Heart Failure: Questions & Answers
By Deanna Stephens, FNP
Heart failure means the heart is not pumping blood as well as it should. It does not mean the heart has stopped working. Instead, the heart may be too weak to pump strongly or too stiff to fill properly. When this happens, the body may not get enough oxygen-rich blood, and fluid can build up in the lungs, legs, or abdomen.
Q: What are the most common causes?
A: Heart failure is often caused by coronary artery disease (including past heart attacks), high blood pressure, and cardiomyopathy (weakening of the heart muscle). Other causes include heart valve problems, abnormal heart rhythms like atrial fibrillation, untreated sleep apnea, diabetes, and certain infections or toxins that affect the heart.
Q: What symptoms should I watch for?
A: Common symptoms include shortness of breath, especially with activity or when lying flat, swelling in the feet, ankles, or legs, rapid weight gain from fluid, fatigue, and reduced exercise tolerance. Some people notice a persistent cough, feeling bloated, or waking up at night gasping for air.
Q: How is heart failure diagnosed?
A: Diagnosis usually involves a medical history and exam, plus tests such as an echocardiogram (ultrasound of the heart) to check ejection fraction and structure. Other helpful tests may include blood work like BNP/NT-proBNP, an EKG, chest X-ray, stress testing, or heart catheterization depending on the situation.
Q: Can heart failure be treated?
A: Yes. Treatment aims to improve symptoms, prevent hospitalizations, and help patients live longer. Key medications may include beta blockers, ACE inhibitors/ARBs or ARNI, diuretics (water pills) for fluid, mineralocorticoid receptor antagonists, and SGLT2 inhibitors. Some patients benefit from devices such as pacemakers, defibrillators, or CRT.
Q: What lifestyle changes matter most?
A: Limiting salt, monitoring daily weights, taking medications consistently, staying active with safe exercise, and avoiding smoking and excess alcohol are essential. Patients should contact their healthcare team if weight increases 2-3 pounds overnight or 5 pounds in a week, or if breathing and swelling worsen.
Q: What is the outlook?
A: Many people live well with heart failure when it is treated early and managed closely. Regular follow-ups and quick response to symptom changes make a big difference.
Deanne Stephens is a board-certified nurse practitioner with UNC Health Southeastern Cardiology and Cardiovascular Care. To learn more about health services available through UNC Health Southeastern, visit Heart & Vascular Care | Lumberton, NC | UNC Health Southeastern.
