What does heart failure mean?
The heart is a muscular pump whose purpose is to provide blood for all the organs in the body to work i.e. your brain, kidneys, muscles etc. The term heart failure is used to described a heart which is not working adequately, the main consequences being accumulation of fluid in the lungs (lung congestion) causing breathlessness or leg swelling.

Is heart failure a common problem?
As our population ages heart failure is becoming more common however it still only affects 2% of the general population but is more common amongst the elderly. Improvements in treatment over the last decade now allow patients with this condition to lead active lives.

What are the symptoms of heart failure?

The most common symptoms include:

• Fatigue
• Shortness of breath, especially with activity
  
• Shortness of breath when lying flat
• Swollen feet and ankles
• Weight gain, over a short period of time i.e. days
• Loss of appetite and abdominal swelling
  
• dizziness or near fainting episodes
• Irritable cough, sometimes producing frothy sputum.
• sudden severe breathlessness waking one from sleep - this requires urgent attention
  

What can be done to help?

(1) Medication: The aims of which are to reduce congestion by getting rid of excess fluid and easing symptoms while improving the muscle function of the heart.

(2) Diet: Salt restriction is a critical component of treatment of heart failure. Salt consumption results in fluid retention and in the development of congestion. The salt content of foods can be highly deceptive and all food labels should be carefully checked for salt or sodium content. Salt is used for preservative purposes. Processed and convenience foods are all highly salted for preservation purposes, therefore should be avoided.

• Table salt should be avoidedbut salt added to food while cooking is reasonable
  
• Alternative seasonings such as pepper, lemon, onion, garlic, fresh/dried herbs can be used.
• "Salt Substitutes" are not suitable alternatives to salt
• Fresh fruit and vegetables should play a large role in the diet.

(3) Alcohol: This should be taken in moderation. In some cases where alcohol has a causative role, it is best avoided and this should be discussed with your doctor in more detail.

(4) Activity: The old saying "Rest is Best" is not really true for patients with Heart Failure. By severely restricting physical activity you can get "out of shape" and reduce your stamina, so that even a short walk may seem like a big task. You may feel your heart race and pound, as breathing becomes more difficult. Being out of condition places added stress on your heart. In short it is better to keep active. By exercising regularly and keeping your body in condition, you will feel better and be able to accomplish more. You will do routine activities more easily.

This does not mean that rest is bad. Regular periods of exercise and rest should be included in your daily activities. Resting for 30-60 minutes after meals allows the heart to use its fullest capacity for digestion. Perhaps this is what the afternoon "siesta" is all about! Extra rest also helps during periods of emotional stress or illness.

Overall you will feel better when you don’t overdo it. If you listen to your body you will know just how much you can exercise. You should start off with gentle exercise, building it up gradually. The important aspect is to exercise regularly not sporadically. Best forms of exercise include walking, swimming and gentle exercises. Using weights to exercise is not advised.

General Advice

• Take an active role in the management of your condition
• Enrol a member of your family or a friend to help you
• Learn the signs of impending problems and contact help
• Ensure accurate compliance with your medication
• Exercise wisely and take rest periods during the day.
• Ask your GP about the flu injections