Living With Heart Failure: A Practical Guide

Being told you have heart failure is frightening. The name itself sounds terminal, which is misleading. Heart failure means your heart is not pumping as efficiently as it should. It does not mean your heart has stopped or is about to. Many people live well with heart failure for years, but it does require you to make changes and stay on top of things.

Understanding Your Medication

You will almost certainly be prescribed several medications. ACE inhibitors or ARBs to reduce the workload on your heart. Beta-blockers to slow your heart rate and lower blood pressure. Diuretics to reduce fluid build-up. Possibly an aldosterone antagonist, and increasingly a newer drug called sacubitril/valsartan (Entresto) which has been shown to reduce hospital admissions.

Take your medication exactly as prescribed, even on days when you feel well. Heart failure drugs work by keeping things stable. Skipping doses because you feel fine is one of the most common reasons people end up back in hospital. If side effects are bothering you, talk to your specialist rather than stopping anything yourself.

Fluid and Salt

Your specialist may ask you to restrict fluid intake, typically to 1.5 to 2 litres per day. That includes tea, coffee, soup, anything liquid. It sounds manageable until you try it. Get a water bottle with measurements on the side so you can track where you are through the day.

Reducing salt is just as important. Salt causes your body to retain fluid, which makes your heart work harder. Aim for less than 6 grams a day. The biggest culprits are processed foods, bread, cereals, and ready meals. Cooking from scratch gives you far more control.

Weighing Yourself

Weigh yourself every morning, same time, same clothes, after using the toilet. Write it down. A sudden weight gain of more than 2kg over two or three days usually means you are retaining fluid and you should contact your heart failure nurse. This is one of the simplest and most effective early warning systems.

Exercise

It seems counterintuitive, but exercise is one of the best things you can do for heart failure. Your heart failure team will probably refer you to a cardiac rehabilitation programme, which is a supervised exercise course designed for people with heart conditions. It is safe, it is tailored to your ability, and the evidence for its benefits is very strong. Walking is also excellent. Start gently and build up gradually.

When to Get Help

Call your heart failure nurse or GP if you notice: increasing breathlessness, swelling in your ankles or legs, a sudden weight gain, waking up at night gasping for breath, a persistent cough, or feeling much more tired than usual. Call 999 if you have severe chest pain or you cannot breathe.

This article is for general information only and is not a substitute for professional medical advice. If you have concerns about your health, speak to your GP or a qualified healthcare professional. If you believe you are experiencing a medical emergency, call 999 immediately.