Shortness of breath and heart failure

What is heart failure?

Heart failure means the heart is not pumping blood as efficiently as it should. It does not mean the heart has stopped. With the right treatment, many people with heart failure live well and stay active.

Heart failure can develop after a heart attack, due to high blood pressure, valve disease, or other conditions that place extra strain on the heart muscle.

Common symptoms

• Breathlessness, especially on exertion or when lying flat
• Swollen ankles, legs, or abdomen
• Fatigue and reduced ability to exercise
• Waking at night feeling short of breath
• A persistent cough, sometimes with frothy sputum

How is it diagnosed?

• Echocardiogram: the key test to assess how well the heart is pumping and to check the valves
• Blood tests: including BNP or NT-proBNP, a marker of heart strain
• ECG: to check the heart's electrical activity
• Chest X-ray: to look for fluid on the lungs
• Cardiac MRI: in some cases, for a more detailed look at the heart muscle

How is it treated?

• Medications: several tablets that are proven to improve symptoms and prolong life in heart failure
• Lifestyle changes: managing fluid intake, staying active within your limits, reducing salt
• Device therapy: in selected patients, a pacemaker or defibrillator may be recommended
• Treating the underlying cause: such as opening a blocked artery or repairing a damaged valve

How should you prepare?

For any appointment it helps to bring: a list of your current medications and doses; copies or details of any previous heart tests (ECGs, scans, or angiogram reports); a note of your symptoms, when they happen, and what brings them on; and your questions. If you have results from another hospital, ask that clinic to send them ahead of your visit.

When to seek urgent help

If you develop sudden, severe breathlessness, especially at rest, or if your symptoms worsen rapidly, call 999 or 112 or go to the emergency department immediately.