What causes heart failure?
Will I live to see my middle son go to school, or my baby learn to walk? Realistically, I don't know.
Bronnach's story can be seen as part of our Mending Broken Hearts Appeal.
There are lots of reasons why you might be diagnosed with heart failure. It can be sudden or it can happen slowly over months or even years.
The most common causes are:
Heart failure can also be caused by:
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Heart failure can also 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.
What are the symptoms of heart failure?
The main symptoms are:
- shortness of breath - when you are being active or at rest
- swelling - of your feet, ankles, stomach and lower back areas
- fatigue - feeling unusually tired or weak
Symptoms occur because the heart does not have enough strength to pump blood all the way round the body efficiently. This can cause fluid to pool in the feet and legs. If this fluid is left unmanaged, it can build and spread to your stomach area and sit beneath your lungs. This reduces their ability to expand and makes you short of breath.
Medication and making changes to the way you live can make a real difference to these symptoms. People with heart failure experience different symptoms and everyone copes in different ways, so speak to your GP and your heart failure nurse about what is best for you.
For more information about understanding and managing the symptoms of heart failure, take a look at our advice and information on living with heart failure.
How is heart failure diagnosed?
To diagnose heart failure, your doctor will ask you questions about your medical history, talk about your symptom and do a physical examination. In most cases you will also have further tests to confirm the diagnosis and guide how your symptoms are controlled. These include blood tests, an electrocardiogram (ECG), a chest x-ray, an echocardiogram and a coronary angiogram.
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. A normal ejection fraction is around 50-65 per cent, as there is always some blood left in the heart after each heartbeat. Some people with heart failure have a normal ejection fraction, so ejection fraction is used alongside other tests to help diagnose heart failure.
After a diagnosis, your doctor may discuss your 'stage' or 'class' of heart failure. There are four classes, which are based on your symptoms and how they affect you. The higher the number of the class you are in, the more serious your heart failure has become. It is also possible to move between stages as you may have episodes where your heart failure is worse because of other events, such as a further heart attack.
What treatments are available for heart failure?
While there isn't a cure for heart failure at the moment, the treatments available to control symptoms are helping many people live full and active lives.
Your doctor is likely to prescribe drugs that will help control your blood pressure and help the pumping action of your heart.
They will also give you advice about making changes to your lifestyle such as cutting down on salt, which will help control your blood pressure, and stopping smoking.
A combination of medication and lifestyle changes will hopefully help you continue to do the things you enjoy, by helping you manage your symptoms and keeping your condition as stable as possible.
Some people with heart failure will benefit from a pacemaker or ICD. Your doctor will talk to you about these treatments if they are right for you.
Find out more
Fighting for a cure
At the moment, if you have a heart attack your heart muscle suffers damage that can never be repaired. But with recent advances in regenerative medicine, repairing a damaged heart is a realistic goal.
We've launched our most ambitious research programme yet to progress the UK's fight against heart failure – our Mending Broken Hearts appeal.