Heart failure

What is heart failure?

Heart failure is a term used to describe a number of conditions which affect the heart's ability to pump blood to the lungs and the rest of the body. Although it sounds like a life-threatening illness, effective drug treatments can be prescribed by your doctor.
If you suffer from heart failure you may experience tiredness, swelling of the ankles and legs and shortness of breath when lying down. Breathing may be easier when you are propped up on a bed.

What causes heart failure?

Causes can include high blood pressure, an earlier heart attack, diseased heart muscle or faulty heart valves. Lung diseases such as chronic bronchitis may also contribute to heart failure. The heart is forced to work harder to pump blood around the body and eventually weakens. As a result, the lungs become water-logged, making breathing more difficult. Fluid retention (oedema) in other parts of the body causes swelling, particularly in the ankles and legs.

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Who gets heart failure?

Studies suggest that around one in 100 people in the UK have heart failure, although the numbers rise steeply with age. Ten per cent of people over 85 are affected. More than 100,000 people with heart failure are admitted to hospital each year for treatment.
The number of people with the condition is thought to be rising. This is partly because people live longer, and because more people survive a heart attack.

What treatments are available for heart failure?

Treatment depends partly on the cause of the heart failure. Various tests are used to make an accurate diagnosis. These include a chest X-ray, which will show whether the heart is enlarged and an electrocardiogram (EGG) which can detect any abnormal heart function. A special ultrasound device (echocardiograph), gives an image of the heart on a screen and shows damage to the structure of the heart. None of these tests cause any discomfort.
Drug treatments for heart failure include digoxin, which strengthens the heart's contractions, and diuretics, which help the body to get rid of excess fluid, and reduce swelling. A group of drugs called ACE inhibitors, introduced in the 1980s, have brought considerable improvement in many cases of heart failure. They improve the flow of blood by reducing constriction in the blood vessels and can stop the disease progressing. Nitrates help reduce the load on the heart in acute heart failure. These drugs can be prescribed by your GP. It is important that high blood pressure is controlled.

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What can you do to help yourself?

There are steps you can take to help treat your heart failure (see below), but seek advice from your doctor. Regular exercise is beneficial in nearly all cases, but check with your doctor first. Stop smoking, your doctor or practice nurse can help you with this. Smoking increases the heart's need for oxygen and causes constriction of the blood vessels. This means that your heart will have to work harder to pump the blood around your body.

Help yourself

• Stop smoking.
• Avoid becoming overweight. This can add to the strain on the heart, especially during exercise.
• Eat sensibly, avoiding high-fat foods. Don't add salt to your cooking or to your food at the table.
• Limit how much alcohol you drink. No more than 3 units per day = 3 glasses of wine, 1?5 pints of beer or 3 measures of spirits.
• Ask your doctor's advice about exercise. In most cases, regular gentle exercise, such as walking will be encouraged.
• Make sure you take your medication as prescribed. It will help stabilise your heart failure and improve your symptoms.

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Further information

This factsheet supported by Servier

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