Causes of heart failure

Coronary artery disease and a previous heart attack can injure heart muscle. Long-standing high blood pressure can make the heart work harder and gradually become thick or less flexible; see Hypertension for background.

Heart valve disease, an irregular rhythm such as Atrial Fibrillation, heart-muscle disease, inflammation, and some inherited conditions can also reduce pumping or filling. Other contributors include diabetes, kidney disease, alcohol excess, and medicines or treatments that affect the heart. Symptoms may include breathlessness, tiredness, a cough, or swollen ankles, but they can have other causes too.

Arrange a clinical assessment if breathlessness, reduced exercise tolerance, ankle swelling, or unusual fatigue persists. A clinician may review your history and medicines, examine your heart and lungs, check blood pressure, and arrange blood tests, an electrocardiogram, or an echocardiogram.

Bring a list of medicines and note when symptoms occur, whether they worsen when lying down, and any recent weight or swelling change. A Chronic Disease Review can help coordinate monitoring when heart failure or its contributing conditions are diagnosed.

Seek emergency help for severe or rapidly worsening breathlessness, fainting, new confusion, blue or grey lips, or chest pressure that does not settle. Sudden palpitations with dizziness or collapse also need urgent assessment. Do not drive yourself if you feel faint or severely breathless.

Ask which condition may be contributing, whether you need an ECG or echocardiogram, how to monitor swelling and breathlessness, and which medicines or activities need review.