Heart Failure

The symptoms of heart failure can vary from person to person and are notoriously non-specific. They may start suddenly (acute heart failure) or develop gradually over weeks or months (chronic heart failure).

The most common symptoms of heart failure are:

• breathlessness – this may occur after activity or at rest; it may be worse when you’re lying down, and you may wake up at night needing to catch your breath (“paroxysmal nocturnal dyspnoea”).
• fatigue – you may feel tired most of the time and find exercise exhausting.
• swollen ankles and legs – these are caused by a build-up of fluid (oedema); they may be better in the morning (after lying in bed) and get worse later in the day (after standing upright).

Other symptoms of heart failure can include:

• persistent cough, which may be worse at night
• wheezing
• a bloated tummy
• loss of appetite
• weight gain or weight loss
• confusion
• dizziness and fainting
• a fast heart rate
• a pounding, fluttering or irregular heartbeat (palpitations)

Some people with heart failure may also experience feelings of depression and anxiety.

Heart failure is often the result of several problems affecting the heart at the same time.

Conditions that can lead to heart failure include:

• coronary heart disease – where the arteries that supply blood to the heart become clogged up with fatty substances (atherosclerosis), which may cause angina or a heart attack
• high blood pressure – this can put extra strain on the heart, which over time can lead to heart failure
• cardiomyopathy – conditions affecting (weakening) the heart muscle
• heart rhythm problems (arrhythmias), such as atrial fibrillation
• damage or other problems with the heart valves
  congenital heart disease – birth defects that affect the normal workings of the heart

See your GP if you experience persistent or gradually worsening symptoms suggestive of heart failure (such as increasing breathlessness when moving around +/- swollen ankles).

The symptoms can be caused by other, less serious conditions, so it’s a good idea to get them checked out.

Read more about how heart failure is diagnosed.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department as soon as possible if you have sudden or very severe symptoms.

This is a medical emergency that may require immediate treatment in hospital.

A number of tests can be used to help check how well your heart is working, including blood tests, an ECG and an echocardiogram.

Find out more about how heart failure is diagnosed

Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition. Your GP will normally manage this condition but may refer you to a specialist (Cardiologist) for diagnostic investigations or if your symptoms do not respond to initial drug treatments.

There are also specialist Heart Failure nursing teams based at the main hospitals in Devon & Cornwall who can provide ongoing monitoring and support.

Common treatments include:

• lifestyle changes – including eating a healthy diet, losing weight, exercising regularly and stopping smoking
• medicine – a range of medicines can help; many people need to take 2 or 3 different types (these include diuretics/water tablets, beta-blockers & ACE inhibitors)
• devices implanted in your chest – these can help control your heart rhythm
• surgery – such as a bypass operation or a heart transplant

Treatment will usually be needed for life.

A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.

For more detailed information about the current treatments for heart failure click here.