Symptoms of heart failure

Symptoms of heart failure include:

feeling out of breath when doing everyday activities or lying down
being more out of breath than you would expect when doing physical activity
feeling weak, light-headed or very tired, particularly after moving or doing physical activity
feeling light-headed or dizzy
swelling in your feet, ankles, legs or tummy, or feeling bloated
sudden weight gain
coughing at night
coughing up frothy pink phlegm

When and where to get medical help

If you think you have symptoms of heart failure, it's important to get them checked.

Non-urgent advice: See a GP if:

you have symptoms of heart failure

Urgent advice: Ask for an urgent GP appoint or get help from NHS 111 if:

you feel breathless when lying down or from everyday activity
you're coughing up frothy pink phlegm
you have suddenly gained weight

You can call 111 or get help from 111 online.

Immediate action required: Call 999 if:

you're having severe difficulty breathing – you're gasping, choking or not able to get words out
your lips or skin are pale, blue or grey – on brown or black skin this may be easier to see on the palms of the hands, soles of the feet or gums
someone has passed out and is not responding normally

Do not drive yourself to A&E.

The person you speak to at 999 will give you advice about what to do.

Causes of heart failure

There are lots of possible causes of heart failure.

It can happen suddenly, such as after a heart attack or infection, or from long-term strain on your heart from high blood pressure or coronary heart disease, for example.

Other possible causes of heart failure include:

heart valve disease
cardiomyopathy
heart rhythm problems
chronic kidney disease
anaemia
haemochromatosis (a condition that leads to too much iron in your blood)
thyroid problems

Who's most at risk of heart failure

Anyone can get heart failure but you may be more at risk if you:

are 65 or older
are living with overweight or obesity
are pregnant
smoke
drink a lot of alcohol
use cocaine

Tests for heart failure

If the doctor thinks you may have heart failure, they will do some tests to see how well your heart and lungs are working, and refer you to a heart specialist (cardiologist).

Tests for heart failure may include:

asking for samples of your blood and pee
an electrocardiogram (ECG)
scans such as a chest X-ray, echocardiogram and MRI scan
tests to check your lungs, such as a peak flow test and spirometry

You may need to go to hospital for some of these tests.

Types and stages of heart failure

There are different types and stages of heart failure. If you're diagnosed with heart failure, your doctor will discuss the type and stage with you.

The type relates to why your heart is not pumping as well as it should.

The stage of heart failure explains how severe your symptoms are.

Find out more

Treatments for heart failure

There is currently no cure for heart failure, but treatment aims to ease symptoms and help prevent your condition from getting worse.

Your treatment will depend on the type and stage of heart failure you have, and your overall health.

Medicines

You may be given different types of medicine to help your symptoms. These include medicines to:

make you pee more to reduce fluid build-up in your body (diuretics), such as furosemide
widen your blood vessels, so your heart does not have to work as hard to pump blood (for example, candesartan or enalapril)
slow your heart down, so it does not need as much oxygen (such as beta blockers)

Surgery

You may need surgery if you have heart failure. This could be to:

improve blood flow from blocked or damaged arteries
repair or replace damaged heart valves
fit a pacemaker or implantable cardioverter defibrillator (ICD) to control your heart rate or fix an irregular heartbeat

If your heart failure is severe, you may be offered:

a device that helps your heart pump blood properly (left ventricular assist device)
a heart transplant, if treatments are not helping

Cardiac rehabilitation

Everyone diagnosed with heart failure should be offered cardiac rehabilitation.

What you're offered depends on your condition and what's available where you live but may include:

an assessment and advice about how you can safely exercise
exercise classes or a personal exercise programme
guidance, information and support around lifestyle changes, such as healthy eating
support groups and the chance to share your experiences with other people who have heart failure

These programmes may take place in hospital, clinics or in the community, and involve face-to-face or online sessions.

Find out more

How heart failure affects your life

Heart failure is a serious condition that affects everyone differently. Symptoms can vary from day to day and week to week.

While there's currently no cure, treatment and lifestyle changes can help manage symptoms and keep heart failure stable for many years.

A heart specialist (cardiologist) and care team will talk to you about treatment options and any other changes you may need to make. This will depend on the type of heart failure you have, what's caused it and any other conditions.

If you work, you may need to make adjustments to your job, such as limiting physical activity. Some people may need to stop working entirely.

If you drive, you will need to tell the DVLA about your condition. You should also check with your insurance company.

What happens when heart failure progresses

As part of your treatment you should be referred to a team of doctors and nurses for palliative care (symptom control team or palliative care team).

Palliative care focuses on improving your quality of life and is for anyone who has a lifelong illness that cannot be cured. Palliative care treatment includes:

managing your symptoms
helping you feel more comfortable
thinking about your practical needs, such as equipment you may need at home
supporting your family
end of life care, if appropriate