heart failure can develop for several reasons including:

  • Coronary artery disease (a narrowing of the heart’s arteries)
  • High blood pressure (hypertension) which can cause the heart to weaken and/or stiffen over time, leaving it unable to circulate blood properly
  • Myocardial infarction (heart attack)
  • An infection within the heart
  • A disease of the heart muscle (cardiomyopathy)
  • Damaged or infected heart valves
  • An abnormal heart rhythm (arrhythmia)
  • Congenital heart conditions which form before birth
  • Excessive alcohol consumption
  • Low iron levels in the body (anaemia) which reduces the amount of oxygen carrying red blood cells in your blood
  • Unmanaged thyroid gland disease.

What are the symptoms of heart failure?

It’s important to see your GP if you experience any of the following symptoms (which may or may not be caused by a heart problem). The most common symptoms include:

  • Shortness of breath (dyspnoea), while active or resting
  • Fluid retention (oedema) most often in the feet, ankles, and lower back area
  • Swelling of the abdomen caused by fluid accumulation (ascites)
  • Feeling unusually tired or weak
  • A rapid or irregular heartbeat
  • A persistent cough or wheezing with white or pink blood-tinged phlegm
  • An increased need to urinate at night
  • Very rapid weight gain (caused by fluid retention)
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness
  • Chest pain (if your heart failure is caused by a heart attack).

If you have any of the above symptoms contact your GP as quickly as possible. Early diagnosis and treatment can improve the symptoms, and may also be able to halt the progression of the disease.

How is heart failure diagnosed?

If your GP suspects that you’re suffering from heart failure, they and your local hospital can perform a number of tests. These might include, but are not limited to, blood tests, an echocardiogram (an ultrasound test), a chest x-ray, an electrocardiogram (which records the electrical activity of your heart through painless electrodes attached to your skin), a stress test of the heart, and a CT scan of your heart.

How is heart failure treated?

If heart failure is confirmed, treatment focuses on improving the symptoms and preventing the progression of the disease. The type of treatment offered depends on the stage of heart failure and its cause(s). Once it develops, it generally cannot be reversed but quality of life can be improved.

How can I reduce the risks of developing heart failure?

To keep your heart healthy, the British Heart Foundation offers a number of guides to preventing heart disease via their ‘Ten minutes to change your life’ booklets. Their top tips include:

  • Stopping smoking – a major risk factor in developing heart disease
  • Cutting back on alcohol
  • Keeping your blood pressure in check
  • Lowering your cholesterol if your GP tells you that yours is too high
  • Having a diabetes test, and ensuring that you follow your GP’s guidance if you have the condition
  • Taking time out to relax, and practising stress management techniques on a regular basis
  • Eating well for heart health
  • Ensuring that you get enough exercise every day.