Heart Failure Management
Heart failure does not mean the heart has stopped. It means it is not pumping well enough to meet the body's demands, which shows as breathlessness, swollen ankles and exhaustion. It is a long-term condition, and it responds well to treatment that is adjusted patiently over months.
- Echocardiography to measure pumping function
- Medication titrated over months
- Fluid and weight monitoring taught
- Admissions reduced by good outpatient care
Stay
Outpatient, with admission during flare-ups
Duration
Ongoing, reviewed every few months
Anaesthesia
Not applicable
About Heart Failure Management
Modern heart failure treatment has changed considerably, and the medications now available extend life as well as easing symptoms. Getting the benefit means building the doses up gradually while watching kidney function and blood pressure, which takes several appointments rather than one. Alongside that, most of the day-to-day control comes from salt, fluid and daily weight, which patients manage themselves once they are shown how.
- Several medications used together, each at the highest dose you tolerate
- Doses are built up over months, not started at full strength
- Daily weight is the earliest warning of fluid building up
- Most admissions are preventable with good outpatient care
Before you read on
Everything here is general information about heart failure management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest heart failure management.
- Breathlessness on exertion or when lying flat
- Swelling of the ankles, legs or abdomen
- Reduced pumping function found on an echocardiogram
- Heart failure after a heart attack
- Repeated hospital admissions with fluid overload
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment
An echocardiogram measures how well the heart is pumping, with blood tests and an ECG to look for the cause and any contributing factors.
Starting treatment
Medication is started at low doses, with kidney function and blood pressure checked as it is introduced.
Building up doses
Over the following months doses are increased towards the levels shown to work, as far as your blood pressure and kidneys allow.
Ongoing review
You are seen regularly, with the echocardiogram repeated to see whether pumping function has improved, which it often does.
How to prepare
What to sort out before you come in.
- Bring every medication box, including anything bought without a prescription
- Bring previous echocardiogram and blood test reports if you have them
- Start weighing yourself daily at the same time and keep a note
- Note how far you can walk before becoming breathless, as a baseline
Recovery
What to expect afterwards, and roughly when.
- Symptoms usually improve within weeks of starting treatment
- Weigh yourself daily and report a gain of two kilograms over a few days
- Keep salt intake down, which matters more than fluid restriction for most people
- Do not stop medication because you feel better, as that is the treatment working
- Report increasing breathlessness or swelling early rather than waiting for the next appointment
Why choose Humayun for heart failure care
Heart failure is managed in clinic over years, and it is the follow-up rather than the first appointment that changes the outcome.
- Doses built up properly over months rather than left at the starting level
- Echocardiography on site, so treatment is adjusted against measured function
- Kidney function and electrolytes monitored as doses change
- Admissions treated as a failure of outpatient care rather than a normal part of the illness
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