Navigating your way around heart failure treatments

Diagnosis of Heart Failure

Although there are many different causes of Heart Failure, the diagnosis is broadly based on the results of an echocardiogram or MRI scan of the heart, performed in order to establish whether the heart muscle’s pumping function is reduced (Heart Failure with reduced Ejection Fraction HFrEF), or preserved (Heart Failure with preserved Ejection Fraction HFpEF).

As the treatment for Heart Failure varies depending on whether the ejection fraction is preserved or reduced, the information contained here summarises the management of patients who have Heart Failure with reduced Ejection Fraction.


Several medications are designed to improve/stabilise the heart muscle’s pumping function. The type of medication used may vary depending on your ejection fraction.

These medications are designed to:

  1. Relieve congestion
  2. Improve heart function
  3. Reduce the risk of you being hospitalised due to Heart Failure
  4. Improve your prognosis and reduce your risk of dying prematurely

For Heart Failure patients with reduced heart pumping function (ranging from mildly impaired, to more significantly moderate or severe impairment), up to 5 different types of medications may be used in your treatment, such as:

  1. Diuretics (water tablets)
  2. Beta blockers
  3. ACE inhibitors ARB or ARNi (patients may be prescribed any one of these medications designed to improve and stabilise heart function. In a majority of cases your specialist may discuss switching an ACE inhibitor or ARB over to ARNi.)
  4. MRA
  5. SGLT2 inhibitors

Mild to moderately reduced heart muscle pumping function In selected patients with less severe heart muscle impairment (mild–moderately impaired), only some medications may be indicated. These may include:

  • Diuretics (water tablets)
  • Beta blockers
  • ACE inhibitors/ARB

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