Also known as: Congestive Heart Failure (CHF)
Heart failure is a chronic condition where the heart cannot pump blood efficiently enough to meet the body's needs. It causes fluid buildup, breathlessness, and fatigue.
Heart failure affects over 64 million people globally and is a leading cause of hospitalisation in adults over 65. Despite its name, heart failure does not mean the heart has stopped — it means it is not pumping as well as it should.
HFrEF (reduced ejection fraction) involves weakened heart muscle contraction. HFpEF (preserved ejection fraction) involves stiff heart walls that don't relax properly. Both cause similar symptoms.
Modern treatment with guideline-directed medical therapy (GDMT) has dramatically improved outcomes, with four pillars of therapy reducing mortality by up to 60%.
People with Heart Failure often experience the following symptoms.
Breathlessness during exertion initially, progressing to breathlessness at rest. Worsens when lying flat (orthopnoea).
Fluid accumulation in the legs, ankles, and feet from the heart's inability to return blood efficiently.
Waking suddenly gasping for air 1-2 hours after lying down — a classic and alarming heart failure symptom.
Progressive inability to perform physical activities that were previously tolerable.
Certain factors may increase your likelihood of developing Heart Failure.
Common approaches to managing heart failure. Always consult a healthcare provider for personalized treatment.
Reduce cardiac workload and remodelling. Sacubitril/valsartan (ARNI) is now preferred over ACE inhibitors in HFrEF.
Carvedilol, bisoprolol, or metoprolol succinate slow heart rate and reduce mortality in HFrEF.
Dapagliflozin and empagliflozin reduce heart failure hospitalisation regardless of diabetes status.
ICDs for sudden death prevention. CRT for dyssynchronous contraction. LVADs as bridge to transplant.
Echocardiogram measuring ejection fraction. BNP/NT-proBNP blood test (elevated in heart failure). Chest X-ray showing cardiomegaly and pulmonary congestion. ECG for rhythm assessment.
Seek emergency care for sudden severe breathlessness, coughing up pink frothy sputum, rapid weight gain (2+ kg in a day), or inability to lie flat.
Steps that may help reduce the risk of developing or worsening heart failure.
Control blood pressure
Treat coronary artery disease
Limit alcohol
Maintain healthy weight
If left untreated or poorly managed, heart failure may lead to:
Some causes (alcohol, tachycardia-mediated) can be reversed. Others can be stabilised and improved but not fully cured.
With modern treatment, many patients live years to decades. Early diagnosis and treatment are key.
Yes. Supervised cardiac rehabilitation and regular moderate exercise improve symptoms and outcomes.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.