Living with heart failure

A woman is talking to an older woman at an outdoor table.

Explaining chronic heart failure

“Not to be confused with a heart attack, where the heart’s blood supply is suddenly stopped, heart failure is a gradual decrease in the heart’s ability to pump enough blood around the body.”

Risk factors associated with heart failure

Risk factors

Common symptoms of heart failure

As less blood is circulating around the body due to heart failure, a range of symptoms can be experienced:3

  • Chronic coughing, wheezing or shortness of breath
  • Dizziness
  • Swelling in the legs and ankles (fluid retention)
  • Reduced ability to exercise
A heart failure diagnosis can be daunting and the right support is needed when it comes to navigating the road ahead. As doctors, it is important that we help those living with heart failure to understand how they can best manage their condition and closely monitor symptoms for signs of progression.
Professor Carolyn Lam
Senior Consultant at the National Heart Centre Singapore & Professor of the Duke-NUS Cardiovascular Academic Clinical Program

Ejection fraction: The difference between HFrEF and HFpEF

“The action of a healthy heart is like being able to fill the tank with water and empty most of this tank with a single pull of the lever. In heart failure with a reduced ejection fraction, the tank can fill, but the pump is weak.”

Living with worsening heart failure


A change in symptoms is a warning signal from the body. It is important to take action as soon as possible.

For many people living with heart failure and a reduced ejection fraction, symptoms can continue to worsen despite receiving guideline-recommended therapies.4 For example, symptoms can progress to a point where breathing can become very difficult.2 Such a change may result in needing to go to hospital or a modification to your outpatient treatment regimen – this is referred to as decompensation event, also known as a ‘worsening heart failure event.’5

When living with chronic heart failure, it is important to keep a close watch for any changes in symptoms, particularly those highlighted below. As soon as a change is noticed, or if there are any concerns about symptoms, a doctor should be contacted.1 A change in symptoms is a warning signal from the body and the sooner action is taken, the better.1

A red and white infographic showing different types of exercise.

There is a lot that can be done to manage worsening heart failure. Along with the many treatment options available today, there are some lifestyle changes that can be made to better manage the condition and its symptoms.7

Diet: Doctors may recommend reducing the amount of salt, alcohol, and fat in someone’s diet, as well as reducing weight if necessary.7

Exercise: Gentle physical activity can help relieve symptoms and increase wellbeing. A doctor can suggest ways to develop a healthy exercise routine.7

Smoking: Smoking can worsen existing damage to the heart muscle, making it even more difficult for the heart to transport blood around the body. It’s never too late to benefit from stopping smoking.7

Friends & family: Living with heart failure can be worrying, but there are things that can help you relax and feel in control of your condition. Friends and family are an important source of support.2 They can help you come to terms with your heart failure, and social connections can be a great way to reduce stress and anxiety.2

Doctor Conversations: When living with heart failure, open discussion with your doctor is key. As well as sharing how symptoms are progressing, it’s important to let them know how you are coping emotionally to help them provide you with the additional information and support you may need.

Supporting someone with heart failure

An older couple exercising in a park.

If you care for someone who has been diagnosed with heart failure, it’s important to familiarize yourself with the condition and what to look out for. The following advice may help: 7

  • Listen to how they are feeling is an important source of support for them, as they may feel uncertain or afraid. You can help them come to terms with their heart failure
  • Join in with any recommended lifestyle changes – it can be easier for people to make changes together
  • Help them to follow the guidance from their doctor so they get the most out of their treatment
  • Remind them to take their medicine
  • Support them when visiting their doctor; you can help remind them of all the questions they may want to ask, as well as any advice they were given by their doctor
  • If the person has been in hospital, help to schedule regular follow-up visits after they come home. Be familiar with their management plan and help ensure their heart failure does not progress further
  • Watch out for worsening events and encourage them to speak to their doctor as soon as you notice a difference
  • Encourage them to keep all their appointments – patients who have regular follow-up visits with their doctor after being hospitalized after a worsening event tend to do better and are less likely to need to go into hospital


  1. Mayo Clinic. Heart failure – symptoms & causes. Available at: accessed September 2021
  2. National Heart, Lung and Blood Institute, NHLBI. Heart failure. Available at: accessed September 2021.
  3. NHS. Heart failure. Available at: accessed September 2021
  4. Cheng RK, Cox M, Neely ML, et al. Am Heart J. 2014;168(5):721-30.
  5. Butler J, Yang M, Manzi AM et al. J Am Coll Cardiol. 2019;73(8):935–944.
  6. AHA. Warning signs of heart failure. Available at: accessed September 2021
  7. NHS. Living with heart failure. Available at: accessed September 2021