There are around 900,000 people living with heart failure in the UK. Heart failure is debilitating and outcomes are poor: 5 year survival rate is worse than breast or prostate cancer (1); 30-40% of those diagnosed with heart failure die within the first year. Heart failure is a major cost to the NHS. It is a leading cause of hospital admission in over 65s (2) and is one of five long-term conditions responsible for 75% of unplanned hospital admissions.(3) Costs are growing. Hospital admissions for heart failure are projected to rise by 50% within 25 years due to an ageing population.(4)
No one likes the word failure. The Pumping Marvellous Foundation was started with the mantra to be positive around heart failure so let’s start by saying that you are not a failure. If you have been told you have heart failure, then it means that your heart is failing to pump as efficiently as it should, in order to supply the body with the oxygen and nutrients that it needs. You may hear technical terms to describe this as heart failure with reduced ejection fraction (HFREF). There is another less common type of heart failure whereby the heart fails to relax and fill efficiently called heart failure with preserved ejection fraction (HFPEF). The question to ask to your Doctor or Nurse is, “Why is my heart not working efficiently?”
Generally, there is a reason why the heart is not pumping correctly. The most common reason is that the heart muscle has been damaged by a poor blood supply such as after a heart attack. Other causes include;
• High blood pressure
• A virus that has affected the muscle of the heart
• As a result of the heart’s rhythm being abnormal for example, atrial fibrillation
• A genetic condition which may have affected the muscle of the heart as in Cardiomyopathy
• Excessive alcohol intake
• The valves of the heart are damaged
• Some types of chemotherapy
• In rare cases a form of heart failure in pregnancy or just after delivery called Peripartum Cardiomyopathy.
On very rare occasions we are simply unsure of the cause.
Treatment will consist of therapy in order to correct or modify the underlying causes of your heart failure as well as improve the efficiency of your heart.
Many may be struggling with other conditions such as low vitamin and iron levels which make life with heart failure even tougher. It is thought that iron deficiency, which affects up to 50% of patients with heart failure, is particularly bad as iron is essential for a healthy heart and body, and not having enough iron can lead to increased anxiety, fatigue and even food cravings.
(1) Stewart et al. Population impact of heart failure and the most common forms of cancer. Circulation: Cardiovascular Quality and Outcomes. 2010. Available at: https://circoutcomes.ahajournals.org/content/early/2010/10/05/CIRCOUTCOMES.110.957571.full.pdf [Accessed July 2016]
(2) NICE. Acute heart failure: diagnosing and managing acute heart failure in adults. October 2014. Available at: https://www.nice.org.uk/guidance/cg187
(3) NHS England. Emergency admissions for Ambulatory Care Sensitive Conditions – characteristics and trends at national level. March 2014. Available online at: https://www.england.nhs.uk/wp-content/uploads/2014/03/red-acsc-em-admissions-2.pdf [Accessed July 2016]
(4) NICE. Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care. August 2010. Available at: https://www.nice.org.uk/guidance/cg108