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Heart failure

What is heart failure?

Heart failure is a condition where the heart fails to pump enough blood around the body. It doesn’t mean the heart has failed completely, but it has become weaker or too stiff to do its job properly.

Heart failure cannot be cured, but symptoms can often be treated.

Heart failure symptoms

The symptoms of heart failure can come on suddenly or develop over time. Not everyone will experience every symptom - but they include:

  • Breathlessness, when doing activities or resting, and may feel worse when lying down.
  • Fatigue, feeling too tired to do activities.
  • Ankle or leg swelling caused by fluid building up that may worsen during the day. A weak heart pumps less blood to your kidneys and causes fluid and water retention, resulting in swollen ankles, legs, and abdomen (called oedema) and weight gain. This can also cause an increased need to urinate during the night as your body attempts to get rid of this excess fluid.
  • Long-term cough that's often worse during the night
  • Wheezing and congested lungs. A weak heart causes fluid to back up in the lungs. This can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
  • Stomach bloating.
  • Lost appetite.
  • Unplanned weight loss or weight gain.
  • Feeling confused.
  • Dizziness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
  • Fainting.
  • Rapid heart rate - or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a fast or irregular heartbeat.
  • Depression.
  • Anxiety.

Heart failure diagnosis

A doctor will begin to make a diagnosis of heart failure based on the symptoms, a person's medical history and a physical examination.

Additional tests may be arranged, including:

  • Blood tests for signs of heart failure or other conditions
  • Electrocardiogram (ECG) to check the heart's electrical activity
  • Echocardiogram, a special ultrasound scan of the heart
  • Spirometry and peak flow breathing tests, which also check for lung problems
  • X-ray of the chest for heart or lung problems, including fluid in the lungs.

These tests will help doctors or heart specialists diagnose heart failure and assess the stage or class of the condition. This may be given as numbers or Roman numerals:

The stages of heart failure include:

  • Class I (1) - no symptoms during usual activities
  • Class II (2) - physical activity causes symptoms, but these ease while resting
  • Class III (3) - small amounts of physical activity can trigger symptoms, but symptoms are not there when resting
  • Class IV (4) - symptoms during any activity and sometimes while resting.


Heart failure treatments

Depending on the class or stage of heart failure, doctors or specialists will recommend treatment and lifestyle changes.

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