Heart failure (HF) doesn’t mean your heart has failed, only that it isn’t pumping as well as it should. A weakened heart cannot keep up with its workload. It’s not able to pump enough oxygen and nutrient-rich blood throughout your body. The result is fatigue and shortness of breath; some people also have coughing. HF, also called congestive heart failure, makes everyday activities such as walking, climbing stairs or carrying groceries very difficult because of shortness of breath.

HF is a serious, progressive, long-term condition. But many people with HF can lead a full, enjoyable life. It can be managed effectively, and the progression of HF can be slowed or prevented, with heart failure medications and healthy lifestyle changes, according to the American Heart Association.

It is unlikely that you will notice symptoms of heart failure when it first begins. Generally, it develops slowly as the heart tries to keep up with the body’s demands. The heart will enlarge or stretch so it can contract more strongly and pump more blood. But, an enlarged heart can cause the body to start retaining fluid, causing the lungs to get congested. This can cause the heart to beat irregularly. Because heart failure also effects the kidneys’ ability to get rid of water and sodium (salt), the extra fluid increases swelling (edema). The heart pumps faster to increase the output of blood. The body tries to compensate by narrowing blood vessels to keep blood pressure up. The body will also divert blood away from other organs and tissues. HF progresses and worsens as these “work-a-rounds” become increasingly ineffective.

Get help with these symptoms

If you have more than one of these symptoms, contact your doctor and ask for a heart evaluation. The most common HF symptoms are:

  • Shortness of breath can happen during activity, or at rest or while sleeping. If you have trouble breathing while lying flat, try propping yourself up on pillows. You may wake up feeling tired because you didn’t get enough oxygen while sleeping.
  • Swelling, especially in the feet, ankles, legs or belly area; may include weight gain; discomfort in the belly area
  • Weight gain of more than three pounds in a day; or five pounds in a week
  • Coughing or wheezing that produces white, pink or blood-tinged mucus; may have a dry cough
  • Feeling very tired or lightheaded – everyday activities tire you out, or you’re tired after exertion or exercise
  • Weakness
  • Nausea or feeling full; lack of appetite
  • High heart rate; heart feels like it is racing or you have palpitations
  • Confusion, trouble thinking or feeling disoriented

Treatment options

There are several types of drugs that are successfully used to treat HF. Each one treats a different symptom and each HF patient may need a different combination of drugs. It’s important to take the drugs exactly as your doctor prescribes them. They work together to help your heart.

Each drug can have unwanted side effects and the more medications you take, the greater your chance of side effects. Be sure to tell your doctor about all side effects, especially when drugs are added, changed or dosages adjusted.

The American Heart Association recommends these lifestyle changes to help reduce HF symptoms:

  • Quit smoking because nicotine increases both your heart rate and blood pressure, and reduces the amount of oxygen-rich blood circulating in your body.
  • Take your medications exactly as your doctor prescribes.
  • Maintain a healthy weight. Extra weight raises your blood pressure and cholesterol. Sudden weight gain or loss can mean your HF is progressing. Weigh yourself at the same time each morning. If you gain three or more pounds in a day or five or more pounds in one week, tell your doctor right away.
  • Track how much fluid you drink. HF can make you retain fluid and your doctor may tell you to limit the amount of liquids you drink.
  • Limit alcohol to no more than two drinks a day for men; no more than one drink per day for women. If you don’t drink alcohol, don’t start.
  • Limit caffeine to no more than a cup or two of coffee per day; limit caffeine from tea and soft drinks, too.
  • Eat healthy by reducing foods that are high in salt, saturated fat, trans fat, cholesterol, and especially junk foods full of fat, salt and calories. Instead, eat more fruits, vegetables, whole gains, fish, and lean meat and poultry. Try the DASH eating plan.
  • Get moving, either with daily exercise (get your doctor’s permission) or a structured cardiac-rehabilitation program. Find an activity you enjoy and exercise with a friend for extra motivation. Walking can improve your strength and energy level.
  • Manage stress with exercise, meditation, yoga or Tai Chi, prayer, listening to music or whatever works for you.
  • Monitor your blood pressure at home and record it to show to your doctor.
  • Get enough sleep every night. Elevate your head, avoid naps and big meals before bedtime. Discuss any sleeping problems with your doctor.
  • Keep up with your shots and other health screenings. Get a flu shot every year and, if you are over age 65, ask about pneumonia shots. Regular checkups with your doctor are important.
  • Select appropriate clothing by avoiding tight socks or stockings (thigh-high or knee-high hose) because they can slow blood flow to the legs and cause clots. Avoid temperature extremes by dressing in layers so you can adjust your temperature.