Heart Failure

What is heart failure?

Heart failure (HF) means the heart is not pumping blood as well as it should. It may pump at a different speed, pump blood with less force, or pump less blood with each heartbeat. When less blood is flowing out of the heart to the body, muscles and other tissues may not get enough oxygen. The kidneys may not work as well to remove excess fluid in the form of urine. As a result, blood backs up into the blood vessels. The extra fluid seeps into the lungs or other parts of the body. Fluid in the lungs makes it hard to breathe. Fluid seeping into other parts of the body causes swelling. When there is too much fluid in the body, it puts more strain on the heart.

Heart failure is one of the most common causes of heart-related illness and death in the US.

What is the cause?

A number of things can cause heart failure, such as:

  • Narrowing or blockage in the arteries that bring blood to the heart muscle
  • Infection of the heart
  • Heart attack
  • High blood pressure
  • Heart valve problems
  • Genetic problems with the heart muscle
  • Alcoholism
  • Diabetes
  • Lung disease

Problems that may worsen or trigger heart failure, especially if your heart muscle is weak, include:

  • Severe anemia (a low level of red blood cells)
  • An overactive or underactive thyroid gland
  • Infection
  • A heartbeat that is too fast or too slow
  • Too much salt or fluid in the diet
  • Working your body too hard with exercise or daily activities
  • Emotional stress

What are the symptoms?

The symptoms of heart failure may include:

  • Shortness of breath or trouble breathing, at first just during exercise, then with any activity, and finally even when you are resting
  • Waking up at night with trouble breathing or being unable to lie flat in bed because of shortness of breath
  • Coughing
  • Swollen ankles, feet, and legs
  • Weight gain caused by extra fluid in the body
  • Feeling tired most of the time and not able to do your usual activities
  • Lack of appetite and feeling sick to your stomach
  • Feeling like your heart is racing or fluttering
  • Lightheadedness or fainting

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Tests may include:

  • Chest X-ray
  • An ECG (also called an EKG), which measures and records your heartbeat
  • Blood or urine tests
  • Echocardiogram, which uses sound waves (ultrasound) to see how well your heart muscle is pumping

How is it treated?

Heart failure can be treated and managed. The goals of treatment are:

  • Help your heart so it doesn’t have to work as hard
  • Help your heart pump blood better
  • Get rid of extra water in your body

Your healthcare provider may prescribe medicine to relax the blood vessels and lower blood pressure. Then the heart doesn’t have to work as hard. You may need to take 2 or more medicines to treat your heart failure. It may take several weeks or months to find the best treatment for you.

In some cases, heart failure can get better and even be cured. For example, if it is caused by an infection, it may be cured with treatment of the infection. Heart failure due to coronary artery disease is generally not cured and most often gets worse over time. However, carefully following your treatment plan can:

  • Slow down the worsening of heart failure and help you live longer
  • Help prevent trips to the hospital
  • Help you feel better and do more

How can I take care of myself?

If you have heart failure, there are things you can do to take care of yourself now and prevent problems in the future.

Follow your treatment plan and know how to take your medicines.

  • Work as a partner with your provider. This means having regular provider visits and following your treatment plan.
  • Follow the directions that come with your medicine, including information about food or alcohol. Make sure you know how and when to take your medicine. Do not take more or less than you are supposed to take.
  • Many medicines have side effects. A side effect is a symptom or problem that is caused by the medicine. Ask your healthcare provider or pharmacist what side effects your medicine may cause and what you should do if you have side effects. Ask if you should avoid some nonprescription medicines.

Don’t smoke, eat a healthy diet, and watch your weight and blood pressure.

  • Quit smoking if you are a smoker.
  • Lose weight if you are overweight and eat a healthy diet.
    • Follow a low-salt (low-sodium) diet if it is recommended by your provider. Too much salt makes your body keep too much water and makes your heart have to work harder.
    • Follow your healthcare provider's advice about how much liquid you should drink.
    • Ask your provider if you should avoid drinking alcohol. Alcohol can weaken your heart or may worsen heart failure. Also, some of your medicines may not work well if you drink alcohol.
  • Weigh yourself every morning after you use the bathroom but before you eat or drink anything. Weighing yourself every day helps you know if extra fluid is building up in your body. A buildup of fluid is a sign that your heart failure may be getting worse. Weight gain can let you know about fluid buildup before you start having swelling.

    Keep track of your weight in a diary or on the calendar. Ask your healthcare provider when you should report weight gain. Letting your provider know about weight gain when it first happens can save you a trip to the emergency room or a stay in the hospital.

  • Also check your pulse and blood pressure every day. Learn how to take your own blood pressure or have a family member learn how to take it.

Be as physically active as you can.

  • How active you can be depends on how bad the heart failure is. A program of gentle exercise helps most people. Your provider can tell you what level of exercise is right for you. Exercise helps your heart and body get stronger. It also improves your blood flow and energy level. Don’t exercise outdoors if it is very hot, cold, humid, or smoggy. Balance exercise with rest. Make sure that your activities don’t make you too tired or short of breath. Take rest breaks during the day.
  • Avoid getting very hot or cold because it may make your heart work harder.

Try to lessen the stress in your life.

  • Anxiety and anger can cause a fast heart rate and high blood pressure. If you need help with this, ask your healthcare provider.

Protect yourself against infections.

  • Get a flu shot every year. When you have heart failure, you should not get the nasal spray vaccine (FluMist).
  • Get the pneumococcal shot.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent heart failure?

You can prevent this disease with a heart-healthy lifestyle:

  • Eat a healthy diet and keep a healthy weight.
  • Stay fit with the right kind of exercise for you.
  • Decrease stress.
  • Don’t smoke.
  • Limit your use of alcohol.

Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for heart failure.

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Published by RelayHealth.
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