Heart failure – do you recognize the signals?

Heart failure means that the heart can no longer pump blood

This leads to oxygen and nutrients not reaching the body as they should, which negatively affects the entire body. Heart failure can develop slowly (chronic heart failure) or come on suddenly (acute heart failure). The condition is most common in the elderly, but can affect people of all ages. Over 250,000 Swedes live with heart failure today.

Common causes of heart failure are high blood pressure, heart attack, heart valve disease and myocarditis. With early diagnosis and proper treatment, there are good opportunities to slow down the progression of the disease and feel better.

Common symptoms of heart failure – the signals to watch out for

• You experience fatigue and lack of energy – even with light exertion
• Shortness of breath, especially during physical activity or when lying flat
• You get swollen legs, ankles or abdomen due to fluid retention
• The heart rhythm becomes fast, irregular or pounding
• Nocturnal cough, sometimes with the need to sleep with several pillows

The symptoms often come on insidiously in chronic heart failure, which means that many people do not connect the signals as problems in relation to the heart. In acute heart failure, you may experience severe shortness of breath, cold sweats, paleness and anxiety – a serious condition that requires immediate medical attention.

Several different types of heart failure occur

Heart failure is divided into different forms depending on how the heart is affected:

Systolic heart failure – reduced pumping capacity

Approximately half of all people with heart failure have what is known as systolic heart failure. This form is often called HFrEF (Heart Failure with reduced Ejection Fraction). It means that the heart muscle's ability to contract is impaired, and the left ventricle cannot pump enough blood to the body. Common causes include a previous heart attack, high blood pressure, or heart muscle disease. This form of heart failure can usually be treated effectively with medication and sometimes with the help of a pacemaker.

Diastolic heart failure – impaired filling capacity

Diastolic heart failure is often called HFpEF (Heart Failure with preserved Ejection Fraction). In this type, the heart's pumping capacity appears normal (preserved), but the heart muscle is stiff and has difficulty relaxing. This prevents the heart from filling with enough blood before each beat, leading to increased pressure within the heart. The heart's atria may become enlarged and the pressure increases, leading to shortness of breath and fatigue. This form of heart failure, which often affects older adults, still lacks well-established treatments, and research is ongoing to find better solutions.

Many people have elements of both systolic and diastolic heart failure, which means that treatment must often be individually tailored.

Acute heart failure – when the condition worsens rapidly

Acute heart failure means that the heart's function deteriorates quickly. You may experience severe shortness of breath, heavy palpitations, and anxiety. This is often due to a new heart attack, a serious rhythm disturbance, or the pressure in the heart rising so much that fluid accumulates in the lungs. This is a life-threatening condition that requires immediate hospital treatment.

How is heart failure diagnosed?

The diagnosis of heart failure is made through a clinical assessment by a physician, where symptoms and medical history are weighed together with clinical findings. To confirm the diagnosis and determine the specific type of heart failure, the following is required:

• ECG: Records the heart's electrical signals. The ECG shows if there are rhythm disturbances, signs of a heart attack or overload of the heart.
• NT-proBNP: A blood test that measures a hormone that rises when the heart is overworked. High values ​​are typical of heart failure and are often used as an initial screening.

If both ECG and NT-proBNP suggest heart failure, a cardiac ultrasound (echocardiography) is often performed to assess the heart's pumping capacity more accurately. This is the most important examination for a definitive diagnosis.

When should you get tested?

You should get tested if you have several of the following symptoms:

• Constant fatigue or lack of energy
• Shortness of breath during everyday activities
• Swollen legs or weight gain due to fluid
• Have had a heart attack, high blood pressure or diabetes

Early diagnosis can prevent serious complications and significantly improve quality of life.

Quick response gives peace of mind

By combining ECG and NT-proBNP, you quickly get a picture of how your heart is doing. A simple examination can determine whether your symptoms are due to heart failure – or if there are other causes that need to be treated. The earlier heart failure is detected, the better the chance of effective treatment.

Treatment of heart failure

Treatment aims to relieve symptoms, improve heart function, and prevent deterioration. Common treatment options include:

• Medications: ACE inhibitors and ARBs lower blood pressure and relieve the heart. Beta-blockers reduce heart rate and protect the heart. Diuretics help reduce swelling by expelling fluid.
• Lifestyle changes: Quitting smoking, reducing salt intake, weight control, and regular physical activity are important interventions.
• Advanced treatment: For some patients, a pacemaker, defibrillator (ICD), or heart surgery may be necessary.

With the right treatment, many people can live an active and meaningful life despite heart failure. Regular follow-up is crucial to adjust treatment as needed and prevent new complications.