Congestive heart failure

Heart failure is a condition caused by the heart failing to pump enough blood around the body at the right pressure.

It usually occurs because the heart muscle has become too weak or stiff to work properly.

If you have heart failure, it does not mean your heart is about to stop working. It means your heart needs some support to do its job, usually in the form of medicines.

Breathlessness, feeling very tired and ankle swelling are the main symptoms of heart failure. But all of these symptoms can have other causes, only some of which are serious.

The symptoms of heart failure can develop quickly (acute heart failure). If this happens, you will need to be treated in hospital. But they can also develop gradually (chronic heart failure).

Read more about the symptoms of heart failure.

Types of heart failure

There are three main types of heart failure. They are:

heart failure caused by left ventricular systolic dysfunction (LVSD) – this is because the part of the heart that pumps blood around your body (the left ventricle) becomes weak
heart failure with preserved ejection fraction (HFPEF) – usually a result of the left ventricle become stiff, causing difficulty filling with blood
heart failure caused by diseased or damaged heart valves

It is important the type of heart failure you have is identified as it will affect the type of treatment you will be offered. A number of tests can be used to help diagnose heart failure.

You should also have blood tests, an electrocardiogram (ECG) and an echocardiogram. These are used to investigate your heart and check how well it is functioning. If you have not had these tests, you should ask your doctor for an explanation.

Read more about how heart failure is diagnosed.

What causes heart failure?

Heart failure does not often have a single cause. A number of problems usually "gang up" on the heart, causing it to fail.

There are a number of health conditions that increase your chances of developing heart failure, including:

high blood pressure (hypertension) – this can put extra strain on the heart, which over time can lead to heart failure
coronary heart disease (CHD) – where the arteries that supply blood to the heart become clogged up by fatty substances (atherosclerosis), and may cause angina or a heart attack
heart muscle weakness (cardiomyopathy) – this can cause heart failure; the reasons for this are often unclear, but it may be genetic in origin, or caused by an infection (usually viral), alcohol misuse, or medication used to treat cancer
heart rhythm disturbance (atrial fibrillation)
heart valve disease, damage or problems with the heart's valves

Sometimes anaemia, an overactive thyroid gland (hyperthyroidism) or high pressure in the lungs (pulmonary hypertension) can also lead to heart failure.

Read more about the causes of heart failure.

Treating heart failure

In most cases, heart failure is a lifelong condition that cannot be cured. Treatment therefore aims to find a combination of measures, including lifestyle changes, medicines, devices or surgery that will improve heart function or help the body get rid of excess water.

A cure may be possible in cases where heart failure has a specific cause. For example, if your heart valves are damaged, it may be possible to replace them, which can cure the condition.

As treatment will usually be lifelong, you and your doctor will need to find a balance of effective treatments that you can manage in the long term so you have the best symptom control and quality of life possible.

Effective treatment for heart failure can have the following benefits:

it helps make the heart stronger
it improves your symptoms
it reduces the risk of a flare-up
it allows people with the condition to live longer and fuller lives

Read more about how heart failure is treated.

Preventing heart failure

Many of the factors that increase your risk of developing heart failure can be managed either by making lifestyle changes or by taking medicines.

For example, in terms of lifestyle factors, you should:

stop smoking (if you smoke)
keep your blood pressure at a healthy level
keep your cholesterol level under control
maintain a healthy weight (neither too fat nor too thin)
eat healthily, including avoiding excess salt in your diet (but severe salt restriction is rarely necessary and is not good for most people); most people should also ensure they have enough iron in their diet (eating red meat or iron supplements can help this)
exercise regularly
limit your alcohol consumption

Read more about preventing heart failure.

Living with heart failure

Being diagnosed with heart failure may come as a shock. While the outlook is related to age, the severity of the heart condition, and any other health problems that may exist, such as lung or kidney disease, anaemia and diabetes, it also depends on what you do to reduce your risk.

Self care means taking responsibility for your own health and wellbeing, with support from the people who are involved in your care.

It is very important that you take any prescribed medication, even after you feel better. Some medicines are designed to protect or heal your heart.

If you do not take them, they cannot help and the underlying problem will get worse. The medicines can prevent or delay your heart problem and stop symptoms getting worse.

Speak to your healthcare team if you have any questions or concerns about the medication you are taking or any potential side effects.

As heart failure is a long-term condition, you will have regular contact with your healthcare team. Developing a good relationship with the members of your team will enable you to discuss your symptoms and any concerns you have. The more the team knows about you, the more they can help you.

Read more about living with heart failure.