Although heart failure cannot be cured, medication and lifestyle change can improve or maintain heart muscle function. Some people also need more invasive treatments such as a cardiac device or heart surgery.
Many hospitals have a heart failure team who are there to support you and advise on treatment. The team may include cardiologists, heart failure specialist nurses, specialist pharmacists and a cardiac rehabilitation team.
Medication
Most people need a combination of different medications. All medications can have side effects. Your healthcare team will work with you to find the right combination that balances potential side effects with the benefits of particular treatments.
The commonest medications used are:
| Type of medicine | Examples | How do they work? |
| Beta-blockers | Bisoprolol, Carvedilol, Nebivolol | Slow the heart and reduce the work the heart has to do |
| Angiotensin-converting enzyme (“ACE”) inhibitors - “-pril”s | Ramipril, Lisinopril, Perindopril, Enalapril |
Reduce the work the heart has to do Control blood pressure |
| Mineralocortoid antagonists ("MRA"s) |
Spironolactone, Epleronone |
Reduce fluid build up Reduce the work the heart has to do |
| Diuretics (sometimes called “water tablets”) | Frusemide, Bumetanide, Metolazone |
Reduce fluid build up Reduce the work the heart has to do |
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Sodium-glucose co-transporter 2 inhibitors “-gliflozins” |
Dapagliflozin, Empagliflozin |
Reduce symptoms Reduce admissions to hospital |
In addition, people with heart failure are often on medication to treat the underlying cause of the heart failure and to prevent other complications of those conditions.
Healthy living
Making changes to your day-to-day activities can improve symptoms and help to keep your heart healthy.
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Stopping smoking Get support to quit smoking here. Smoking any form of tobacco (cigarettes, cigars, pipes, shisha) as well as chewing tobacco causes narrowing of blood vessels and coronary heart disease. Stopping smoking, even if you have smoked for many years, will have immediate benefits on your heart. |
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There are some simple things you can do to make what you eat day to day healthier:
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Drink less alcohol Learn more about how drinking less can benefit your heart health, along with resources and support for reducing alcohol intake here. Alcohol can damage heart muscle and contribute to narrowing of blood vessels by causing high blood pressure. Although there is a feeling that a small amount of alcohol is beneficial, the evidence for this is not clear. If you do choose to drink alcohol the guidelines are:
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Move more Why not take the first step today? Find out more here. All forms of physical activity and exercise help to keep your heart and you healthy. This doesn’t mean you have to go to the gym. It is more about choosing something that you enjoy which also makes your heart beat a bit faster and makes you breathe a bit harder. Carrying heavy shopping, housework, gardening and walking all count as physical activity. Heart failure should not be a barrier to doing physical activity although you may need to choose an activity that will not put too much strain on your heart. Your doctor will be able to advise on any activities you should avoid. It is important to speak to your healthcare team if you are thinking of taking up exercise that is new to you or more strenuous than you are used to. |
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Reduce Stress Explore our emotional wellbeing pages to learn more and discover the right tools to support you here. Learning how to cope with stress is important but can be difficult. It is useful to consciously develop means of dealing with or avoiding situations that are going to cause stress. In addition, unwinding with hobbies such as yoga and meditation or simply chatting with friends and family can all help. |
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Fluid and weight Some people with heart failure are advised to restrict how much fluid they drink. This helps with the symptoms of heart failure by limiting the build-up of fluid in the feet, legs, tummy or lungs. It is important to remember that a fluid restriction refers to all fluids, not just drinks. It is easy to forget that soups, stews, canned fruit and even ice cream all count as fluids. If your fluid intake is restricted, you may also be asked to weigh yourself very frequently. This is to assess how much fluid you have on board. An increase in weight may mean that things have slipped a bit with the fluid restriction or that you need an alteration in your medication. |
Specialised Treatments
Cardiac devices
Cardiac devices can help some people with heart failure due to problems with the electrical activity in the heart or heart rhythm problems. Cardiac devices are small electrical devices that are inserted just under the skin at the top of the chest on one side. The device is fitted under local anaesthetic, meaning that people are awake but have a medicine injected into the skin to make it numb.
The two main types of device are:
- Pacemaker: helps control the heart rate and reduces the strain on the heart.
- Cardiac resynchronisation therapy (CRT) pacemaker: is a specialised pacemaker that coordinates the timing of the electrical activity and beating of all the parts of the heart.
- Implantable cardiac defibrillator (ICD): detects and treats dangerous heart rhythm problems.
There are different types of pacemaker depending on your specific issue. Your Cardiologist or HF specialist nurse will discuss this with you.
Cardiac surgery
Heart surgery can sometimes be necessary to improve the blood flow to the heart or repair problems with the valves within the heart. However, this is major surgery and is only appropriate for some people. Your heart failure team will consider whether this might be an option for you.
Heart transplant
A heart transplant is occasionally offered to people with heart failure that doesn’t improve despite trying all other possible treatments. In a heart transplant operation, a failing heart is replaced with a healthy heart from a donor. This is major surgery and before an operation is even considered, there is an extensive assessment process to decide whether a person is suitable for such a big operation.
Cardiac rehabilitation
Cardiac rehabilitation is a programme of rehabilitation run over a number of weeks that usually involves a mixture of physical and educational activities as well as offering psychological support. It is a vital element of the treatment of heart failure, improving symptoms and quality of life.
The BHF website has a lot more information about what is involved in cardiac rehabilitation. To find out where your nearest cardiac rehabilitation programme, have a look on the cardiac rehab finder.
How will my heart failure be monitored?
Your healthcare team will support you and monitor how you are getting on.
However, you have the most important role to play in this as only you know how you are feeling. The things to look out for are:
- Breathing: are you becoming more breathless?
- Swelling: are your ankles / legs more swollen?
- Energy: are you less active or mobile than usual?
- Palpitations: have you noticed a fast or irregular heart beat?
- Weight: is your weight increasing very quickly?
If your symptoms are changing, then you should contact your healthcare team.
