What is heart failure?

Heart failure is a condition that develops after the heart becomes damaged or weakened by diseases of the heart, including heart attacks and other medical conditions.

When you have heart failure, it doesn’t mean that your heart has stopped beating. It means that your heart isn’t pumping blood as efficiently as it should. The heart keeps working, but the body’s need for blood and oxygen isn’t being sufficiently met.

How your body masks the problem

At first the heart tries to make up for its decreased efficiency by pumping faster, enlarging, and developing more muscle mass so it can increase output.

But while these temporary measures mask the problem of heart failure, they don’t solve it. Heart failure continues and worsens until these substitute processes no longer work.

The body’s natural compensation mechanisms help explain why some people may not become aware of this condition until years after their heart begins its decline. (It’s also a good reason to have a regular heart check-up with your doctor.)

What are the causes of heart failure?

There are many reasons why you might be diagnosed with heart failure. The most common causes are:

Coronary artery disease (when arteries that supply blood to the heart muscle become narrowed by build-ups of fatty deposits)

  • Heart attack
  • High blood pressure
  • Cardiomyopathy (diseases of the heart muscle)


Heart failure can also be caused by:

  • Heart valve problems – leaking or narrowing of valves
  • Excessive Alcohol
  • An uncontrolled irregular heart rhythm (arrhythmia)
  • Congenital heart conditions (ones you’re born with)
  • A viral infection affecting the heart muscle
  • Being overweight
  • Diabetes
  • Some cancer treatments.


What are the symptoms of heart failure?

For reasons explained previously, heart failure is often difficult to diagnose in its early stages. Experts suspect it is widely under-diagnosed, particularly in women, the elderly and the obese.

People with mild heart failure may have very few symptoms, but in more severe cases the symptoms can be very apparent and may include:

  • Increased shortness of breath, especially when lying flat
  • Swelling – of your feet, ankles, stomach and lower back areas
  • Sudden weight gain from fluid build-up
  • Fatigue – feeling tired or run-down
  • Coughing or wheezing – especially when you exercise or lie down
  • Loss or change in appetite


By themselves, any one sign of heart failure may not be cause for alarm. But if you have more than one of these symptoms, even if you haven’t been diagnosed with any heart problems, report them to a healthcare professional and ask for an evaluation of your heart.

How is heart failure diagnosed?

To diagnose heart failure, your doctor will:

  • Ask you questions about your medical history, talk about your symptoms and do a physical examination.
  • Conduct tests (which may include blood tests, an electrocardiogram (ECG), a chest x-ray, an echocardiogram and a coronary angiogram).


How is heart failure treated?

While heart failure cannot be cured, it can often be treated to enable people to function well at home. Your doctor may:

  • Prescribe medication to strengthen your heart and help your body get rid of excess fluids.
  • Recommend a low-sodium (salt) diet.
  • Encourage certain lifestyle changes such as losing weight, quitting smoking, avoiding or limiting alcohol and caffeine consumption.
  • Provided oxygen for use at home.
  • Suggest surgery or cardiac devices in some cases.


It is important to follow all of your doctor’s recommendations and make the necessary changes in diet, exercise and lifestyle in order to give yourself the best chance of managing this condition.

As the disease progresses and the heart becomes weaker, treatment gets more complex. This is the time to have difficult, yet important, conversations with your family and doctor about the care you want to receive.

The heart failure epidemic

An ageing population, increased survival rates for heart attack victims as well as the increasing prevalence of major heart risk factors like obesity and diabetes among young and middle aged Australians, are all creating a heart failure epidemic within Australia that threatens to become progressively worse.

The statistics speak for themselves:

  • Heart failure now affects 5111,000 people in Australia[1].
  • Over 67,000 new patients are diagnosed with heart failure each year
  • 15% of patients with  heart failure will die within one year of diagnosis[2]
  • 50% of patients with severe heart failure will not live longer than 5 years [3]
  • For patients diagnosed with severe heart failure, the chances of surviving for more than five years are worse than most forms of cancer[4].


[1] AIHW Bulletin Heart Failure What of the Future Issue 6 June 2003

[2] AIHW. Trends in Coronary heart disease mortality: age groups and populations. In: AIHW, editor. Canberra: Australian Institute of Health and Welfare; 2014. (Cardiovascular series; no. 38). Cat. no. CVD 67.

[3] As above

[4] European Journal of Heart Failure Volume 3, Issue 3