Heart Failure
Also known as Congestive heart failure, CHF
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is heart failure?
Heart failure means the heart cannot pump efficiently enough to meet the body demands, causing fluid to build up in the lungs and limbs. It does not mean the heart has stopped. Modern treatment substantially improves symptoms and survival, and daily weight monitoring is one of the most useful self management tools.
Causes
- Coronary artery disease and previous heart attack
- Long standing hypertension
- Heart valve disease
- Cardiomyopathy
- Atrial fibrillation and other arrhythmias
- Excess alcohol and some chemotherapy agents
Symptoms
- Breathlessness on exertion and later at rest
- Waking at night breathless
- Needing extra pillows to sleep flat
- Swelling of ankles, legs or abdomen
- Fatigue and reduced exercise tolerance
- Rapid weight gain from fluid retention
- Persistent cough or wheeze
Risk factors
- Previous myocardial infarction
- Hypertension
- Diabetes
- Obesity
- Chronic kidney disease
- Excess alcohol intake
Diagnosis
- Clinical assessment for fluid overload
- NT proBNP or BNP blood testing
- Echocardiogram to measure ejection fraction
- ECG and chest X-ray
- Blood tests for kidney function, iron studies and thyroid function
- Coronary assessment where ischaemia is suspected
Treatment
- ACE inhibitors or angiotensin receptor neprilysin inhibitors
- Beta blockers introduced at low dose and titrated slowly
- Mineralocorticoid receptor antagonists
- SGLT2 inhibitors, now standard in most patients
- Diuretics for symptom and fluid control
- Cardiac rehabilitation and daily weight monitoring
- Device therapy or transplant assessment in advanced disease
Self care
- Weigh yourself daily at the same time and record it
- Take all heart failure medicines, even when you feel well
- Reduce added salt in cooking and at the table
- Follow any fluid limit you have been given
- Stay as active as you can and attend cardiac rehabilitation
- Get annual influenza and recommended COVID-19 vaccination
- Avoid anti inflammatory painkillers, which worsen fluid retention
When to see a doctor
Book an appointment if:
- Weight gain of more than 2 kilograms over two or three days
- Increasing ankle or abdominal swelling
- Needing more pillows to sleep
- Reduced exercise tolerance
- Dizziness on standing or persistent fatigue
- Palpitations or an irregular pulse
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Control blood pressure, the largest modifiable factor
- Treat coronary artery disease and act fast on chest pain
- Manage diabetes and cholesterol
- Limit alcohol and stop smoking
- Treat atrial fibrillation and valve disease
- Attend follow up so treatment can be optimised early
Outlook
Heart failure is a long term condition, but modern combination therapy has substantially improved both symptoms and survival. Many people remain active for years. Prognosis depends on the underlying cause, ejection fraction and how consistently treatment is taken. Daily weight monitoring and early diuretic adjustment prevent many hospital admissions.
Common questions
Why weigh yourself every day?
Fluid accumulates before breathlessness worsens. A gain of more than two kilograms over two to three days usually signals fluid retention and allows early diuretic adjustment rather than a hospital admission.
Does heart failure mean the heart is about to stop?
No. It describes reduced pumping efficiency. Many people live for years with good quality of life, and modern combination therapy has substantially improved survival.
How much fluid and salt are allowed?
Advice is individual, but reducing added salt helps most people, and some are given a daily fluid limit. Restrictions should be set by the treating team rather than adopted independently.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.