Heart Failure

What is the heart and how does it work?

The heart is a muscle inside your chest, which pumps blood around your body to your vital organs. It’s important that your organs receive blood filled with oxygen to keep them alive and working well. Your heart receives its own supply of blood full of oxygen, from a few vessels called the coronary arteries. These arteries wrap around your heart and keep it alive.

What is heart failure?

Heart failure happens when your heart doesn’t pump properly. In some cases, the heart doesn’t completely fill up with blood, or sometimes it can’t pump all the blood out.

The heart might be weak, stiff, large or shaped a little differently. Heart failure can vary in severity – it can be mild, or very severe. When your heart isn’t pumping properly, blood gets backed up. This can cause fluid to build up in your lungs or legs.

What are the signs and symptoms of heart failure?

Some of the most common signs and symptoms are:

  • Feeling short of breath, especially when lying flat, or waking up in the middle of the night struggling to breathe
  • Getting tired very quickly or struggling to breathe when being active
  • Feeling tired and run-down, or sad
  • Coughing or wheezing
  • Swelling in the feet or legs
  • Gaining weight (fluid build up)

Other signs and symptoms include:

  • Swelling in your belly
  • Loss of appetite
  • Dizziness or feeling like fainting
  •  Feeling your heart racing (palpitations)

Why do I have heart failure?

There are lots of things that can cause heart failure, including:

  • A build-up of cholesterol (fat) in the arteries that supply your heart
  • A previous heart attack
  • High blood pressure
  • Problems with the valves within the heart
  • Diabetes
  • Smoking or alcohol use
  • Infections or diseases of the heart muscle
  • Being obese

Can you cure heart failure?

There is no cure for heart failure, but it can be managed with lifestyle changes and medications that fix symptoms, keep you out of hospital, improve your quality of life and survival.

How do we manage heart failure?

Cardiac rehabilitation

Your doctor will likely refer you to specific programs that are designed for people with heart failure. These programs are created to educate you about your condition and teach you strategies to improve your quality of life. They involve physical activities, social supports, advice about medications, how to watch for symptoms and how to manage fluid and salt restrictions.

Staying active and healthy

Although heart failure can make you feel tired and limit some of the activities you can do, gentle exercise is still excellent for your health and can improve your heart function. Going for walks, taking public transport, arm exercises and light activities like hanging laundry or cooking dinner are great ways to stay active.

Eating lots of fruit, vegetables and low-fat meats is great for your health and can help you lose weight. Weighing a healthy amount is a very important part of managing heart failure.

Salt and fluid restriction

Because your heart can’t pump as well as it used to, if you drink too much water it puts strain on your heart. This might cause swelling in your ankles, or fluid on the lungs. To avoid this, you will be asked to restrict your fluid intake to between 1 – 1.5 litres each day. Take care to keep track of all the different drinks you have, like glasses of water, cups of tea, coffee, alcohol or soft drinks. Try not to have more than this daily allowance.

Salt holds fluid in your body and can put too much strain on your heart. You will also be asked to restrict how much salt you eat, aiming for less than a teaspoon a day. Watch out for salty foods like dried meats, chips, pretzels, fast food, soy sauce and olives. You will have access to resources that help explain which foods to avoid, and how to keep track of your salt intake.

Medications

Your doctor will prescribe a mix of medications that have been proven to improve survival and quality of life for people with heart failure. These will most likely include tablets to slow your heart down and improve its pumping function (beta blocker), a fluid tablet (diuretic), and a tablet to lower your blood pressure. You might have some other medications as well, and your doctor will explain these to you. It’s important for you to take these medications every day as they will keep your symptoms under control and improve your quality of life.

Monitor symptoms

You should keep an eye out for symptoms of your heart failure getting worse. Get in touch with your doctor promptly if you notice you’re becoming more short of breath (especially when you’re walking, or lying flat), waking up breathless in the middle of the night, swelling around your ankles or tailbone, feeling more tired or coughing and wheezing. You should weigh yourself every day and keep a diary – if you put weight on quickly (more than 2kg in two days), please let your doctor know straight away. If you feel chest pain you should go to the emergency department or call an ambulance (000).