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Heart failure Q&As

Published by Bupa's health information team, September 2008.

Answers to questions about heart failure

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

What can I do to help myself?

By following your treatment plan you can ease your symptoms and improve your condition. This means taking medicines and making changes to your lifestyle. There are lots of things you can do that will help you to feel better day to day and that will slow down any worsening of your heart failure.

Explanation

As well as improving your condition and preventing it from getting worse, changing your lifestyle can also help to prevent you from becoming ill enough to need to go to hospital. All of the following can help to improve your condition.

Taking your medicines

Everyone who has heart failure will benefit if they take medicines to help their condition. If you choose not to take medicines you will be more likely to need to go back into hospital because your condition has got worse. Most people with heart failure will need to take a combination of medicines to help control and stabilise their condition. You may find that the first medicines you try don't suit you, or don't work as well as they should, so there may be a period of trial and error until you find the right medicines for you. Always ask your GP or nurse for advice and read the patient information leaflet that comes with your medicines.

Stop smoking

If you smoke, you should stop. Smoking is one of the main factors linked to heart disease and stopping smoking is the single most important thing that any smoker can do to live longer and improve their health. There are lots of treatments and services available to help you quit, including local stop smoking groups, special Quitlines run by the NHS, and nicotine replacement therapy (NRT). NRT and the medicine bupropion can both help you to stop smoking and are safe to use for most people with heart failure. Ask your GP or nurse for advice.

Eat less salt

Eating less salt can lower your blood pressure and help to control the amount of fluid in your body. Some people with heart failure are also asked to drink a limited amount of fluid, as well as eating less salt, as this can help to reduce ankle swelling and ease breathlessness. There are three ways to cut down on the amount of salt that you eat:

  • don't add salt to the food on your plate
  • don't add salt to cooking. Using herbs, spices and other flavourings can help to add flavour instead of salt
  • eat fewer manufactured or processed foods and choose those with less salt

Weigh yourself regularly

If you have heart failure, it's important to keep an eye on your weight, so weigh yourself every morning. If your weight goes up suddenly and you gain 4lbs (about 2kg) over a couple of days, tell your GP or nurse. This increase in weight could be extra fluid and you may need to change your medicines to help your body get rid of it.

Lose excess weight if you are overweight

For some people with heart failure who are overweight, losing excess weight may help to ease their symptoms and improve their condition. Aim to lose weight slowly and steadily as this will help to ensure that the excess weight stays off. About a pound a week is a healthy amount to lose.

Limit the amount of alcohol you drink

Alcohol can affect your condition. Your GP or nurse may ask you to limit the amount that you drink, for example, he or she may ask you to drink less than the normal recommendation or no alcohol at all. If your heart failure has been caused by heavy drinking, it's important that you don't drink alcohol at all. If you stop drinking completely, you can improve the way your heart works and ease your symptoms. You are also less likely to end up in hospital because your condition has got worse.

One unit is roughly the same as half a pint of ordinary strength beer or lager, a single measure of spirits or a small glass of wine.

Be active within your limits

If you have heart failure, the thought of increasing the amount of activity you do can seem frightening. However, being inactive can make your condition worse. You may be given an exercise plan to follow as part of a rehabilitation programme or your GP or nurse may give you a plan to follow. Build up the amount of activity you do gradually and stay within the limits set by your GP or nurse. If you get very breathless, slow down or stop until you recover.

Get your vaccinations for flu and pneumonia

Getting your vaccinations against flu and pneumonia can reduce your chances of becoming ill and needing to go to hospital.

Look after your mental and emotional wellbeing

It's common for people with heart failure to feel anxious and worried about their condition and their future. It's also common for people with heart failure to become depressed. For some people this may make their condition worse and lead to a stay in hospital or may even increase their risk of dying from the condition. So it's vital that as part of your treatment you look after your mental health and wellbeing. Talk to your GP or nurse about how you are feeling and ask for help and advice when you need it. He or she may be able to refer you to a counsellor to help you cope with your condition or suggest medicines to help with depression.

Further information

Sources

  • Management of chronic heart failure. Scottish Intercollegiate Guidelines Network (SIGN). 2007. www.sign.ac.uk
  • Chronic heart failure: National clinical guideline for diagnosis and management in primary and secondary care. National Institute for Health and Clinical Evidence (NICE) 2003. www.nice.org.uk
  • Management of heart failure. Understanding NICE guidance - information for people with heart failure, their carers, and the public. National Institute for Health and Clinical Evidence (NICE), 2003. www.nice.org.uk
  • British Heart Foundation. Heart Information Series 8, 2004. Living with heart failure
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007: 338-339
  • Heart failure - Management issues. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 2 February 2008
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How can I ease the symptoms?

The main symptoms of heart failure are breathlessness, swollen feet and ankles and tiredness. Medicines can help to ease these symptoms but there are also a number of things that you can do to help you feel more comfortable.

Explanation

Heart failure can cause many different symptoms and what affects one person may not affect someone else. However, the main symptoms that most people get are listed below, along with some practical tips on how to cope with them.

Breathlessness

Being short of breath is one of the main symptoms of heart failure. It happens because fluid builds up in your lungs and it usually gets worse when you lie down or when you are active. Taking diuretics (water tablets) will help to improve your breathing by helping your body to get rid of the extra fluid it is carrying. Many people find that being breathless disturbs their sleep. Sleeping propped up with pillows and with a window open can help you to breathe more easily at night. Seeing a physiotherapist can also help you to feel more in control of your breathing. If you become very short of breath, your GP may give you a small amount of a medicine called an opioid which can help to make breathing easier. Some examples of opioids are pethidine and morphine. Pethidine and morphine are often given as an injection although opioids can also be taken as tablets.

Tiredness and lack of energy

This is a very common problem for people with heart failure and can make normal day to day life very difficult and frustrating. You might find that you become tired when you are resting or doing very little. One of the main reasons why you feel so tired is because the blood flow to your muscles isn't working as well as it should. Pace yourself so that you have the energy to do the things you need to, or the things that you enjoy. Try breaking up big tasks into small parts and ask for help from your family and friends. If you are struggling to manage then talk to your GP or nurse about getting some help.

Swollen ankles and feet

The medical word for this is oedema. It's caused by your body holding on to water and salt. It can affect your feet, ankles and lower legs but it can also spread much further, to include the whole of your leg, your groin and the lower part of your stomach (abdomen). The following can help to prevent swollen ankles:

  • keep your feet up when you can by resting them on a stool or chair and don't sit or stand for long periods.
  • wear comfortable shoes and socks that don't feel tight.
  • regularly exercise your lower leg (calf) and foot muscles. For example, bend and straighten your legs, feet and toes. Better still, get up and walk if you can.
  • look after the skin on your lower legs and feet as it can become fragile and break easily. If the skin breaks, it can easily become infected and lead to an ulcer. Put moisturiser or emollient on every day. Check for cuts and bruises and let your GP or nurse know if you find any.

Further information

Sources

  • British Heart Foundation. Heart Information Series 8, 2004. Living with heart failure
  • Chronic heart failure: National clinical guideline for diagnosis and management in primary and secondary care. National Institute for Health and Clinical Evidence (NICE), 2003. www.nice.org.uk
  • Management of chronic heart failure. Scottish Intercollegiate Guidelines Network (SIGN), 2007. www.sign.ac.uk
  • Living with heart failure. Chest, heart and stroke Scotland, 2004. www.chss.org.uk
  • Alexander M. Fawcett J, Runciman P. Nursing practice: hospital and home: the adult. 3rd ed. : London: Churchill Livingstone Elsevier, 2006: 46-47
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Will I just continue to get worse and worse?

Heart failure can be life-threatening and at the moment there is no cure. However, there are very effective treatments that can help to stabilise your condition, prolong your life and allow you to get the most from your day-to-day life. It's very difficult for your GP to know for certain how your health may change in the future but he or she can help you to understand and manage your condition well. You can also help yourself by following your treatment plan.

Explanation

Heart failure is a condition that can affect people very differently. You may be able to carry on a normal life with few symptoms, or you may find day to day life very limited with symptoms that are there even when you are resting. You may also find that your symptoms vary from day to day - you have good days and bad days. Sometimes your symptoms may be so bad that you need to go into hospital for a while.

Even with modern medicines and treatments heart failure will progressively get worse. Some people have very severe and sudden worsening of their condition that can be fatal. In order to make sure that you get the right treatment quickly and keep your condition well controlled, it's important for both you and your GP to monitor your health and how you are feeling. Your GP or nurse will see you regularly - depending on how you are this could be every day or as little as every six months. You can also help by keeping an eye on your symptoms and by weighing yourself every day. If your condition changes, tell your GP or nurse straight away.

Further information

Sources

  • Management of heart failure. Understanding NICE guidance - information for people with heart failure, their carers, and the public. National Institute for Health and Clinical Excellence (NICE), 2003. www.nice.org.uk
  • Management of chronic heart failure. Scottish Intercollegiate Guidelines Network (SIGN). 2007. www.sign.ac.uk
  • ABC of heart failure - clinical features and complications. Student BMJ. http://student.bmj.com, accessed 11 February 2008
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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