Heart failure is a chronic condition in which the heart’s ability to pump blood throughout the body has been weakened  enough to interfere with activities of everyday living. Heart failure symptoms can include fatigue and shortness of breath. Many types of heart disease and some medical conditions can lead to heart failure. Heart failure can be caused by structural changes in the shape and function of the heart chambers, disorders of the heart valves, coronary artery disease or other illnesses. Heart failure may appear suddenly or develop over time.

Heart failure is a cardiovascular diagnosis that is increasingly common as people live longer. The American Heart Association estimates that by 2030 more than 8 million people in the U.S. will have heart failure. That is one person in 33. Heart failure is the most common cause of hospitalization for older Americans. Age and gender also affect risk. Between age 60-79, nearly twice as many men than women will have heart failure. By age 80, heart failure is diagnosed as often in women as in men.

Heart failure may affect only one side of the heart or both sides.  Whether there is a change in the heart’s ability to contract well or to relax enough to allow blood to fill the large chambers well, it is much harder for your heart to do its job:  pump blood throughout your body. When your heart can’t do that, you will notice that you can no longer live life as you always have. You may notice that you’re breathless by the time you walk from your car to your home. You may feel more tired than usual. You might not be able to sleep unless you are sitting up. You may notice that your abdomen, legs, ankles and feet are abnormally swollen.

If you are diagnosed with heart failure, you can improve your heart’s function in many ways. Many people with heart failure have made lifestyle changes that have allowed them to resume many daily activities that they enjoy. These changes include staying active, not smoking, limiting or stopping alcohol use, maintaining a healthy weight and monitoring heart failure-related symptoms.

The two most important actions, however, are to follow your doctor’s instructions about how and when to take your medication, and to follow a low-sodium diet that includes fresh ingredients such as vegetables, fruits, nuts, beans and whole grains, avoiding packaged or processed foods.  Patients with heart failure are prescribed evidence-based medical therapies.  It’s very important to learn about how each medicine works and why you are taking it. We strongly recommend that you keep an up-to-date medication list in your wallet or smartphone. Please tell your care provider immediately about any side effects or concerns you have about your medications. Do not decide on your own to stop taking your medication or to reduce your dose. It is very important to stay on top of refills. Many pharmacies offer automatic prescription refills so you will not risk being without the medication you need. Many heart failure medicines are available in generic formulation and can be bought at low cost. Getting lab tests done as instructed is also important to monitor your serum electrolytes and kidney function while your medication doses are adjusted.

Most Americans consume too much salt or sodium in their diet—typically more than 3,000 mg daily. High levels of salt cause water to accumulate in the body, which makes more work for the heart. This can further stress the heart and contribute to symptoms such as difficulty breathing or undue tiredness.

To reduce your heart’s workload, do not add salt to your food and limit how much you consume in processed and prepared foods which have a high salt content.   Read nutrition labels and take into account the stated serving size.  A low sodium diet means eating less than 2,000 mg daily, but the easiest way to  manage your salt intake is to follow this advice:   “Nothing out of a can, nothing out of a bag, nothing out of a box and no processed foods.” 

Yes, being active is one of the best things you can do for your heart. Years ago, patients with heart conditions were told to rest and avoid exertion. Since then, evidence has shown that activities like walking, gardening, swimming, dancing or golfing are good for you. The key is to monitor your tolerance of activity. It’s also important to rest when you feel tired or notice an increase in symptoms. Over time, your endurance will improve. 

A good goal is 30 minutes of activity at least five times a week. You do not need to do all 30 minutes in one session. Some patients start with two or three shorter sessions during a day. Many people find activity easier to continue if they are part of a structured cardiac rehab program, especially after a hospitalization for heart failure. This type of program has benefits beyond the exercise. You can learn more about your heart health. You can meet others who are learning to live with heart failure. You also will have help monitoring your progress. Your medical care provider can give you information on a cardiac rehab program in your community.

Today, there are options beyond medication to treat advanced heart failure. There are specific criteria for these therapies. Which therapy is right for you is a joint decision to be made by you, your family and your clinicians. Therapy should be aimed at helping you achieve your personal goals for your life. The non-medication therapies now available may include a special type of pacemaker, a small mechanical device that takes over some of the heart’s work or even a heart transplant.