Heart failure is a serious long-term health condition that affects how effectively the heart pumps blood around the body. It can develop gradually or occur following damage to the heart. Although the name may sound frightening, heart failure does not mean that the heart has stopped working.
Millions of people live with heart failure, and recognising its early warning signs can help them seek medical attention sooner. With appropriate treatment, regular monitoring and lifestyle support, many people can manage the condition and maintain a better quality of life.
In this guide, we explain what heart failure means, its early symptoms, possible causes, risk factors and the different ways it can affect the body.
What Is Heart Failure?
Heart failure occurs when the heart muscle cannot pump blood effectively enough to meet the body's needs. In some people, the heart becomes too weak to pump properly. In others, the heart muscle becomes stiff and cannot fill with enough blood between beats.
When the heart does not work efficiently, the body may receive less oxygen-rich blood. Fluid can also build up in the lungs, legs, ankles and other parts of the body.
Heart failure is usually a long-term condition, although it can sometimes develop suddenly. Treatment aims to reduce symptoms, improve heart function where possible and prevent the condition from getting worse.
Is Heart Failure the Same as a Heart Attack?
No. Heart failure and a heart attack are two different medical conditions, although one can lead to the other.
Heart attack: This happens when blood flow to part of the heart muscle becomes blocked, usually because of a problem in a coronary artery. Without prompt treatment, the affected heart muscle can become damaged.
Heart failure: This happens when the heart cannot pump or fill with blood effectively enough to meet the body's needs.
A previous heart attack can damage the heart muscle and increase the risk of developing heart failure. However, heart failure can also develop because of high blood pressure, heart valve disease, abnormal heart rhythms and other conditions.
9 Early Warning Signs and Symptoms of Heart Failure
Heart failure symptoms may develop slowly or become noticeable over a short period. Some symptoms can initially be mistaken for ageing, tiredness or a lack of fitness.
Here are nine important warning signs to recognise.
1. Shortness of Breath
Shortness of breath is one of the most common symptoms of heart failure.
You may notice that breathing becomes difficult when walking, climbing stairs or performing everyday activities. Some people also experience breathlessness while resting or lying flat.
This can happen when fluid builds up in or around the lungs, making breathing more difficult.
2. Swelling in the Feet, Ankles or Legs
Fluid retention can cause swelling in the lower parts of the body.
You may notice:
Swollen feet or ankles.
Legs that feel heavy or tight.
Shoes or socks leaving deeper marks than usual.
Swelling that becomes more noticeable later in the day.
This type of swelling is known as oedema (edema in US English). It can occur when blood flow is less efficient and fluid collects in body tissues.
However, leg swelling can also have other causes, including kidney, liver and vein conditions.
3. Persistent Coughing or Wheezing
A cough that continues, particularly at night or when lying down, can sometimes be associated with heart failure.
Some people experience wheezing or cough up white or pink-tinged frothy mucus. This may happen when fluid accumulates in the lungs.
A persistent cough does not automatically mean heart failure, but it should be medically assessed if it occurs alongside breathlessness or swelling.
4. Unusual Tiredness and Fatigue
Feeling unusually tired even after adequate rest may be another warning sign.
When the heart cannot pump enough blood to meet the body's demands, muscles and organs may not receive the oxygen-rich blood they need.
You may find it difficult to:
Walk your usual distance.
Climb stairs without resting.
Complete household activities.
Maintain your usual energy levels.
Persistent or unexplained fatigue deserves medical attention, especially when accompanied by other symptoms.
5. Sudden Weight Gain
An unexpected increase in body weight over a short period can sometimes indicate fluid retention.
For people living with heart failure, extra fluid may accumulate in the body, causing weight to rise quickly.
A sudden change in weight is different from gradual weight gain caused by changes in diet or body fat.
If you have been diagnosed with heart failure, ask your healthcare team how often to weigh yourself and what weight changes should prompt a call.
6. Difficulty Breathing When Lying Down
Some people with heart failure find it difficult to breathe comfortably when lying flat.
They may need extra pillows or prefer sleeping in a more upright position. This symptom is known as orthopnoea.
It can occur because fluid in the lungs becomes more problematic when lying down.
New or worsening breathlessness while resting or lying down should be assessed promptly by a healthcare professional.
7. Rapid or Irregular Heartbeat
You may notice that your heart beats faster than usual, races or feels as though it is skipping beats.
Heart failure can be associated with abnormal heart rhythms. In some cases, an irregular rhythm may also contribute to the development of heart failure.
Palpitations can have several causes, so an ECG and medical assessment may be needed to identify the reason.
8. Loss of Appetite, Nausea or Bloating
Some people with heart failure experience digestive discomfort.
Possible symptoms include:
Reduced appetite.
Feeling full after eating a small amount.
Nausea.
Abdominal swelling or bloating.
Fluid accumulation and changes in blood flow can affect the digestive system and contribute to these symptoms.
9. Dizziness, Light-headedness or Confusion
Reduced blood flow, changes in blood pressure and other complications may cause dizziness or light-headedness in some people with heart failure.
Older adults may also experience confusion or difficulty concentrating, particularly when the condition becomes more severe or other health problems are present.
Sudden confusion, fainting or severe dizziness requires urgent medical assessment.
When Should You Seek Emergency Medical Help?
Heart failure symptoms can sometimes become life-threatening.
Call emergency services immediately if you or someone else experiences:
Severe difficulty breathing, including gasping or struggling to speak.
Sudden severe breathlessness.
Blue, grey or unusually pale lips or skin.
Collapse or loss of consciousness.
New or severe chest pain, particularly with sweating, nausea or breathlessness.
Do not assume that severe breathing difficulty is simply a symptom of an existing heart condition. It may indicate an emergency that needs immediate treatment.
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Heart Failure: Causes, Risk Factors, Types and Stages
What Causes Heart Failure?
Heart failure usually develops when the heart muscle becomes damaged, weakened or stiff, or when it has to work harder than normal over a long period.
Several medical conditions can contribute to this problem. In some cases, more than one condition is responsible.
1. Coronary Artery Disease
Coronary artery disease occurs when fatty deposits build up inside the arteries that supply blood to the heart muscle.
This can reduce the amount of oxygen-rich blood reaching the heart. Over time, the heart muscle may become damaged, increasing the risk of heart failure.
2. Previous Heart Attack
A heart attack occurs when blood flow to part of the heart muscle is blocked.
The affected muscle may become permanently damaged. If enough heart muscle is affected, the heart may lose some of its ability to pump blood effectively.
3. High Blood Pressure
High blood pressure forces the heart to work harder to move blood around the body.
When blood pressure remains uncontrolled for many years, the heart muscle can become thicker and stiffer. This may eventually interfere with its ability to fill and pump blood properly.
4. Diabetes
Diabetes can increase the risk of heart disease and heart failure.
Long-term high blood glucose levels can damage blood vessels and contribute to problems affecting the heart muscle. Diabetes may also occur alongside high blood pressure, obesity and abnormal cholesterol levels, further increasing cardiovascular risk.
5. Heart Valve Disease
Heart valves help blood move through the heart in the correct direction.
If a valve becomes narrowed or does not close properly, the heart may need to work harder to maintain normal blood circulation.
Untreated valve problems can eventually contribute to heart failure.
6. Cardiomyopathy
Cardiomyopathy refers to diseases affecting the heart muscle.
The heart muscle may become enlarged, thickened, stiff or weakened. Some forms are inherited, while others may develop because of infections, certain medicines, alcohol exposure or other medical conditions.
7. Abnormal Heart Rhythms
Abnormal heart rhythms, also known as arrhythmias, can affect how efficiently the heart pumps blood.
A persistently fast or irregular heartbeat may weaken the heart over time. Atrial fibrillation is one example of an abnormal rhythm associated with an increased risk of heart failure.
8. Other Medical Conditions
Other conditions that may contribute to heart failure include:
Chronic kidney disease.
Thyroid disorders.
Severe anaemia.
Certain heart infections.
Congenital heart conditions.
Some cancer treatments and medications that can damage the heart.
Identifying and managing the underlying condition is an important part of heart failure care.
10 Major Risk Factors for Heart Failure
Some factors increase the likelihood of developing heart failure, even before symptoms appear.
1. Older Age
The risk of heart failure increases with age because the heart and blood vessels can undergo changes over time.
However, heart failure can affect younger adults too.
2. Uncontrolled High Blood Pressure
Long-term high blood pressure places additional strain on the heart and is an important risk factor.
Regular blood pressure monitoring and appropriate treatment can help reduce this risk.
3. Diabetes
People with diabetes have a higher risk of cardiovascular complications, including heart failure.
Managing blood glucose, blood pressure and cholesterol is important for long-term heart health.
4. Overweight and Obesity
Excess body weight can increase the workload on the heart.
Obesity is also associated with high blood pressure, diabetes and sleep apnoea, which can contribute to cardiovascular problems.
5. Smoking
Smoking damages blood vessels and increases the risk of coronary artery disease.
Stopping smoking can improve overall cardiovascular health and reduce future heart-related risks.
6. High Cholesterol
High levels of LDL cholesterol can contribute to fatty deposits in the arteries.
When these deposits affect the arteries supplying the heart, they can reduce blood flow and increase the risk of heart attacks and heart failure.
7. Excessive Alcohol Consumption
Regular heavy alcohol consumption can damage the heart muscle and contribute to cardiomyopathy.
Reducing or avoiding alcohol may be recommended depending on a person's health and medical history.
8. Family History
A family history of cardiomyopathy or certain inherited heart conditions may increase the risk of developing heart failure.
People with a known inherited heart condition in their family should discuss appropriate screening with a healthcare professional.
9. Physical Inactivity
A sedentary lifestyle can contribute to obesity, high blood pressure and diabetes.
Regular physical activity supports cardiovascular health and helps manage several important risk factors.
10. Sleep Apnoea
Obstructive sleep apnoea causes repeated interruptions in breathing during sleep.
It is associated with high blood pressure, abnormal heart rhythms and other cardiovascular problems. Untreated sleep apnoea may increase the risk of heart failure.
Different Types of Heart Failure
Heart failure is not a single condition. Doctors classify it in different ways depending on which side of the heart is affected and how well the heart muscle pumps or fills with blood.
1. Left-Sided Heart Failure
The left side of the heart receives oxygen-rich blood from the lungs and pumps it to the rest of the body.
When the left side cannot pump effectively, pressure can build up in the blood vessels of the lungs.
Possible symptoms include:
Shortness of breath.
Difficulty breathing when lying down.
Persistent coughing.
Reduced exercise tolerance.
Unusual tiredness.
Left-sided heart failure is commonly classified into two major types based on the heart's pumping function.
2. Right-Sided Heart Failure
The right side of the heart pumps blood to the lungs to receive oxygen.
When the right side cannot function effectively, blood and fluid can build up in the body's veins.
Possible symptoms include:
Swelling in the feet and ankles.
Swelling in the legs.
Abdominal swelling.
Weight gain caused by fluid retention.
Discomfort or fullness in the abdomen.
Right-sided heart failure can develop because of left-sided heart failure or conditions affecting the lungs and pulmonary blood vessels.
3. Heart Failure With Reduced Ejection Fraction (HFrEF)
This type occurs when the left ventricle, the heart's main pumping chamber, cannot contract strongly enough to pump an adequate amount of blood.
Doctors assess this using a measurement called the ejection fraction.
In many cases, an ejection fraction of 40% or lower is classified as reduced.
4. Heart Failure With Preserved Ejection Fraction (HFpEF)
In this type, the heart can still pump out a relatively normal proportion of the blood inside the left ventricle.
However, the heart muscle becomes stiff and does not relax or fill with blood properly.
An ejection fraction of 50% or higher is commonly used in this classification, alongside other clinical evidence supporting the diagnosis.
5. Heart Failure With Mildly Reduced Ejection Fraction (HFmrEF)
This type describes people whose left ventricular ejection fraction falls within an intermediate range, generally 41% to 49%.
Doctors consider symptoms, heart imaging and other clinical findings when confirming this diagnosis.
Important: Ejection fraction is only one part of heart failure assessment. A normal or preserved ejection fraction does not automatically rule out heart failure.
What Are the Four Stages of Heart Failure?
Doctors may use the American College of Cardiology and American Heart Association (ACC/AHA) classification to describe the progression of heart failure.
These four stages help healthcare professionals identify risk, recognise disease progression and plan appropriate care.
Stage A: At Risk for Heart Failure
At this stage, a person has risk factors for heart failure but does not have symptoms or evidence of structural heart disease.
Examples include people with:
High blood pressure.
Diabetes.
Obesity.
Coronary artery disease risk factors.
A family history of cardiomyopathy.
Managing these risk factors can help prevent heart failure from developing.
Stage B: Pre-Heart Failure
At this stage, there is evidence of structural heart disease, increased heart pressure or other abnormal findings, but the person has not experienced symptoms or signs of heart failure.
For example, someone may have an abnormal heart scan but feel completely normal.
Early medical management is important to reduce the risk of progression.
Stage C: Symptomatic Heart Failure
At this stage, a person has current or previous symptoms of heart failure.
Symptoms may include breathlessness, fatigue, swelling and reduced ability to perform everyday activities.
Treatment usually involves a combination of medication, regular monitoring and lifestyle support.
Stage D: Advanced Heart Failure
This is an advanced stage in which symptoms significantly interfere with daily activities and may continue despite appropriate medical treatment.
People may experience repeated hospital admissions or severe limitations in their physical activity.
Specialist care may include advanced medications, medical devices, selected surgical procedures and supportive or palliative care.
Remember: These four stages describe the progression of heart failure. They are different from the New York Heart Association (NYHA) functional classes, which describe how symptoms limit physical activity.
Can Heart Failure Be Prevented?
Not every case of heart failure can be prevented, particularly when inherited conditions or certain infections are involved.
However, managing risk factors and protecting cardiovascular health can help lower the likelihood of developing heart failure.
1. Control Your Blood Pressure
Have your blood pressure checked regularly.
If you have high blood pressure, follow your healthcare professional's treatment plan and attend recommended follow-up appointments.
2. Manage Diabetes
Keep track of your blood glucose and attend regular diabetes reviews.
Take prescribed medication as directed and discuss cardiovascular risk reduction with your healthcare team.
3. Maintain Healthy Cholesterol Levels
Have your cholesterol checked when recommended.
If your cholesterol is high, discuss suitable lifestyle changes and medication options with your healthcare professional.
4. Stay Physically Active
Regular physical activity supports heart health.
Walking, cycling, swimming and other suitable activities can help improve cardiovascular fitness.
If you already have heart disease or heart failure, ask your healthcare team which activities are safe for your condition.
5. Avoid Smoking
Smoking increases the risk of heart and blood vessel disease.
Stopping smoking is one of the most important steps you can take to improve your cardiovascular health.
6. Follow a Heart-Healthy Eating Pattern
Choose a balanced eating pattern that includes:
Vegetables and fruits.
Whole grains.
Beans and other fibre-rich foods.
Fish and other suitable protein sources.
Nuts and seeds.
Foods lower in excess sodium and saturated fat.
People already diagnosed with heart failure may need individual advice about salt and fluid intake.
7. Limit Alcohol
Excessive alcohol consumption can damage the heart muscle.
Follow recommended alcohol guidance and discuss whether avoiding alcohol is advisable for your health.
8. Maintain a Healthy Weight
A healthy weight can help reduce the strain on the heart and improve blood pressure and blood glucose control.
Aim for sustainable lifestyle changes rather than extreme weight-loss plans.
9. Treat Sleep Apnoea
If you regularly snore loudly, wake up gasping or feel excessively sleepy during the day, discuss possible sleep apnoea with a healthcare professional.
Appropriate diagnosis and treatment can help manage associated cardiovascular risks.
10. Attend Regular Health Check-ups
Regular health assessments can help identify high blood pressure, diabetes, cholesterol problems and other conditions that may increase heart failure risk.
Early treatment of these conditions can help protect your heart over time.
Heart Failure: Diagnosis, Treatment, Recovery and Frequently Asked Questions
How Is Heart Failure Diagnosed?
Heart failure cannot be diagnosed based on symptoms alone. Several tests help doctors understand how well the heart is working, identify the underlying cause and determine the most appropriate treatment.
A healthcare professional may recommend the following investigations.
1. Physical Examination and Medical History
The doctor may ask about your symptoms, medical history, medications and family history.
During the examination, they may check:
Blood pressure and heart rate.
Breathing and oxygen levels.
Swelling in the legs, ankles or abdomen.
Heart sounds.
Signs of fluid accumulation in the lungs.
2. Blood Tests
Blood tests help identify possible heart failure and check for other medical conditions.
Some commonly used tests include:
BNP or NT-proBNP: These substances can become elevated when the heart is under increased pressure or strain. They help support the diagnosis, but an abnormal result does not confirm heart failure on its own.
Kidney function tests: Check how well the kidneys are working.
Electrolytes: Measure minerals such as sodium and potassium.
Full blood count: Helps identify anaemia and other blood-related problems.
Thyroid tests: Check whether thyroid problems may be contributing to symptoms.
Blood glucose and cholesterol: Help assess cardiovascular risk factors.
3. Electrocardiogram (ECG)
An ECG records the electrical activity of the heart.
It can help identify:
Abnormal heart rhythms.
Evidence of a previous heart attack.
Electrical conduction problems.
Other changes that may require further investigation.
The test is usually quick and painless.
4. Echocardiogram
An echocardiogram is one of the most important tests used to assess heart failure.
It uses ultrasound waves to create images of the heart.
The test helps doctors examine:
The size and structure of the heart.
How well the heart chambers pump blood.
How well the heart muscle relaxes and fills.
The function of the heart valves.
The ejection fraction.
5. Chest X-ray
A chest X-ray can help identify an enlarged heart or signs of fluid accumulation in the lungs.
It may also help doctors investigate other possible causes of breathing difficulties.
6. Cardiac MRI
A cardiac MRI uses magnetic fields to produce detailed images of the heart.
It may be recommended when doctors need more information about heart muscle damage, inflammation, scarring or certain types of cardiomyopathy.
7. Additional Tests
Depending on the suspected cause, doctors may recommend:
Exercise stress testing.
Coronary angiography.
CT scans.
Heart rhythm monitoring.
Other specialised investigations.
Not everyone needs every test. The diagnostic plan depends on symptoms, examination findings and medical history.
What Is Ejection Fraction in Heart Failure?
Ejection fraction (EF) is the percentage of blood that the left ventricle pumps out with each heartbeat.
For example, if the left ventricle contains 100 millilitres of blood and pumps out 60 millilitres, the ejection fraction is 60%.
Doctors use this measurement to help classify heart failure.
| Ejection fraction | Classification |
|---|---|
| 40% or lower | Reduced ejection fraction (HFrEF) |
| 41%–49% | Mildly reduced ejection fraction (HFmrEF) |
| 50% or higher | Preserved ejection fraction (HFpEF) |
These ranges are commonly used in clinical classification. Doctors also consider symptoms, examination findings and other test results.
Important: A normal ejection fraction does not always mean that the heart is completely healthy. Some people have heart failure because the heart muscle is too stiff to fill properly, even though its pumping percentage is preserved.
How Is Heart Failure Treated?
Heart failure treatment depends on its type, severity, underlying cause, other medical conditions and individual health needs.
The main goals are to:
Reduce symptoms such as breathlessness and swelling.
Improve heart function where possible.
Prevent hospital admissions.
Slow disease progression.
Improve quality of life and survival.
Treatment may include medicines, lifestyle changes, medical devices and selected surgical procedures.
1. Medicines Used to Treat Heart Failure
Several medicines are available to manage heart failure. Different medicines work in different ways, and some people need a combination.
ACE Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels and reduce the workload on the heart.
Examples include:
Ramipril.
Lisinopril.
Enalapril.
Doctors monitor blood pressure, kidney function and potassium levels during treatment.
Angiotensin Receptor Blockers (ARBs)
ARBs help relax blood vessels and reduce the effects of certain hormones that increase blood pressure.
Examples include:
Losartan.
Valsartan.
Candesartan.
They may be considered when an ACE inhibitor is unsuitable for a particular patient.
Angiotensin Receptor-Neprilysin Inhibitors (ARNIs)
ARNIs combine two actions that help reduce strain on the heart and improve blood circulation.
Sacubitril/valsartan is an example.
It may be prescribed for selected people with heart failure, depending on their condition and previous treatment.
Beta-Blockers
Beta-blockers help slow the heart rate and reduce the heart's workload.
Examples used in heart failure include:
Bisoprolol.
Carvedilol.
Metoprolol succinate.
They are introduced and adjusted under medical supervision.
Mineralocorticoid Receptor Antagonists (MRAs)
These medicines help reduce the effects of aldosterone, a hormone that can contribute to fluid retention and heart strain.
Examples include:
Spironolactone.
Eplerenone.
Kidney function and potassium levels need monitoring during treatment.
SGLT2 Inhibitors
Sodium-glucose cotransporter-2 (SGLT2) inhibitors were initially developed to help manage type 2 diabetes.
They are also used in heart failure treatment, including in many people who do not have diabetes.
Examples include:
Dapagliflozin.
Empagliflozin.
These medicines can reduce the risk of worsening heart failure and hospitalisation in appropriate patients.
Diuretics
Diuretics help the body remove excess salt and water through urine.
They can reduce fluid accumulation and help improve symptoms such as swollen ankles and breathlessness.
Furosemide is a commonly used loop diuretic.
Doctors may monitor kidney function, blood pressure and electrolyte levels during treatment.
Important: Not every medicine is suitable for every person or every type of heart failure. Never start, stop or change heart medication without medical advice.
2. Medical Devices Used in Heart Failure
Some people may benefit from implanted medical devices, particularly when medicines alone do not adequately manage their condition.
Implantable Cardioverter-Defibrillator (ICD)
An ICD is a small device implanted under the skin.
It continuously monitors the heart rhythm and can deliver an electrical shock or pacing treatment when certain dangerous abnormal rhythms occur.
It may be recommended for selected people who have an increased risk of life-threatening heart rhythms.
Cardiac Resynchronisation Therapy (CRT)
CRT uses a specialised pacemaker to help the heart's lower chambers contract in a more coordinated way.
It may improve symptoms and heart function in certain people with heart failure and specific electrical conduction problems.
Left Ventricular Assist Device (LVAD)
An LVAD is a mechanical pump that helps the left ventricle move blood around the body.
It may be considered for selected people with advanced heart failure, sometimes while waiting for a heart transplant or as longer-term support.
3. Surgical Procedures
Surgery may be necessary when heart failure is caused or worsened by a condition that can be treated with an operation or procedure.
Possible options include:
Coronary artery bypass surgery: Helps improve blood flow around blocked coronary arteries.
Heart valve repair or replacement: Treats certain serious valve problems.
Heart transplant: Replaces a severely damaged heart with a donor heart in carefully selected people with advanced heart failure.
The suitability of each procedure depends on the person's overall health and the underlying heart condition.
Can Heart Failure Be Reversed?
Heart failure is not always reversible, but some people experience significant improvement with appropriate treatment.
For example, heart function may improve when doctors successfully treat an underlying cause, such as an abnormal heart rhythm, certain heart valve problems or uncontrolled high blood pressure.
Some people with reduced ejection fraction experience improved pumping function after treatment. This is sometimes called heart failure with improved ejection fraction (HFimpEF).
However, improved symptoms or ejection fraction do not necessarily mean the condition has been permanently cured.
People should continue their prescribed treatment and follow-up appointments even when they feel better.
How Long Can Someone Live With Heart Failure?
There is no single life expectancy for everyone with heart failure.
Some people live for many years with manageable symptoms, while others experience more serious complications.
Life expectancy depends on several factors, including:
Age and general health.
The underlying cause of heart failure.
Ejection fraction and heart function.
Severity of symptoms.
Kidney function and other medical conditions.
Response to treatment.
Access to appropriate medical care.
Early diagnosis, evidence-based treatment and regular monitoring can improve outcomes for many people.
Living With Heart Failure: 8 Daily Management Tips
If you have been diagnosed with heart failure, everyday habits and regular medical care can make a meaningful difference.
1. Take Your Medicines as Prescribed
Follow your treatment schedule and do not skip doses or stop medicines because symptoms improve.
Ask your healthcare team if you experience side effects or have difficulty taking your medication.
2. Monitor Your Weight
Daily weight monitoring may help identify fluid retention before symptoms become severe.
If your healthcare team recommends it:
Weigh yourself at the same time each morning.
Use the same weighing scale.
Wear similar clothing.
Record your weight.
Contact your healthcare team if your weight increases rapidly or reaches the warning threshold they have given you.
3. Follow Individual Salt and Fluid Advice
Excess sodium can contribute to fluid retention in some people with heart failure.
Your healthcare professional may recommend limiting sodium or avoiding particularly salty foods.
Some people also need fluid restrictions, but these are not necessary for everyone.
Do not drastically reduce your water intake or follow a strict fluid restriction without medical guidance.
4. Stay Physically Active Within Your Limits
Suitable physical activity can improve fitness and everyday functioning.
Walking, supervised exercise and cardiac rehabilitation may be helpful for selected patients.
Ask your healthcare team about a safe activity plan, particularly if you have recently been diagnosed or hospitalised.
Stop exercising and seek medical advice if you develop unusual breathlessness, chest discomfort or dizziness.
5. Eat a Balanced Diet
Choose a balanced eating pattern that includes vegetables, fruits, whole grains and suitable sources of protein.
Pay attention to sodium in packaged foods, processed meats, canned soups and ready-made meals.
Your nutritional needs may differ depending on kidney function, medications and other health conditions.
6. Avoid Smoking
Smoking increases cardiovascular risk and can make existing heart disease worse.
If you smoke, ask your healthcare professional about support and treatments that can help you quit.
7. Attend Regular Follow-up Appointments
Heart failure requires ongoing monitoring.
Your doctor may check your symptoms, blood pressure, heart rate, kidney function, electrolytes and medication response.
Keep your appointments even when you feel well.
8. Recognise Changes in Symptoms
Contact your healthcare team if you notice:
Increasing breathlessness.
New or worsening ankle swelling.
Rapid weight gain.
Increasing tiredness.
Difficulty sleeping because of breathing problems.
Reduced ability to perform normal activities.
Early medical review may help prevent symptoms from becoming more severe.
Frequently Asked Questions About Heart Failure
1. What are the first signs of heart failure?
Common early signs include shortness of breath during physical activity, unusual tiredness, swollen ankles, persistent coughing and difficulty breathing when lying down. Symptoms vary between individuals.
2. Can heart failure happen suddenly?
Yes. Acute heart failure can develop suddenly or existing heart failure can worsen rapidly. Severe breathlessness, chest pain or collapse requires emergency medical attention.
3. Can a person have heart failure without knowing it?
Yes. Some people have early heart changes without noticeable symptoms. Others may mistake mild breathlessness or fatigue for normal ageing or lack of fitness.
4. Can heart failure affect young adults?
Yes. Although the risk increases with age, younger adults can develop heart failure because of inherited heart conditions, cardiomyopathy, infections, heart valve disease or other causes.
5. Does heart failure mean the heart has stopped working?
No. Heart failure means the heart cannot pump or fill with blood effectively enough to meet the body's needs. It does not mean that the heart has stopped beating.
6. Can walking help people with heart failure?
Appropriate physical activity can improve fitness and quality of life for many people with stable heart failure. The type and intensity of exercise should be based on individual medical advice.
7. Is heart failure always fatal?
No. Heart failure is a serious condition, but it is not automatically a death sentence. Many people manage it for years with appropriate treatment, monitoring and lifestyle support.
8. What is the difference between heart failure and cardiac arrest?
Heart failure is a condition in which the heart cannot pump or fill effectively enough. Cardiac arrest occurs when the heart suddenly stops pumping blood effectively, causing loss of consciousness and requiring immediate emergency treatment.
9. Can diabetes increase the risk of heart failure?
Yes. Diabetes is an important risk factor because it can damage blood vessels and contribute to heart muscle problems. Managing blood glucose and other cardiovascular risk factors is important.
10. What is the best test to detect heart failure?
An echocardiogram is one of the key tests because it shows the heart's structure and function. Doctors may also use BNP or NT-proBNP blood tests, an ECG, chest X-ray and other investigations.
Conclusion
Heart failure is a serious condition that affects the heart's ability to pump or fill with blood effectively. Its symptoms may include shortness of breath, swelling in the legs, persistent tiredness, coughing and unexpected weight gain.
Recognising these warning signs and seeking medical advice can help people receive an accurate diagnosis and appropriate treatment.
Although heart failure cannot always be reversed, modern treatments, regular monitoring and healthy lifestyle habits can help many people manage the condition and improve their quality of life.
If you experience new or worsening symptoms, do not ignore them. Speak with a healthcare professional, and seek emergency help for severe breathing difficulties, chest pain or collapse.
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Medical Disclaimer
This article is intended for general educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment.
Heart failure symptoms can overlap with those of other medical conditions. Always consult a qualified healthcare professional for an accurate diagnosis and an individual treatment plan.
Never start, stop or change prescribed medication without consulting your healthcare professional. If you experience severe breathing difficulty, chest pain, collapse or other signs of a medical emergency, contact your local emergency services immediately.
References
NHS – Heart Failure: https://www.nhs.uk/conditions/heart-failure/
National Institute for Health and Care Excellence (NICE) – Chronic Heart Failure in Adults: Diagnosis and Management: https://www.nice.org.uk/guidance/ng106
American Heart Association – Heart Failure: https://www.heart.org/en/health-topics/heart-failure
American College of Cardiology – 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: https://www.acc.org/Guidelines
European Society of Cardiology – Heart Failure Guidelines: https://www.escardio.org/Guidelines
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