Heart Failure

Heart failure is a condition which becomes increasingly common with age. It can be viewed as a conditions where the heart is unable to supply the body with the blood it needs, often only on exertion, but sometimes at rest. The problem with heart failure is that making the diagnosis can be difficult at times as defining what is normal and abnormal is not always easy and cardiologists still debate where the boundaries lie.


Heart failure typically causes breathlessness and fatigue. People frequently notice swelling of the ankles. It is important to note that all of these symptoms can have many causes and having these symptoms does not necessarily mean you have heart failure.


Certain signs can be noted by your doctor, for example swelling in some of the neck veins or crackles when listening to your chest.


The electrocardiogram (ECG) may be abnormal, as may a chest X-ray. There is a blood test called brain natriuretic peptide (BNP), which is increasingly commonly performed in Somerset, which can suggest the diagnosis if the value is above a certain level.


To help confirm or refute the diagnosis doctors typically resort to performing tests which can visualise the heart working. The most commonly performed test is an echocardiogram - an ultrasound scan of the heart - but other tests include cardiac magnetic resonance imaging (MRI), and coronary angiography.


There are now many good treatments for heart failure and the outlook for patients is much better than it used to be 10-20 years ago. Treatments include diuretics (water tablets), typically frusemide, beta-blockers such as bisoprolol and carvedilol and ACE inhibitors such as ramipril or lisinopril or drugs such as candesartan or valsartan which are similar. These all act on different systems within the body to improve the overall situation and outlook. Other medications include spironolactone and digoxin. Digoxin is one of medicines oldest medicines and is derived from the foxglove. Not all patients need all of these medications and these medications can be used for other conditions, not only heart failure. These drugs are commonly used to treat high blood pressure and heart attacks.