Heart failure is a common chronic condition in Australia, with a higher prevalence among older adults; around 20% of people aged over 75 years live with heart failure. An evidence-based approach to heart failure management can be effective at relieving your symptoms and supporting your quality of life.
Heart failure is a cardiac condition involving an inability of your heart to pump blood around your body. It may be due to a weak or damaged heart muscle unable to beat efficiently, or a heart muscle that has become too stiff to properly fill with blood.
There are different types of heart failure, typically categorised using a measurement known as the ejection fraction (EF). EF is reported as the percentage of blood that is pumped out of the heart with each beat compared to the volume of blood filling the heart’s chambers between beats. A normal ejection fraction is 50% or higher. Heart failure may be defined as with reduced ejection fraction or with preserved ejection fraction.
Heart failure is not a one-off event but a chronic condition that requires ongoing management.
Heart failure may be caused by many different conditions or situations that result in a weakened or stiffened heart muscle, the most common being heart attack and coronary artery disease.
Other heart failure causes and risk factors include:
Heart failure may also be associated with pregnancy, due to the increased demands on the heart.
Heart failure symptoms arise from the inability of your heart to pump oxygenated blood effectively around your body, resulting in a chronic deprivation of vital nutrients and oxygen to your organs and muscles. This also causes increased fluid retention and swelling as blood does not circulate properly through your veins, forcing excess fluid out into the surrounding tissues.
The most common heart failure symptoms include:
If you have already been diagnosed with heart failure, your symptoms may deteriorate rapidly if you develop angina or arrhythmia, catch an infection, take certain medications, or incorporate too much fluids, salt, or alcohol in your diet.
Effective heart failure management starts with specific tests to diagnose the condition, including identifying which type of heart failure you have and its severity. These tests will be guided by your symptoms and medical history, and may also help to rule out other possible causes of heart failure symptoms such as shortness of breath. To make a heart failure diagnosis, your cardiologist may organise an electrocardiogram (ECG), chest X-ray, blood test for specific peptides (amino acids), or echocardiogram.
As a chronic condition, heart failure treatment is required long-term to maintain your wellbeing and quality of life, and often takes a multifaceted approach.
Positive lifestyle modifications can improve your symptoms, delay the progression of disease, and support your overall quality of life. An ideal lifestyle for heart failure includes:
You may also be enrolled in a heart failure management program, involving a multidisciplinary care team that will help you to understand the condition and how to manage it well.
You may be prescribed one or more medications to improve your heart function and relieve heart failure symptoms. Among other types of drugs, these medications can include ACE inhibitors, diuretics, beta-blockers, and SGLT2 inhibitors. They all work via different pathways, and most are prescribed for long-term use to keep your condition under control.
For some individuals, more intensive treatment with surgery, an implantable device, or another procedure might be needed to improve symptoms.
Pacemakers and implantable cardioverted defibrillators are medical devices designed to address arrhythmia by regulating the electrical currents through your heart. These devices are implanted under your skin and connected to your heart with thin leads.
Other procedures used in heart failure treatment include catheter ablation for arrhythmia, heart valve repair or replacement, coronary bypass surgery for those with coexisting coronary artery disease, or more rarely, a heart transplant.
At Harbourside Cardiology, our team is dedicated to providing holistic, patient-centred care that aligns with the most recent clinical guidelines and research. We are with you every step of your health journey, providing continuity of care of all heart conditions from initial assessment through to treatment and recovery.
