Other names: Congestive cardiac failure, CCF, HFrEF, HFpEF

Basic overview

• Heart failure is constellation of signs and symptoms that result from an inability of the heart to pump enough blood to the body at rest or with exercise
• There are many different causes of heart failure (including heart attacks), but generally speaking, heart failure is divided into two broad groups depending on the ejection fraction (volume of blood pumped out with each beat, expressed as a percentage – this is normally greater than 52%)

Symptoms

• Breathlessness with exercise or laying flat, waking in the night with sudden breathlessness or choking, ankle swelling, abdominal swelling / fullness

Treatment

• Treatment for heart failure is complex and often involves multiple specialists including a cardiologist, a general practitioner, a heart failure nurse and sometimes allied health professionals (i.e. dietitian)

• Lifestyle modifications:

  • Maintaining a healthy fluid balance
    • Fluid restriction less than 1.5 – 2.0 litres daily depending on your level of congestion
    • Salt restriction (less than 2 g daily) – excess dietary salt cause retention of water (fluid)
    • Daily weights – if weight increases by 2kg in 2 days this is an indication that you have rapid fluid accumulation and your diuretic medication will need to be increased (urgent advice from your treating doctor / GP is recommended)
  • Maintaining a healthy weight
    • Obesity is present in 30-50% of patients with heart failure – this places extra stress on the heart and leads to a poorer outcome
    • Healthy eating (Mediterranean diet), especially in order to lose weight if your BMI is >25 – please refer to the heart foundation recommendations (heartfoundation.org.au)
  • Limitation of alcohol intake (no more than two standard drinks a day for men and one for women, with at least 2 alcohol-free days a week)
  • At least 30 minutes of moderate intensity exercise daily
  • Avoidance of smoking

  Medications:

  • There are several classes of medications that your doctor may prescribe. 
  • The back-bone of medical therapy for heart failure is:
    • Beta-blockers
    • ACE-inhibitors / angiotensin receptor blockers
  • There are other specialised medications that can be used on an individual basis (depending on the severity of your heart failure)