What is heart failure?

Attending a specialised program for people with heart failure can reduce the risk of complications and having to go to hospital. Going to a program can also help you live longer and improve your quality of life. 

Heart failure programs, sometimes called chronic disease management programs, are run by health care professionals who work as a team to help you manage your condition. The team can include a heart failure nurse, a cardiologist, pharmacist, physiotherapist, dietitian or a psychologist.  

When you attend a heart failure management program, you’ll get information to help you manage your condition. This can include:  

• how to manage your heart failure medicines
• when to act if your symptoms get worse
• how to monitor your fluid levels.  

You might already know that physical activity is important for good heart health. Did you know that people with heart failure can also benefit from regular physical activity, and is recommended by cardiologists and experts?  

People who have heart failure can sometimes find it difficult to carry out day-to-day activities because they can feel short of breath or tired in the legs. But physical activity and exercise can improve these feelings.

Attending a cardiac rehabilitation program is one of the best things you can do for heart failure. Everyone can benefit from cardiac rehabilitation - it can improve your quality of life, keep you out of hospital and have a positive impact on your wellbeing.  

Cardiac rehabilitation combines exercise and education sessions to help you make healthy changes. This includes exercise to help increase your strength, fitness and confidence levels. Exercise includes activities that make you slightly out of breath, while still being able to hold a conversation. For example, walking or riding a stationary bike. It might also include exercises that use light weights or other equipment. You’ll get a tailored exercise program to suit you and you will be able to go at your own pace.

Find a cardiac rehabilitation program near you, here. You can also join a Heart Foundation walking group or sign up for a Personal Walking Plan, here.  

Medicines for heart failure make it easier for your heart to pump blood around your body, help you feel better, keep you out of hospital and lead a longer, healthier life.

Heart failure medicines usually need to be taken long-term. Your doctor may increase the dose of your medicines even if you feel well. It’s important you do not stop taking your heart failure medicines without speaking to your doctor or pharmacist first. 

Below are some common types of heart failure medicines. Your doctor will prescribe certain medicines depending on the type of heart failure you have. Many people with heart failure need to take a combination of medicines.   

For more information about heart failure medicines, visit the NPS MedicineWise website.

More information about general heart medicines is also available, here.

Angiotensin-converting enzyme inhibitors (ACE inhibitors) 

ACE inhibitors dilate the blood vessels to improve the flow of oxygen and blood around the body. These medicines help the heart to pump blood more easily and efficiently.

Angiotensin receptor blockers (ARBs) 

ARBs work in the same way as ACE inhibitors. 

Your doctor might prescribe an ARB instead of an ACE inhibitor if you get side effects from taking ACE inhibitors (for example, a persistent cough).  

Angiotensin receptor-neprilysin inhibitors (ARNIs) 

Your doctor might prescribe an ARNI instead of an ACE inhibitor or ARB if they think these medicines would work best for you. ARNIs work by helping to manage your blood pressure and can also get rid of extra fluid.

Beta blockers  

Beta blockers help your heart pump more efficiently by pumping slower and stronger.  

Mineralocorticoid receptor antagonists (MRAs or aldosterone blockers) 

MRAs block the effects of the hormone aldosterone, which helps manage blood pressure. These medicines can also help prevent or reduce damage and changes to the heart muscle.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors

These medicines can improve symptoms of heart failure by reducing extra fluid in the body. SGLT2 inhibitors also help manage blood sugar levels in people with heart failure and diabetes.

Diuretics  

Diuretics help get rid of extra fluid from your body, including your lungs, abdomen (tummy), legs, ankles and feet. They do this by increasing the amount of urine (pee) you make.

Diuretics help you feel better by reducing swelling and making it easier to breathe. They are usually used every now and then. 

You doctor might also prescribe other medicines for heart failure.

The heart has its own electrical system that regulates the heartbeat. With every heartbeat, there's an electrical signal that travels through your heart, causing it to contract and pump blood around the body.

For some people with heart failure, the electrical system doesn’t work properly. People with heart failure have an increased risk of abnormal heart rhythms (arrythmias), like atrial fibrillation.  If you have an abnormal heart rhythm, you may need a pacemaker or device to regulate the heart rate and rhythm.

There are different types of pacemakers and devices. Your doctor will talk to you about which type of pacemaker is most suitable for you. Having a pacemaker or device can greatly improve your quality of life and for some people it can be lifesaving.

Pacemakers and other devices  

A pacemaker is a small implantable device that electrically stimulates the heart to maintain a regular heart rhythm. It is inserted under the skin on your chest (or tummy) and has one or more wires that connect to your heart. The pacemaker produces small electrical currents that stimulate the heart to pump regularly.  

Pacemakers are sometimes used in people with heart failure to help reduce symptoms when the left and the right side of the heart don’t beat together. This is a special type of pacemaker, also sometimes called a ‘cardiac resynchronisation therapy (CRT) device’ or a ‘biventricular pacemaker’. This type of pacemaker is often combined with an implantable cardioverter defibrillator (CRT-D).

A pacemaker shouldn’t affect your day-to-day life. You may need to make a few small changes for a short time. People who have pacemakers and devices need to have regular follow-up appointments to make sure the device is working well. A pacemaker battery usually lasts between five to 15 years. Your doctor will check the battery. When the battery is running low, you will need to go back into hospital to have a new pacemaker inserted.

Implantable cardioverter defibrillator (ICD) 

An ICD is a small battery-powered box (smaller than a matchbox) that is inserted under the skin, usually in the space just below the collar bone (clavicle). Thin wires connect the ICD to the heart. The ICD continuously monitors your heart and can correct dangerous abnormal heart rhythms by delivering controlled electric ‘shocks’. There are different types of ICDs and your doctor will talk to you about which option is right for you.

Some people with heart failure may need other surgeries and procedures to improve symptoms and quality of life. The type of surgery depends on the cause of your heart failure, how severe your symptoms are and any other medical conditions you might have.

Types of surgery and procedures include:

• Catheter ablation to help regulate the heartbeat in people with abnormal heart rhythms. Ablation removes the area of the heart where the abnormal electrical signals are coming from.
• Heart valve surgery to repair or replace damaged heart valves.
• Coronary artery bypass graft surgery for people with coronary heart disease.
• Heart transplant. Only a very small number of heart transplants are performed each year in Australia. 

Read more, here.