Heart failure

What is heart failure?

Heart failure occurs when the heart stops being able to pump blood around the body in an efficient way.

This does not mean the heart has completely stopped working – rather it is no longer functioning in the way that it should.

When blood is pumped around the body, it carries with it oxygen and nutrients that provide energy to vital organs. If blood flow is restricted, it can affect the function of vital organs, resulting in debilitating symptoms.

Heart failure symptoms

The main symptoms of heart failure are:

• breathlessness
• extreme fatigue
• ankle swelling

However, these symptoms are also common to other conditions, so it is important to see a health professional to get a proper diagnosis of heart failure.

Other symptoms of heart failure include:

• a rapid heart rate
• weight loss
• reduction in appetite
• a persistent cough

What causes heart failure?

Heart failure can occur for a number of reasons. It can happen slowly (over a number of months or years) or all of a sudden.

Some causes of heart failure include:

• high blood pressure (hypertension)
• damaged heart valves
• heart attack
• angina
• weakness of the heart muscles (cardiomyopathy)
• heart rhythm disturbance (such as atrial fibrillation)
• congenital heart conditions (which are inherited)

Diagnosing heart failure

If you or your GP suspects that you have heart failure, you may be required to have a number of diagnostic tests for heart conditions. These may include:

• blood tests
• breathing tests
• an electrocardiogram (ECG), which records the electrical activity of your heart
• an echocardiogram (‘echo’), which uses ultrasound waves to examine the structure and function of the heart

Due to the debilitating nature of some of the symptoms of heart failure, the condition can drastically interfere with everyday life.

Heart failure treatment

In the majority of cases, heart failure is a long-term condition that cannot be cured. For these people, ongoing medical treatment will be required, although those with severe symptoms may require immediate surgery or even a heart transplant.

Depending on the nature of the problem(s) causing heart failure, one or more of the following treatments may be carried out.

Lifestyle changes to treat heart failure

The following changes can prevent further damage and decrease pressure on the heart:

• eating more healthily
• quitting smoking (if you smoke)
• doing more exercise

Devices to treat heart failure

In cases where heart failure is caused by abnormal heart rhythms, a pacemaker or implantable cardioverter defibrillator (ICD) may be needed.

When the walls of the left ventricle are not in sync with each other, cardiac re-synchronisation therapy (CRT) may be used to restore their function and make them contract at the same time.

Surgery to treat heart failure

For patients whose heart failure is caused by coronary heart disease, surgical treatment could include a coronary angioplasty (stenting) or a coronary artery bypass graft (CABG).

For those with damaged or diseased heart valves, then valve repair or replacement will be recommended.

Individuals with severe heart failure may be offered a left ventricular assist device (LVAD) to boost the heart’s left ventricle and its ability to pump blood. A heart transplant may also be offered as a last resort.