Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2004;70(11):2171-2172

What is heart failure?

Heart failure happens when your heart can’t pump enough blood to meet your body’s needs and causes poor blood flow. Poor blood flow has a bad effect on many of your body’s organs, such as your brain, lungs, and kidneys.

In heart failure, your body holds onto salt and water. This makes your feet, ankles, and legs swell. It also makes it hard to breathe. Heart failure can cause many kinds of symptoms.

How does a person get heart failure?

These are the most common causes of heart failure:

  • Coronary artery disease (also called hardening of the arteries)

  • High blood pressure that you’ve had for a long time

  • Diabetes

  • Heart attacks

  • Thyroid problems

  • Heart valve problems

  • Heavy use of alcohol

Less common causes include congenital heart problems and infections of the heart caused by a virus.

How can my doctor tell that I have heart failure?

Your doctor will ask you about the symptoms of heart failure. These can include chronic tiredness, fluid retention and weight gain, swelling of the feet and ankles, and shortness of breath (at rest, with activity, or while sleeping).

Your doctor may find other signs of heart failure during an exam. Your doctor may order an echocardiogram. This special picture shows the doctor how the valves and chambers of your heart are working.

How is heart failure treated?

Heart failure is treated with lifestyle changes, medicines, exercise, and close follow-up with your doctor. Some tips are listed below:

Lifestyle Changes

  • Quit smoking.

  • Eat a diet low in fat and cholesterol.

  • Limit salt in your diet. Avoid canned foods. Don’t add extra salt to food.

  • Limit or avoid alcohol.

  • Control your weight or lose weight.

Medicines (your doctor may combine several medicines.)

  • Diuretics (also called water pills), to help your body get rid of extra salt and water

  • Digoxin, to help your heart beat stronger

  • Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers

  • Beta blockers

  • Spironolactone

  • Other medicines to help control blood pressure, lower cholesterol levels, or control your thyroid gland

Exercise

  • If you don’t exercise now, ask your doctor before starting.

  • Slowly work up to walking 20 or more minutes on most days of the week.

  • Start with an exercise program that is designed for people with heart failure. Your doctor can help you find a program.

What can I expect?

Heart failure usually gets progressively worse over time. You can slow this progression, however, by following your family physician’s treatment advice, making the necessary lifestyle changes, and taking your medicines.

Can I prevent heart failure from getting worse?

If you already have heart failure, a healthy lifestyle can help you feel better. Try to do the following:

  • Don’t smoke.

  • Avoid alcohol and drug abuse.

  • Exercise 20 minutes or more most days of the week.

  • Eat a healthy diet. Keep your weight as close to your ideal body weight as possible. If you are overweight, slowly lose weight over the next year and try to keep the weight off.

  • Control your blood pressure and cholesterol. Lifestyle changes will help you do this. Some people need medicine to reach their goals.

Where can I learn more about heart failure?

You can find out more about heart failure at the American Heart Association’s Web site: http://www.americanheart.org.

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