Heart Failure
What is It?
Heart failure occurs as a result of the heart failing to pump enough blood around the body. It occurs when the heart muscle becomes too weak or too stiff to meet the body’s demands for oxygen and nutrients. Heart failure is a common condition affecting roughly 1 in 50 Australians, with higher prevalence in older adults. It is a serious, chronic condition that requires specialist input.
What are the symptoms?
The most common symptoms are breathlessness (particularly on exertion or when lying flat), tiredness, and fluid retention leading to ankle, leg or abdominal swelling. Other symptoms include persistent cough or wheezing, rapid weight gain from fluid retention, reduced exercise capacity, heart palpitations, and loss of appetite. As there are other causes of breathlessness, it is very important to make the correct diagnosis.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of heart failure. Common causes include:
- Coronary artery disease and previous heart attacks, which damage the heart muscle.
- High blood pressure (hypertension), which forces the heart to work harder over time.
- Heart valve disease, causing abnormal blood flow and strain on the heart.
- Cardiomyopathy from infections, alcohol, chemotherapy, or inherited genetic conditions.
- Arrhythmias and congenital heart defects, along with contributing factors such as diabetes, obesity, and thyroid disease.
How is it investigated?
A number of tests are used to diagnose heart failure and determine the underlying cause. You will need basic blood tests (including BNP/NT-proBNP biomarkers), an ECG and an echocardiogram to assess heart structure and ejection fraction. Further tests such as cardiac MRI, coronary angiography, stress testing or chest X-ray may be required to identify the underlying cause.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing heart failure and will provide a personalised treatment plan for your heart failure. Heart failure is usually a chronic condition requiring lifelong treatment with a combination of lifestyle measures and medication. Treatment options include:
- Medical therapy: The four pillars of heart failure therapy include ARNIs, beta-blockers, mineralocorticoid receptor antagonists (MRAs), and SGLT2 inhibitors. Diuretics are used to manage fluid retention.
- Lifestyle measures: Stopping smoking, controlling blood pressure and cholesterol, limiting salt and fluid intake, regular monitored exercise, and daily weight tracking.
- Device therapy: Selected patients may benefit from an implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy (CRT).
- Advanced therapies: In severe cases, ventricular assist devices or heart transplantation may be considered.