For Heart Failure

How should I live my life with heart failure?

Heart failure doesn’t mean your heart has failed or stopped working. It means your heart isn’t able to pump enough blood to the rest of your body. This can happen because the chambers in your heart are either too weak to pump blood effectively, or too stiff to fill with blood.

If you’ve been diagnosed with heart failure, your doctor or your heart failure nurse will give you a personalised treatment plan which will help you to manage your condition and live a fulfilling life. The aims of your treatment plan are to:

  • Treat the cause of your heart failure
  • Stop your heart failure from getting worse, and
  • Improve your quality of life
  • Help you recognise and manage your symptoms

How can I prevent my heart failure from becoming worse?

Monitoring your heart failure symptoms is a key step towards living well with heart failure. You can monitor your symptoms by:

  • Weighing yourself daily - weigh yourself at the same time every day and record the results; if your weight goes up more than 2kg in two days, call your doctor or heart failure nurse
  • Controlling your fluid intake - excess fluid can build up and be a sign that your heart isn’t working as well as it could be, so you may need to drink less fluid (water, tea, coffee, juice) - your doctor or your heart failure nurse will give you advice about the right fluid level for you. Usually around 1 to 1.5 Litres of fluid per day

Some of the most common symptoms of heart failure and tips on how to manage common them include the following:

  • Shortness of breath - balancing rest and exercise, using extra pillows at night, and certain medications - also, some patients may require oxygen at home if their symptoms are very severe
  • Weight gain - monitoring your weight daily will enable you to keep track of any changes (which is an indication of how much fluid your body is retaining)
  • Swelling in the ankles or belly - an indication your body is retaining fluid
  • Tiredness - if you’re constantly feeling tired, try to include more rest in your day and take active steps to reduce your stress levels (you may need to consider getting some services to assist you)
  • Dizziness and heart palpitations - stop what you’re doing and sit down slowly until the feeling passes; if these symptoms continue or are occurring frequently, phone your doctor or heart failure nurse
  • Chest pain - if your chest pain goes on for longer than 10 minutes, phone an ambulance (triple 0) and speak to the operator until the ambulance arrives
  • Sleep disturbances - try sleeping at a slightly elevated level, and go to bed at the same time every night to establish a regular sleep/wake pattern (also, talk to your doctor or heart failure nurse as you may need tests to check for sleep apnoea, which is common in heart failure patients)
  • Loss of appetite - try eating smaller meals and exercising every day
  • Constipation - eat a healthy diet containing a good amount of high-fibre foods, and drink water within your fluid requirements talk to  your heart failure nurse or pharmacist for assistance

What should I eat when I have heart failure?

Many studies have shown that a diet rich in fruits, vegetables, wholegrains, nuts and seeds can reduce your risk of heart disease. A healthy diet provides your body with plenty of heart-protective nutrients - like vitamins, minerals, antioxidants and dietary fibre. Ideally, your healthy diet should include:

  • Meat - and/or meat alternatives such as eggs, tofu, legumes and nuts
  • Fish - 2 serves of oily fish per week such as salmon, mackerel or sardines will help you get plenty of heart healthy omega-3 fats
  • Wholegrains - good wholegrain choices include wholemeal or wholegrain bread or crackers, brown rice, wholemeal pasta, quinoa, freekah, barley, rye, rolled oats, polenta and couscous
  • Dairy - preferably low fat
  • Healthy fats - a small amount of healthy fats and oils from nuts, seeds, avocado and oily fish
  • Water - avoid sugary soft drinks and drink alcohol only in moderation

Aim to consume 2 serves of fruit, 5 serves of vegetables and 4 or more serves of wholegrains - depending on your energy needs. Some other tips to help you eat well include:

  • Reducing your salt intake - salt can impact your body’s fluid balance, so it’s important to avoid foods high in salt, such as processed meats, takeaway foods, chips, and commercial sauces
  • Avoiding sugary foods - these are often eaten in place of healthy foods and can contribute to weight gain. Limiting or cutting out soft drinks, cordials and alcoholic drinks are also key steps of maintaining a healthy diet

You can hear tips from our dietitian about healthy eating in this short video.

What medications will I need to take for heart failure?

After you’re diagnosed with heart failure, you’ll be given medications to help you control your symptoms and prevent your condition from getting any worse. Medications work best when you’re being healthy in all areas of your life - for example, exercising, quitting smoking, managing any other chronic conditions and eating a healthy diet.

Generally, you’ll be required to take one or more medications. Here’s an explanation of what you could be given and how they help you:

  • Ace inhibitors (usually end in “pril”) – widen your blood vessels and reduce your heart’s workload
  • Angiotensin II receptor blocker (usually end in “sartan”) – widen your blood vessels and reduce your heart’s workload
  • Angiotensin Receptor-Neprilysin Inhibitor (ARNI) - widen your blood vessels and reduce your heart’s workload
  • Beta blockers (usually end in “lol”) – lower your blood pressure and slow your heart rate to reduce the workload on your heart
  • Anticoagulants or “blood thinners” – thin your blood, preventing blood clots
  • Vasodilators – widen the blood vessels and reduce your heart’s workload
  • Diuretics or “water pills”– remove extra fluid from your body which helps to improve symptoms like swollen legs
  • Digoxin – helps your heart to pump more blood and slow your heart rate down
  • Potassium or magnesium – if you are taking fluid tablets, your levels of potassium or magnesium may decrease, so you may need to take supplements
  • SGLT2 Inhibitors - increases the amount of sugar excreted in the urine. This drug is usually used for diabetic patients, but studies have shown benefits for patients with heart failure with or without diabetes
  • Statins (cholesterol-lowering medications) – statins control the level of cholesterol in your blood, and very large studies have demonstrated that they reduce the risk of blood vessel diseases, heart attacks and stroke

Remember: everyone has individual requirements for medications, and you’ll be given a personalised medicine plan that’s right for you. If you have any questions about the medication you’re taking, speak to your doctor or heart failure nurse or pharmacist.

You can learn more from our pharmacist about the medications you may need to take by watching this video.

How do I manage my heart failure?

Along with monitoring your symptoms, taking your medications and eating a healthy diet, living with heart failure involves taking steps to help improve the quality of your life.

  • Exercise regularly - exercise is a key component of a healthy lifestyle, and it helps to increases your fitness levels and keep you relaxed - watch our video on the importance of exercise
  • Rest regularly - while exercise is important, regular rest is equally as important - have regular periods of rest throughout your day, and try to conserve your energy where possible
  • Manage your diabetes - monitor your blood glucose levels and ensure they remain in the normal range
  • Be smoke free - quitting smoking is an important step, and you don’t have to do it alone - watch our video on quitting smoking
  • Vaccinations - it is recommended that you have your yearly flu shot, as well as a pneumonia vaccination every 5 years
  • Ambulance cover - it’s likely you may need to return to hospital via ambulance, so ensure your cover is current and suitable for your ongoing needs

What activities can I do with heart failure?

Returning to your regular activities, depend on the severity of your condition as well as any treatments you may have had. Follow your doctor’s orders, and ease back into your usual routine with plenty of rest time in between activities. If you work in position that requires a lot of heavy lifting or strenuous physical activity, speak to your doctor about the best way to manage this.

Having heart failure may impact your sexual relationship in a variety of ways, including emotionally as well as physically. You may need to make changes to your sex life to ensure you’re not putting yourself at risk. Medications may also affect your feelings of arousal. Be open and honest with your partner about this, talk about how you’re feeling, and don’t be afraid to speak to your doctor or heart failure nurse about any concerns.

Where can I go for ongoing support for heart failure?

If, at any stage, you feel like you need additional support or advice to help you manage your heart failure, don’t hesitate to contact your medical team or your heart failure nurse. You can also contact the following organisations for support and advice:

  • National Heart Foundation: (02) 9211 5188
  • Heartline: 1300 362 787
  • Australian Nutrition Foundation: (02) 9516 8191

Remember, you are not alone in this. Your team and support network are there for you, to help you recover as best you can - so you can go on to live a healthy, fulfilling and active life for many years to come.

The St Vincent’s Hospital Heart Failure Service is a clinic and home visiting team of specialist health care professionals, including nurse practitioners, pharmacist and dietitians who can assist you, your family, your general practitioner and your cardiologist in optimising your heart failure care. Call 02 8382-1450 for more information or to make a referral.