Diagnosis & managing heart failure
Having experience living with heart failure, you will be aware that there are numerous ways to manage your condition. Attention to maintaining a healthy lifestyle, medical regime and having a strong support network is vital. Keeping in regular touch with your healthcare team and monitoring disease progression can also ensure the best possible management plan.
Can it be treated?
Chronic heart failure is a long-term condition for which there is no cure. But setting and adhering to a good management plan can keep the symptoms under control and provide a high standard of living for many years1,2.
Main types of medical approaches include:
There are several different medications a doctor may prescribe, depending on the individual’s condition. Some include1,3:
- ACE inhibitors & Angiotensin receptor blockers (ARB) – lower blood pressure and prevent damage to heart and kidneys
- Beta blockers – to slow heart rate and reduce blood pressure
- Diuretics – to help reduce fluid retention
- Aldosterone antagonists – potassium-sparing diuretics, mainly for those with severe systolic heart failure
- Inotropes- for severe conditions to help heart pumping function and maintain blood pressure
- Digoxin – increases the strength of your heart muscle contractions
- Angiotensin receptor blockers (ARB) – lower blood pressure and prevent damage to heart and kidneys.
- Angiotensin Receptor-Neprilysin Inhibitors (ARNI) – reduce blood pressure and improve fluid status in the body
- Mineralocorticoid Receptor Antagonists (MRA) - decrease sodium reabsorption and increase water excretion
Device implants that control heart rhythm1,4
Several devices can be implanted to help heart function. They include :
- CRT (biventricular pacing) – a sort of pacemaker that sends electrical impulses to both of the heart’s lower chambers to help them pump more efficiently.
- ICDs – like a pacemaker it monitors heart rhythm and tries to speed or reduce the heartbeat if becoming too fast or slow.
- VADs – ventricular assist devices; a mechanical pump that helps your heart pump blood from the ventricles to the rest of your body.
This is less common and only used when necessary, such as in severe cases. Possible forms of surgery include1,4:
Coronary bypass surgery – this is when blood vessels from the legs, arms or chest bypass a blocked artery to help improve blood flow. This is usually only when arteries are severely blocked.
Heart valve repair or replacement – if heart failure is the result of a faulty valve, a doctor may suggest repairing or replacing it. Valve replacement is only performed if repair is not possible and is performed using a prosthetic valve.
Heart transplant – Usually only in such severe cases that other surgical interventions or medications can’t help. Heart transplants may improve survival rates and increase life expectancy. However, depending on where you live, some people may have to wait long periods before a suitable donor heart becomes available.
Often, a management plan may require all the above. A doctor will help plan the most suitable approach based on factors such as symptoms, age, and lifestyle.
Tips for living with HF
Like any long-term medical condition, living with heart failure means consistently monitoring your health and taking care of yourself. This involves not only sticking to the management plan outlined by your doctor, but also keeping active and controlling your diet5. Heart failure, when well managed, doesn’t have to ruin your social or personal life.
Some General Tips to Keep in Mind
Build a strong support network
Keep a close eye on your symptoms
Report any problems you experience to your doctor straight away
Try to keep doing the things you enjoy (hobbies, exercise, etc.)
Talk about your concerns openly with friends and family
Maintaining a healthy lifestyle
Lifestyle and advice tips for HF
Making some simple lifestyle changes and better, healthier choices is important in managing heart failure6,7. The key is to make small changes to your lifestyle and your approach to healthier eating and the exercise to ensure your heart is functioning as well as it can8.
Any changes to your diet or exercise regime should be made under the guidance of your doctor.
It is important to maintain a good level of physical activity, for your body and mind9-11. As your muscles are also affected by how blood is pumped around the body you may experience some cramping and fatigue at first. With that in mind, it’s important to build your exercise regime gradually7.
Here are some useful tips to follow:
Try to maintain a regular frequency of exercising. Scheduling exercise at the same time every day can help make it a regular part of your life. But don’t over strain yourself. This is most certainly a marathon, not a sprint. Start slow and steady and build from there .
Aerobic exercise, such as walking, combined with some light strength training is usually best11.
Depending on your levels of fitness starting out, you should build up in small increments until you can comfortably work out from 30-40 minutes, but your doctor can help you define your routine9.
Things to avoid/be conscious of7:
• Any sort of high-intensity activities.
• Reduce activity when tired.
• Make sure you take adequate rest periods.
Keeping your heart working well also means paying close attention to what you’re eating. A good diet can lower cholesterol, sodium levels and reduce your weight, which takes pressure off your heart12.
Don’t try crash-dieting or fads, balance is key. Try to eat :
• Five portions of fruit and vegetables a day.
• Wholegrain bread, rice and pasta.
• A small number of dairy products.
• Protein rich foods like eggs, fish, meat and beans – in moderation.
• Very little high-fat or sugary foods.
• Sodium intake should be discussed and managed with your treating physician. Excess sodium is best avoided where possible and only taken very minimally. Sodium can raise blood pressure and have negative effects on the heart.
Alcohol should also be limited. Talk to your doctor about alcohol consumption guidelines and stick to them12.
Take a look at our Living with heart failure page for more information on heart failure management.
Learn to live with HF
- Heart failure treatment. Available at: https://www.nhs.uk/conditions/heart-failure/treatment/. Accessed 2 September 2020.
- American Heart Association. Treatment Options for Heart Failure. Available from: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure. Accessed 2 September 2020.
- American Heart Association. Medications Used to Treat Heart Failure. Available from: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/medications-used-to-treat-heart-failure. Accessed 3 September 2020.
- American Heart Association. Devices and Surgical Procedures to Treat Heart Failure. Available from: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/devices-and-surgical-procedures-to-treat-heart-failure. Last accessed 2 September 2020.
- American Heart Association. Living with Heart Failure and Managing Advanced heart failure. Available from: https://www.heart.org/en/health-topics/heart-failure/living-with-heart-failure-and-managing-advanced-hf. Last accessed: 2 September 2020.
- Living with heart failure. Available from: https://www.nhs.uk/conditions/heart-failure/living-with/. Last accessed 16 September 2020.
- Living with heart failure. Available from: https://www.bhf.org.uk/informationsupport/support/practical-support/living-with-heart-failure. Last accessed 16 September 2020.
- American Heart Association. Lifestyle Changes for Heart Failure. Available from: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/lifestyle-changes-for-heart-failure. Last accessed 16 September 2020.
- Exercise training as therapy for chronic heart failure. Available from: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-14/Exercise-training-as-therapy-for-chronic-heart-failure. Last accessed 16 September 2020.
- American Heart Association. Why is physical activity so important. Available from: https://www.heart.org/en/healthy-living/fitness/fitness-basics/why-is-physical-activity-so-important-for-health-and-wellbeing. Last accessed 16 September 2020.
- Hopkins Medicine. 7 Heart Benefits of Exercise. Available online at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/7-heart-benefits-of-exercise. Last accessed 16 September 2020.
- Healthy eating. Available from: https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating. Last accessed 16 September 2020.
- Healthline. Tips for caring for someone with heart failure. Available from: https://www.healthline.com/health/heart-failure/caregiving-tips. Last accessed 16 September 2020.