Heart failure - what happens before and after diagnosis?

Written by: Dr David Brull
Edited by: Jay Staniland

Heart failure (previously called congestive heart failure) occurs if the heart is unable to pump blood around the body normally. It usually happens because the heart has become too weak or stiff. It is a long term (or chronic condition) that can’t usually be cured but can be successfully treated.


Common Symptoms of heart failure


Symptoms can develop quickly (known as acute heart failure) or gradually over weeks or months (chronic heart failure). Symptoms include:

  • breathlessness
  • swollen feet, ankles and abdominal swelling
  • feeling tired and finding exercise exhausting

People may experience other symptoms such as cough, a fast heart rate, and dizziness.


When should you get medical advice?


You should see your GP if you experience persistent or gradually worsening symptoms of heart failure.

Call 999 or go to your nearest accident and emergency department as soon as possible if you have sudden or severe symptoms.


Causes of heart failure


Many conditions can lead to heart failure including:

  • Coronary heart disease – where the arteries that supply blood to the heart become blocked with fatty substances (atherosclerosis), which may cause angina or a heart attack
  • High blood pressure – this can strain the heart, which over time can lead to heart failure
  • Cardiomyopathy – conditions affecting the heart muscle
  • Heart rhythm problems (arrhythmias) – such as atrial fibrillation
  • Damage to the heart valves
  • Congenital heart disease – birth defects that affect the normal heart function

Contributory factors to heart failure


Sometimes anaemia, excessive alcohol consumption, an overactive thyroid, or high pressure in the lungs (pulmonary hypertension) can also lead to heart failure.


Investigating the cause of heart failure


A number of tests can be used to help assess how well your heart is working, including blood tests, a chest X-ray, a heart tracing (called an electrocardiogram or ECG), and an ultrasound of the heart (or echocardiogram).

Often further specialist investigations maybe necessary. These can include:

  • Coronary angiogram (also known as cardiac catheterisation)
  • Magnetic resonance imaging (MRI)

Treatment for heart failure


Treatment for heart failure aims to control the symptoms and slow down the progression of the condition. Treatment will usually be needed for life.

Common treatments include:

  • Lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
  • Medication – a range of medicines can help; many people need to take two or three different types.

Other treatments for heart failure include:

  • Pacemaker or defibrillator devices implanted in your chest – these can help control your heart rhythm and improve function.
  • Surgery – such as a coronary artery bypass operation, valve replacement surgery or rarely a heart transplant.

Outlook for patients with heart failure


Heart failure is a serious long-term condition that will usually progress over time. It can severely limit the activities you're able to do and it may eventually be fatal, however it's very difficult to tell how the condition will progress on an individual basis. Many people remain well for many years, while in some cases the condition progresses rapidly.

If you would like to book an appointment with a consultant cardiologist, you can do so here.

Dr David Brull

By Dr David Brull

Dr David Brull is a London heart specialist and leading Consultant Cardiologist with wide experience in treating all aspects of adult heart disease. His specialist interest is in the treatment of coronary artery disease through percutaneous coronary intervention (angioplasty and stenting).

Dr Brull was appointed Consultant Cardiologist and Honorary Senior Lecturer to the Whittington Hospital and Heart Hospital, University College Hospitals in October 2003 and became Cardiology Clinical Lead at The Whittington in 2011. Following his appointment in 2003, Dr Brull played an integral part in setting up the Primary PCI (heart attack) Service based at Heart Hospital UCLH, providing immediate access and round the clock treatment for heart attack patients throughout North and Central London. In April 2015 The Heart Hospital services moved to The Bart’s Heart Centre, forming the UK’s largest Cardiothoracic centre.

Dr Brull routinely sees patients with all common cardiac conditions including: angina (chest pain), hypertension (high blood pressure), heart failure, referrals for investigation of palpitations and collapse, cardiovascular risk assessment, perioperative cardiac assessment and treatment of elevated cholesterol levels. In addition to his work in the field of coronary artery disease, Dr Brull runs a specialist perioperative risk assessment clinic for patients prior to elective general surgery, working with a large multi-disciplinary team in order to reduce perioperative risk.

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