Living With Heart Failure

What does the diagnosis mean?

Heart failure can involve reduced pumping strength, abnormal filling, or both. It can occur with a reduced or a preserved ejection fraction (EF). EF is one measurement, not the whole diagnosis.

Breathlessness, leg swelling, fatigue and difficulty lying flat can occur, but these symptoms have other possible causes. Clinicians combine the history, examination, blood tests and imaging to make the diagnosis.

Treatment depends on your type of heart failure

For heart failure with reduced EF, several medicine groups can improve outcomes: an ARNI, ACE inhibitor or ARB; an evidence-based beta blocker; a mineralocorticoid receptor antagonist; and an SGLT2 inhibitor. The combination and doses depend on blood pressure, kidney function, potassium and tolerance.

For preserved or mildly reduced EF, SGLT2 inhibitors and management of contributing conditions can be helpful. Diuretics may relieve congestion. Some people benefit from devices or specialist treatments. Ask what each medicine is intended to do.

An improved EF is encouraging, but do not stop treatment just because a later scan looks better.

Build a home plan with your team

• Know which symptoms and weight changes should trigger a call. Use the specific thresholds your team gives you.
• If daily weights are recommended, use the same scale and similar conditions each morning.
• Discuss sodium and fluid advice for your situation; avoid applying another person's limits to yourself.
• Ask about safe activity and cardiac rehabilitation.
• Keep an updated medicine list and a plan for follow-up blood tests.

My Heart Health Tracker can help you keep a record. It does not send readings to your care team or generate clinical alerts.

When to seek care

Call 911 for severe shortness of breath at rest, chest pain, fainting or new confusion. Contact your care team promptly for worsening swelling, new difficulty lying flat, unexpected weight gain according to your plan, or a clear fall in your ability to do usual activities.

Do not take extra diuretic doses unless your clinician has given you a specific action plan.

Questions for your next visit

• Which type of heart failure do I have?
• What changes should prompt a call, and whom should I call?
• Which medicines, blood tests and activity goals are part of my plan?

Keep reading

• Your Echocardiogram
• Cardiac Rehabilitation
• My Heart Health Tracker