Heart Failure (Weak Heart Pumping)
Heart failure means the heart muscle cannot pump or fill as well as the body needs, leading to breathlessness, swelling of the feet and tiredness that need regular treatment.
The heart has not stopped
The name sounds frightening, but heart failure does not mean the heart has stopped or is about to stop. It means the pump is weaker or stiffer than it should be. Blood backs up into the lungs and the body, so fluid collects and causes breathlessness and swelling. The kidneys respond by holding on to more salt and water, which can make the swelling worse.
Doctors often describe it using the ejection fraction (EF), the percentage of blood the main pumping chamber pushes out with each beat, measured on echo. Heart failure can happen with a reduced EF or with a preserved EF, where the heart pumps but is stiff and does not fill well.
What leads to a weak heart
- A previous heart attack or blocked heart arteries
- Long-standing high blood pressure
- Diabetes
- Heart valve disease
- Disease of the heart muscle (cardiomyopathy), sometimes linked to alcohol or infection
- A very fast or irregular heartbeat over a long time
How it is diagnosed
An echocardiogram is the key test. An ECG, chest X-ray and blood tests such as NT-proBNP, kidney function, sodium and potassium, haemoglobin and thyroid are also common. If blocked arteries are suspected, angiography may be advised.
Living with heart failure
- Take medicines regularly. Several modern medicines improve symptoms and can help people live longer, and diuretics (water tablets) relieve swelling.
- Limit salt and follow the fluid advice your doctor gives.
- Weigh yourself every morning. A gain of about 2 kg over 2 to 3 days should be reported, or follow the limit your doctor sets.
- Stay active as advised, and take vaccines your doctor recommends.
Treating the cause, such as opening blocked arteries or controlling BP, is part of the plan. Some people with a low EF are at risk of dangerous rhythms and may be advised an ICD; some also benefit from a special pacemaker called CRT.
When to go to the emergency
Severe breathlessness at rest, being unable to lie down, frothy or pink sputum, chest pain or fainting need immediate care. Call 108 and see the emergency page.
Diagnosis and treatment are decided only after examination by your doctor. This page is for understanding the condition.
For understanding only — the right test or treatment is decided after examination.
