Heart failure is a complex condition caused by a weakening or stiffening of the heart muscle which leads to symptoms during exertion or sometimes even at rest.
A detailed discussion of your current symptoms will help to determine whether you may be developing this condition. Common symptoms include:
- breathlessness
- feeling breathless when lying flat – and needing to use pillows or sit upright to assist with breathing more comfortably
- waking suddenly because of breathlessness
- fatigue
- weight gain
- ankle swelling
An indentation remaining after pressing on the skin for several seconds suggests oedema (fluid retention).
There are many possible causes of heart failure and a careful history and physical examination is required to determine which factors may be important in your specific situation. Further tests (such as blood tests and an electrocardiogram) are usually needed to assess for any causes that may be contributing – the reason for any tests will be carefully explained to you.
An echocardiogram (ultrasound of the heart) is particularly important in assessing the the main pump chamber of the heart. Assessment includes both the pump function (left ventricular ejection fraction) and the ability of the left ventricle to relax and fill with blood. Guiding your treatment and results of this important test will be discussed in detail. This is because we now recognise that many patients with heart failure have normal heart pump function, but develop symptoms due to issues with the heart relaxing and filling with blood.
Your treatment plan will be tailored to your own, specific situation. Lowering your intake of fluid and taking diuretics (medication that removes fluid from the body) can often help to improve your symptoms and ability to exercise. Depending on your ultrasound results, other medications may also be recommended. As patients with heart failure tend to develop increased fluid retention at times, a clear plan for recognising worsening fluid retention and taking action early will also be developed with you and your general practitioner.
A diagnosis of heart failure often causes considerable anxiety amongst patients, particularly at first. It is important to have the opportunity to ask questions about your condition so that you can better understand your unique situation and why certain treatments may be recommended for you.
Many patients experience a very significant improvement in their symptoms and quality of life with medications alone. Initially you may need more regular appointments to ensure that you are on the most appropriate types and dose of medications for this condition.
If you could benefit from other treatments such as a pacemaker, defibrillator, cardiac surgery or an ablation procedure for an abnormal heart rhythm you may be referred on to an appropriate specialist for further evaluation and management.
Cardiomyopathy
There are a broad range of cardiomyopathies – some of these are listed below:
- Ischaemic cardiomyopathy
- Hypertensive cardiomyopathy
- Dilated cardiomyopathy
- Takotsubo cardiomyopathy
- Hypertrophic cardiomyopathy
- Amyloid cardiomyopathy
