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Heart failure

Heart failure means that your heart is not pumping blood around your body as effectively as it should. 

Having heart failure doesn’t mean that your heart has stopped working, but that your heart needs some support to help it work better.

It's a long-term condition that often gets worse over time. It can’t be cured, but with treatment and lifestyle changes, many people can have a good quality life. It can occur at any age, but is most common in older people.

Symptoms of heart failure

The main symptoms are:

  • Shortness of breath when you are being active or at rest.
  • Swollen feet, ankles, stomach and around the lower back area.
  • Feeling unusually tired or weak.

Symptoms occur because your heart is not able to pump blood around the body efficiently. This can lead to a build-up of fluid that backs up into the lungs, which causes breathlessness. Also because the heart is not pumping properly it can cause fluid retention, causing swelling in your legs, ankles, feet or in the small of your back or abdomen.

You may also feel extremely tired because your heart is not able to deliver enough blood and oxygen to the muscles in your body.

You should see your GP if you begin to experience any of these symptoms.

To find out more about managing the symptoms of heart failure, visit our living with heart failure page.

What causes heart failure?

There are lots of reasons why you may develop heart failure. It can be sudden or it can happen slowly over months or even years.

The most common causes are:

  • A heart attack – this can cause long-term damage to your heart which can affect how well the heart can pump.
  • High blood pressure - this can put extra strain on the heart, which over time can lead to heart failure.
  • Cardiomyopathy - a disease of the heart muscle. There are different types which can either be inherited or caused by other things, such as viral infections.

Heart failure can also be caused by:  

  • Damaged or diseased heart valves
  • An abnormal heart rhythm (arrhythmia)
  • Congenital heart conditions – heart problems that you’re born with
  • A viral infection affecting the heart muscle
  • Some cancer treatments such as chemotherapy 
  • Excessive alcohol consumption 
  • Anaemia – a lack of oxygen carrying haemoglobin or red blood cells in your blood
  • Thyroid gland disease

Heart Health and Cancer Treatment

If you're having treatment for cancer and have a heart condition, or have been told that your treatment may affect your heart, you might find Heart health and cancer treatment helpful.

It's a new booklet jointly produced by Macmillan Cancer Support and the British Heart Foundation and you can order free copies online from Macmillan Cancer Support.


Pulmonary hypertension

Heart failure can be caused by pulmonary hypertension (raised blood pressure in the blood vessels that supply your lungs). This condition can damage the right side of your heart, leading to heart failure. In some cases the pulmonary hypertension itself is caused by an existing heart condition. 

Find out more about pulmonary hypertension on NHS Choices and PHA UK.


Heart failure can also be caused by a rare group of conditions called amyloidosis. This is when abnormal proteins, called amyloid, build up in organs (such as the heart, kidneys and liver) and tissues, making it difficult for them to work properly. Without treatment, this can lead to organ failure.

If amyloidosis affects the heart it is called cardiac amyloidosis – or ‘stiff heart syndrome’. Cardiac amyloidosis tends to make the ventricles (the two lower pumping chambers of the heart) stiff, making it more difficult to pump blood around the body.

About 600 new cases are diagnosed in the UK every year.

Visit NHS Choices for more information.

How is heart failure diagnosed?

To diagnose heart failure, your doctor will ask you questions about your medical history, talk about your symptom(s) and do a physical examination. This will include checking your heart rate and rhythm, taking your blood pressure, and checking if you have fluid in your lungs, legs and other parts of your body. In most cases you will also have further tests to confirm the diagnosis and guide how your symptoms are controlled.

You may hear your doctor talk about the ‘ejection fraction’ of your heart. This refers to the amount of blood that is pushed out of your left ventricle every time your heart beats. It’s usually expressed as a percentage – over 50% is considered normal. 

Some people with heart failure have a normal ejection fraction, so ejection fraction is used alongside other tests to help diagnose heart failure.


While there isn't a cure for heart failure at the moment, the treatments available help to control symptoms leading many people to live full and active lives.
Your doctor is likely to prescribe drugs that will help to improve your symptoms, keep you as well as possible, help prevent your condition from getting worse and help to improve your life expectancy.

Some people with heart failure will benefit from a pacemaker or ICD, which help to improve the pumping action of your heart. Your doctor will talk to you about these treatments if they are the right option for you. 

Keeping your heart healthy

man on weighing scales

Alongside taking your medicines as prescribed, making changes to your lifestyle can also help to keep your condition as stable as possible so you can continue to do the things you enjoy.

Such changes may include:

  • Weighing yourself regularly – sudden weight gain may suggest too much fluid is building up in your body.
  • Watching the amount of fluid you have each day.
  • Controlling your blood pressure to reduce the strain on your heart.
  • Cutting down on salt – too much salt in your diet can make your body hold on to water. 
  • Stopping smoking – this is the single most important thing you can do to live longer.
  • Limiting how much alcohol you drink to ensure your symptoms aren’t made worse and to help keep your heart healthy.
  • Keeping active – this can help improve your energy, stamina and fitness. Regular physical activity can also help you to improve or cope with your symptoms.
  • Keeping to a healthy weight, which will help to prevent your heart from working too hard.

Coping with your condition 

The symptoms of heart failure can make it difficult for some people to live their lives normally. It may take a bit longer, but breaking jobs down into smaller tasks can help - and it means that you’re still able to do the things you want to do. Tell your doctors and nurses about how you feel, and about the ways in which heart failure is affecting your everyday life. They may be able to adjust your treatment to help improve your quality of life.

Read more about the challenges of living with heart failure.

Emotional wellbeing

It’s normal to feel low or sad from time to time. You may feel down about your symptoms and your limitations, or feel that you have a lack of control over your life.

Some people find it very difficult to live with the uncertainty of having heart failure. But learning about your condition and being involved in making decisions about your treatment will all help you to feel more in control and may help to relieve anxiety. It’s also important to discuss your worries with your family and close friends.

Stress affects different people in different ways. People who don’t manage their stress well may turn to unhealthy habits such as smoking, drinking alcohol, or snacking on unhealthy foods. Knowing what triggers the stress can help you to tackle the problem. 

Finding healthy ways of coping with stress and learning to relax can help you manage your heart failure. 

Find out more 

Leading the fight against heart failure

The BHF is the largest independent funder of cardiovascular research in the UK. Some highlights of our heart failure research include:

  • Looking at new ways to repair heart muscle that’s been damaged as a result of a heart attack in people with heart failure. This is known as regenerative medicine. It includes looking at how stem cells can become heart muscle cells to help with this repair.
  • Improving the levels of iron in the blood, which are often low in people with heart failure. Studies looking at whether long-term iron supplements may help improve shortness of breath and quality of life in people with heart failure.

Find out more about our heart failure research and our most ambitious research programme yet to progress the UK's fight against heart failure – our Mending Broken Hearts appeal.

Our life saving research is powered by your support. Every pound raised, helps make a difference to people's lives. Join our fight for every heartbeat.

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