Heart Failure is when patients have an abnormality of heart structure or function that reduces the hearts ability to pump effectively or fill with blood. This leads to symptoms such as breathlessness, ankle swelling and tiredness. There are many different causes of heart failure; the most common causes are coronary artery disease, high blood pressure, inherited (genetic) heart muscle problems, and valve disease.
Heart failure is often defined into different groups according to the left ventricular ejection fraction, (LVEF) which is the percentage of blood ejected from the main pumping chamber with each heart beat (normal is 55-70%). Heart failure with reduced ejection fraction (HFREF) describes patients with a LVEF below 40%; whereas heart failure with preserved ejection fraction describes patients with a normal or near normal LVEF.
In patients with Heart failure with reduced ejection fraction (HFREF), there are quite a few treatments that have been shown to reduce mortality or admission to hospital. These are: drugs (ACE inhibitors, beta blockers, mineralocorticoid inhibitors, salcubitrol / valsartan), Implantable devices (Implantable cardiac defibrillators, cardiac resynchronisation (biventricular) pacemakers, and cardiac monitoring devices such as cardioMems) and systematic treatments (involvement of specialist heart failure nurses, cardiac rehabilitation programmes, and a multidisciplinary approach to coordinated care). All of these treatments are offered in our dedicated heart failure clinics.
Heart Failure is a frightening and misleading term; the heart is not failing it is just weak or stiff. The long term outlook for patients varies widely, outcomes continue to improve, and for certain groups are now excellent. The outlook depends on a variety of factors including the cause, treatment options available and if other organs are affected. The heart failure specialists are able to go through these issues in detail for patients and families or carers.