Myocardial infarctionis a chronic condition that, if left untreated, usually gets worse over time. With advances in medical technology and a greater understanding of how heart failure occurs, most people no longer receive a single treatment for heart failure.
A combination of aggressive lifestyle changes and medical care to optimize heart function and minimize symptoms can stop heart failure and even reverse it.
In this article, we will discuss heart failure, how it can be prevented or reversed, and the outlook for people with the condition.
What is heart failure?
Heart failure occurs when the heart fails to properly pump blood through the body. As a result, the body's tissues and organs may not receive enough nutrients and oxygen.
The body's typical response to heart failure is sodium retention and the accumulation of excess fluid. This leads to swelling of the lower limbs (edema) and pulmonary congestion. In such cases, it is usually called heart failurecongestive heart failure (CHF).
Heart failure can be caused by direct or indirect damage to the heart. Normally, conditions that damage the heart must be well controlled for the heart to stay strong and pump blood efficiently through the body. The following conditions most commonly cause heart failure:
- Coronary artery disease: deposits of fat, cholesterol, calcium and cellular debris (atherosclerotic plates) can narrow the diameter of blood vessels, limiting the amount of blood that can flow through the heart at any given time. Narrowed arteries can lead to heart failure, heart attack, and stroke if atherosclerotic plaque breaks away from one artery and sticks to the other.
- Past heart attack: In a heart attack (myocardial infarction), blood flow in the coronary artery is interrupted. Heart attacks damage the heart by weakening the muscles and impairing its ability to pump blood efficiently through the body.
- Hypertension: High blood pressure makes the heart work harder than usual. Heart failure may develop over time.
- Dignity: Obesity is often associated with type 2 diabetes and sleep apnea. Both conditions are independent risk factors for heart disease. Obesity can make your heart work harder than usual. If you're obese, you're more likely to have high cholesterol, which increases your risk of plaque buildup in your arteries.atherosclerosis) and heart disease.
- Diabetes: Uncontrolled blood sugar (glucose) levels are toxic to the heart, nerves, and blood vessels. People with diabetes also have a higher rate of obesity and hypertension, which are independent risk factors for CHF.
- Valvular heart disease: Damaged heart valves impair the heart's ability to supply blood to the rest of the body, leading to CHF.
- Hyperthyroidism (hyperthyroidism): Too much thyroid hormone can increase blood pressure and heart rate. When the heart beats too fast, it does not allow time to fill with blood. High blood pressure is an independent risk factor for heart failure and puts pressure on the heart.
- Alcohol: Drinking too much alcohol can damage the heart muscle. This condition is called alcoholic cardiomyopathy and is a form of dilated cardiomyopathy.
- Viral myocarditis: Myocarditis can follow a viral illness and lead to heart failure.
- Hereditary heart disease: Some inherited diseases such as familial dilated cardiomyopathy andfamilial hypertrophic cardiomyopathycan lead to heart failure.
- Invasive disease: In some disease states, substances (e.g. abnormal proteins or iron) build up in heart tissue and can lead to heart failure.
- Other situations: Lack of healthy red blood cells to carry oxygen around the body (severeanemia) and abnormal heart rhythm (arrhythmias) can develop for various reasons. Whatever the cause, these conditions limit the amount of oxygenated blood that reaches your organs.
Can heart failure be reversed?
Heart failure usually gets worse over time if left untreated. However, studies have shown that treatment can make the heart stronger. The real breakthrough in the treatment of heart failure comes from the optimization of powerful medical therapies that have been developed over the last 40 years.
For some people who do not respond to these treatments, various procedures may be considered, ranging from special pacemakers to open-heart surgery.
How is heart failure reversed?
The following strategies can be used to reverse heart failure.
Combining heart-healthy lifestyle habits with medication and tight control of blood pressure and blood sugar can lead to greater reversal of heart failure symptoms.
You and your cardiologist will determine the best treatment plan based on the type of heart failure, the severity of the condition, and the possible side effects of treatment. They will also explain how to take the medicine, specifically how often and at what dose.
If you have been diagnosed with heart failure with reduced ejection fraction (HFREF), you will likely be prescribed one of four very effective drugs: β-blockers, renin-angiotensin inhibitors, diuretics (especially spironolactone) and sodium-glucose co-transporter-2 (SGLT2). ) inhibitors. These drugs can improve the way your heart works.
Drugs in these four classes not only improved the heart's ability to pump blood, but also reduced the number of hospitalizations and may help reduce the risk of death from heart failure.
wtbeta-blockers—Coreg (karwedylol), Toprol (metoprolol succinate) and Zebeta (bisoprolol) have been shown to be effective in reducing symptoms, readmissions and mortality in people living with chronic HFrEF.
There is no consensus on the exact mechanism of action behind the effectiveness of β-blockers, but one pathway suggests that they are particularly effective in reversing the neurohumic effects of the sympathetic nervous system that often contribute to heart damage and weakness.
Side effects of beta blockers include fatigue, dizziness, weight gain, cold hands and feet, and difficulty sleeping.
Renin-angiotensin system inhibitors
Thethe renin-angiotensin systemregulates blood pressure through a group of related hormones that influence each other and work together with the kidneys. Drugs affecting this system may be used in heart failure.
Angiotensin converting enzyme inhibitors (ACE inhibitors)
Over time, angiotensin can damage the heart and impair the organ's ability to pump blood efficiently around the body.Inhibitory ACEblock the action of angiotensin, an enzyme that constricts the vessels of the heart and forces the heart to work harder. They also dilate blood vessels, allowing blood to flow freely to the heart.
ACE inhibitors also reduce the production of angiotensin II, which signals the release of hormones that raise blood pressure. The side effects of these medications include fatigue, headache, chronic cough, and dizziness due to a drop in blood pressure.
Angiotensin II blockers (ARBs)
ARBthey act similarly to ACE inhibitors and block the binding of angiotensin II to angiotensin II receptors. This helps to lower blood pressure as well as possible damage to the heart, blood vessels, and kidneys. Side effects of these drugs include dizziness, angioedema, and increased levels of potassium in the blood (hyperkalaemia).
Notably, Entresto (sacubitril/valsartan), a combination of a neprilysin inhibitor and an ARB, has been shown to reduce morbidity and mortality in people living with chronic heart failure with reduced ejection fraction.
Aldactone (spironolactone) is a diuretic (or "water pill") that blocks the activity of aldosterone, a hormone produced by the adrenal glands that helps regulate water and sodium levels in the body.
Sodium glucose co-transporter 2 (SGLT-2)
Jardiance (empagliflozin), a diabetes drug in the SGLT-2 inhibitor class, has been shown to treat diabetes as well as reverse heart failure in both diabetic and non-diabetic people.
Farxiga (dapagliflozin) has also been shown to reduce the risk of cardiovascular death and hospitalization for heart failure, but not reverse heart failure.
Managing any underlying health issues is the cornerstone of treatment and key to alleviating the symptoms of heart failure. No studies have shown that drugs for high blood pressure (e.g. beta blockers, antidiuretics and mineralocorticoid receptor antagonists), antiarrhythmics or antithyroid drugs can reverse the damage caused by heart failure.
However, these drugs can have huge benefits - both directly and indirectly - by reducing the risk of heart attack and stroke, regulating the heart rate, reducing the strain on the heart, and making it easier for the heart to work and pump blood throughout the body.
Taking baby aspirin (81 milligrams) a day was the mainstay of treatment because of the drug's ability to prevent blood clots. It was believed that taking children's aspirin daily could prevent or even reverse heart failure, but recent research has cast doubt on this claim.
Surgical procedures, egheart transplantcan significantly improve the quality of life and extend life, especially when combined with a heart-healthy lifestyle.
If the left side of the heart is damaged or isn't pumping as well as it should,Cardiac resynchronization therapy (CRT)may help with normal left ventricular contraction. In more serious cases of ALeft ventricular assist device (LVAD)— a mechanical pump to keep the heart beating — can help reverse the symptoms of heart failure.
The following lifestyle changes are recommended for people with heart failure:
- Follow a similar dietThe Hypertension Prevention Diet (DASH).theMediterranean diet. These diets contain plenty of fresh fruit and vegetables, are low in sodium and high in potassium. In general, high sodium intake should be avoided.
- Being overweight puts a strain on the heart and is the main cause of high blood pressure. Adequate weight loss through a combination of diet and exercise and weight maintenancebody mass index (BMI)below 30 may be useful.
- A total of 150 minutes of moderate to vigorous exercise per week has significant health benefits and helps with weight management.
- Weigh yourself daily and let your doctor know if your weight has increased or decreased by 3 pounds compared to your starting weight.
How to prevent heart failure
The best way to prevent heart failure and heart failure is to follow the heart health guidelines set by the American Heart Association (AHA) and the United States. Preventive Services Task Force (USPSTF) that requestslow sodium dietwith plenty of fruit and vegetables, regular exercise (preferably five 30-minute sweat-breaking exercises a week), no smoking, and limited alcohol consumption.
Point of view
Heart failure used to be associated with very high morbidity and mortality. With current treatment, most people living with heart failure can recover and participate in normal daily activities and have a longer life expectancy.
There is hope with better treatments. Guidelines for the treatment of heart failurereduced ejection fractionreduces the number of hospitalizations and the risk of death from cardiovascular causes by up to 62% compared to limited conventional therapy.
Symptoms of advanced heart failure are symptoms of very low cardiac output. The following symptoms may mean that someone is dying of heart failure - especially if frequent hospitalizations and specialized treatment regimens are not helping with recovery:
- Feeling full after eating little (early fullness)
- Bad appetite
- Stomach pain
- Motion sickness
- Cough pink sputum
- Kidney failure
- Forgetting and memory problems
Heart failure usually gets worse over time. However, research has shown that surgery, medications, and aggressive lifestyle changes can strengthen the heart and potentially reverse heart failure. Ultimately, your outlook will depend on your overall health, medical compliance, and your body's response to treatment.
A word from Verywell
If you have heart failure, talking to your doctor and getting an early diagnosis will help you start treatment as soon as possible and develop a plan to help you reach your goals. If you're living with heart failure, it's important to take your medications as directed, follow your diet, and take other steps to stay healthy.
Frequently asked questions
Can heart failure go away and come back?
There is no cure for heart failure other than medication, such as diuretics and beta blockers, and lifestyle changes such as a heart-healthy diet, daily exercise, maintaining a healthy weight, managing stress, and controlling blood sugar and blood pressure blood within the normal range can help you manage the symptoms of the disease.
Learn more:How is heart failure treated?
How fast does heart failure progress?(Video) Living a Full Life with Congestive Heart Failure
Heart failure is unpredictable. In some people, the disease can develop quickly (acute heart failure) and in others gradually (chronic heart failure). Your eating habits, smoking habits, and adherence to your treatment plan are among the factors that may play a role in how quickly heart failure progresses.
Learn more:Heart Failure Guidelines
Can you exercise with heart failure?
Heart failure doesn't mean you can't exercise again, but your ability to exercise will depend on the severity of your symptoms.
Learn more:Walking with congestive heart failure
Although heart failure is a serious condition that progressively gets worse over time, certain cases can be reversed with treatment. Even when the heart muscle is impaired, there are a number of treatments that can relieve symptoms and stop or slow the gradual worsening of the condition.How long can you live with heart failure? ›
In general, more than half of all people diagnosed with congestive heart failure will survive for 5 years. About 35% will survive for 10 years. Congestive heart failure (CHF) is a chronic, progressive condition that affects the heart's ability to pump blood around the body.Can the heart repair itself after heart failure? ›
The heart is unable to regenerate heart muscle after a heart attack and lost cardiac muscle is replaced by scar tissue. Scar tissue does not contribute to cardiac contractile force and the remaining viable cardiac muscle is thus subject to a greater hemodynamic burden.What kind of heart failure can be reversed? ›
It is possible to reverse congestive heart failure. Once the condition of your heart is assessed, the physician will take further steps to treat your congestive heart failure and start appropriate treatment.Can heart failure be reversed with exercise? ›
Can heart failure improve with exercise? It's important to remember that exercise will not improve your ejection fraction (the percentage of blood your heart can push forward with each pump). However, it can help to improve the strength and efficiency of the rest of your body.What are the 4 signs your heart is quietly failing? ›
Warning signs and symptoms of heart failure include shortness of breath, chronic coughing or wheezing, swelling, fatigue, loss of appetite, and others. Heart failure means the heart has failed to pump the way it should in order to circulate oxygen-rich blood throughout the body.Can I live a full life with heart failure? ›
It is possible to lead a normal life, even if you have Heart Failure. Understanding and taking control of Heart Failure is the key to success. Your doctor and healthcare providers will provide guidelines and a treatment plan. It is your responsibility to follow the treatment plan and manage your Heart Failure.Has anyone ever cured heart failure? ›
So although there is no absolute cure for heart failure, medication and lifestyle changes can prevent the condition from worsening and in certain cases, return almost regular heart function.How do you strengthen a weak heart? ›
- Eat a well-rounded, balanced diet. ...
- Don't sit for too long. ...
- Brush your teeth every day – and don't forget to floss. ...
- Quit smoking and avoid second hand smoke. ...
- Snack smart throughout the day. ...
- Get plenty of sleep. ...
- Recognize and reduce stress in your life.
Remission of heart failure, defined by resolution of symptoms, normalization of left ventricular ejection fraction, and plasma concentrations of natriuretic peptides and by the ability to withdraw diuretic agents without recurrence of congestion is increasingly recognized among patients with dilated cardiomyopathy.
Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if: You're 65 years old or older.How quickly does heart failure progress? ›
Symptoms can develop quickly (acute heart failure) or gradually over weeks or months (chronic heart failure).Does heart failure show up on EKG? ›
A chest X-ray can be useful to identify evidence of heart failure or other lung pathology; however, a normal result does not rule out a diagnosis of heart failure. An electrocardiogram (ECG) is often abnormal in patients with heart failure, although up to 10% of patients may have a normal ECG.Does deep breathing help heart failure? ›
When the heart pumps more efficiently, the facial and lower leg edema often associated with congestive heart failure reverses. Deep breathing can also correct abnormal heart rhythms, including tachycardia. Blood pressure decreases because blood does not move forcefully through the vessels to receive and deliver oxygen.What are sneaky signs of heart failure? ›
- Changes in skin color (blue or gray tinge)
- Struggling to catch your breath while doing things that used to be easy or struggling to breathe while lying down.
- Swelling in your legs, feet or ankles.
- Coughing and wheezing.
- Rapid weight gain.
- Rapid heartbeat.
- Fatigue: Feeling tired or without energy is a common symptom of a heart that isn't pumping enough blood to the body.
- Activity limitation: ...
- Congestion: ...
- Edema or ankle swelling: ...
- Shortness of breath:
Heart failure symptoms may include: Shortness of breath with activity or when lying down. Fatigue and weakness. Swelling in the legs, ankles and feet.Can you live 20 years heart failure? ›
In general, about half of all people diagnosed with congestive heart failure will survive 5 years. About 30% will survive for 10 years. In patients who receive a heart transplant, about 21% of patients are alive 20 years later.What is the difference between heart failure and congestive heart failure? ›
Actually, heart failure, sometimes called HF, means that the heart isn't pumping as well as it should. Congestive heart failure is a type of heart failure that requires timely medical attention, although sometimes the two terms are used interchangeably.What is Stage 2 heart failure? ›
Stage II: You don't have heart failure symptoms at rest, but some symptoms slightly limit your physical activity. Symptoms include fatigue and shortness of breath. Stage III: Heart failure symptoms noticeably limit your physical activity (but you still are asymptomatic at rest).
Exercise and weight loss can help to reverse heart failure when it's started early enough. However, losing weight and keeping fit is not always enough.What is the first line treatment for heart failure? ›
Loop diuretics should be used as first-line agents, with thiazides added for refractory fluid overload. Diuretic treatment should be combined with a low-salt diet,8 a β-blocker, and an ACE inhibitor.Which are two signs of worsening heart failure? ›
- Shortness of breath.
- Feeling dizzy or lightheaded.
- Weight gain of three or more pounds in one day.
- Weight gain of five pounds in one week.
- Unusual swelling in the legs, feet, hands, or abdomen.
- A persistent cough or chest congestion (the cough may be dry or hacking)
Water is the drink of choice for heart health. If you're thirsty, drink water. When the weather is warm or we're exercising, our bodies need more water than usual. Unflavoured milk, tea and coffee can be enjoyed in moderation.What is the best exercise for heart failure? ›
Ms Eriksen recommends doing an aerobic activity (something where you're moving most of your body, which will increase your heart and breathing rate a little, such as moving to music or walking around) and resistance work, where you add light weights to build muscle strength.What are the signs of a weak heart? ›
- Fatigue, weakness, faintness.
- Loss of appetite.
- Need to urinate at night.
- Pulse that feels fast or irregular, or a sensation of feeling the heartbeat (palpitations)
- Shortness of breath when you are active or after you lie down.
- Swollen (enlarged) liver or abdomen.
- Swollen feet and ankles.
One study says that people with congestive heart failure have a life span 10 years shorter than those who don't have heart failure. Another study showed that the survival rates of people with chronic heart failure were: 80% to 90% for one year. 50% to 60% for year five.Can doctors stop heart failure? ›
Heart failure has no cure. But treatment can help you live a longer, more active life with fewer symptoms. Treatment depends on the type of heart failure you have and how serious it is.Can you come off heart failure medication? ›
Never stop taking your heart medicines without talking to your health care provider first. This is also true for other medicines you take, such as drugs for diabetes, high blood pressure, and other serious conditions.What is the main cause of heart failure? ›
High blood pressure and other conditions that make your heart work harder are the main causes of heart failure with preserved ejection fraction. Conditions that stiffen the chambers of the heart such as obesity and diabetes are also causes of this type of heart failure.
Stress can cause a heart attack, sudden cardiac death, heart failure, or arrhythmias (abnormal heart rhythms) in persons who may not even know they have heart disease.What stage of heart failure is shortness of breath? ›
Stage 2 of Congestive Heart Failure
Stage two of congestive heart failure will produce symptoms such as fatigue, shortness of breath, or heart palpitations after you participate in physical activity.
If you wake up feeling not refreshed, you have daytime sleepiness or if you need to curtail your daytime activity because of lack of energy, these could be signs your heart failure isn't being managed as well as it could be, Dr. Freeman says.What is a good blood pressure for someone with heart failure? ›
Little robust evidence exists regarding the optimal blood pressure target for patients with heart failure, but a value near 130/80 mmHg seems to be adequate according to the current guidelines.What does heart failure fatigue feel like? ›
... a tired feeling all the time and difficulty with everyday activities, such as shopping, climbing stairs, carrying groceries or walking. You may also feel sleepy after eating, feel weak in the legs when walking and get short of breath while being active.How does a doctor diagnose congestive heart failure? ›
Diagnostic tests for congestive heart failure may include: Resting or exercise electrocardiogram (also known as EKG, ECG, or stress test) Echocardiogram. Computed tomography (CT) scan.What is the gold standard for diagnosing heart failure? ›
While most patients with suspected HF do not require invasive testing for diagnosis, the clinical gold standard for diagnosis of HF is identification of an elevated pulmonary capillary wedge pressure at rest or exercise on an invasive hemodynamic exercise test in a patient with symptoms of HF.What is the blood test for heart failure? ›
BNP (B-type natriuretic peptides) tests – these show the level of a hormone in your blood which if elevated can be a sign of heart failure.Will oxygen help congestive heart failure? ›
When you have heart failure, your heart does not pump as well as it should. So it does not send enough oxygen-rich blood to the rest of your body. Oxygen therapy increases the amount of oxygen sent to your body's tissues. This helps reduce your heart's workload.Do you cough up phlegm with congestive heart failure? ›
Chronic coughing or wheezing - Fluid congestion (a buildup of fluid in the lungs) is common with heart failure, and is the reason why doctors often refer to it as "congestive heart failure" (CHF). This congestion can make you wheeze and cough. Some people cough up mucous or phlegm.
practicing deep or guided breathing techniques, such as box breathing. relaxing and trying to remain calm. going for a walk, ideally away from an urban environment. taking a warm, relaxing bath or shower.What is the dying stage of heart failure? ›
If a patient has end-stage heart failure it means they are at high risk of dying in the next 6 to 12 months. These are the common symptoms of end-stage heart failure: pain. breathlessness on minimal exertion or at rest.What is the most common cause of death in heart failure? ›
Patients with congestive heart failure have a high incidence of sudden cardiac death that is attributed to ventricular arrhythmias.Do you ever come out of heart failure? ›
Heart failure is a long-term condition, but people with can live long and full lives with it. Although there's no cure for heart failure, you can stop your condition getting worse by taking your medicines, certain treatments and changes to your lifestyle.What are the signs 6 months before death? ›
in the last 6 to 12 months before death, people with a pro- gressive, debilitating disease commonly experience certain physical symptoms. many people, as they approach the end of life, will become less active and experience chronic fatigue or weakness. Weight loss and diminished appetite are also common.How do you know the end is near with congestive heart failure? ›
Chronic Cough & Wheezing: Just like with the shortness of breath, a chronic cough becomes more prominent in the final months and weeks of congestive heart failure. The cough is often times accompanied by some wheezing and white or pink-colored mucus.Who usually gets heart failure? ›
People 65 years or older have a higher risk of heart failure. Older adults are also more likely to have other health conditions that cause heart failure. Family history of heart failure makes your risk of heart failure higher. Genetics may also play a role.Who mostly gets heart failure? ›
Coronary artery disease, heart attack, and high blood pressure are the main causes and risk factors of heart failure. Other diseases that damage or weaken the heart muscle or heart valves can also cause heart failure. Heart failure is most common in people over age 65, African-Americans, and women.What are 4 typical causes of heart failure? ›
Most often, heart failure is caused by another medical condition that damages your heart. This includes coronary heart disease, heart inflammation, high blood pressure, cardiomyopathy, or an irregular heartbeat.What are the first hints of heart failure? ›
You may have trouble breathing, an irregular heartbeat, swollen legs, neck veins that stick out, and sounds from fluid built up in your lungs. Your doctor will check for these and other signs of heart failure. A test called an echocardiogram is often the best test to diagnose your heart failure.
Typical signs of heart failure include: Breathlessness or Shortness of Breath (Dyspnea) When the heart begins to fail, blood backs up in the veins attempting to carry oxygenated blood from the lungs to the heart. As fluid pools in the lungs, it interferes with normal breathing.What is Stage 4 heart failure life expectancy? ›
Most people with end-stage heart failure have a life expectancy of less than 1 year.