Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies



Heart failure

Heart failure is when your heart doesn’t pump blood around your body as well as it should. This can make it difficult for your body to get as much blood and oxygen as it needs. This then causes the symptoms of heart failure, such as having trouble breathing.

Treatment for heart failure aims to relieve your symptoms and make your heart stronger to improve your quality of life.

How the heart works
Your heart is designed to last a whole lifetime


  • About About heart failure

    Heart failure can happen if your heart structure or function isn’t as it should be. Around 900,000 people have the condition in the UK. You’re more likely to get heart failure as you get older. While about one in every 100 people under 65 has it, this increases to up to 20 in every 100 people over 85.

    You’ll usually have heart failure for a long time, sometimes for the rest of your life. But with treatment, you can keep the symptoms of heart failure under good control for years.

  • Symptoms Symptoms of heart failure

    Your symptoms will depend on which part (or parts) of your heart are damaged, and how severely. Symptoms of heart failure include:

    • trouble breathing – you may feel breathless when you’re doing some exercise or even when you’re resting, particularly when you’re lying flat
    • swollen feet, ankles or abdomen (tummy)
    • feeling extremely tired
    • a cough (often at night) and wheezing

    If you get to know the symptoms of heart failure, then you can contact your GP if you feel they’re getting worse.

    Bupa On Demand: Cardiology services

    Want to talk to a Bupa consultant about your heart health? We’ll aim to get you seen the next day. Prices from £250.

  • Diagnosis Diagnosis of heart failure

    Your GP will ask you about your symptoms and examine you. They’ll ask you about your medical history. Your GP may refer you to see a cardiologist – a doctor who specialises in conditions that affect the heart and blood vessels.

    Tests for heart failure include those listed below.

    • Blood and urine tests. These check your blood count and how well your kidneys are working, as well as other signs of heart failure.
    • An electrocardiogram (ECG). This measures the electrical activity of your heart to see how well it’s working.
    • An echocardiogram. This uses ultrasound to check the structure of your heart and to see how well it’s working. 
    • A chest X-ray. This can check if you have any congestion in your lungs and also rule out other conditions.
  • Self-help Self-help for heart failure

    If you’re diagnosed with heart failure, your doctor may suggest some changes to your lifestyle that you can make to improve your symptoms. These may include:

    If you need help making these changes to your lifestyle, see our related information for advice. Or your GP may be able to arrange for you to attend a local rehabilitation programme and offer information and support too.

  • Medicines Medicines for heart failure

    Below is a list of medicines that can relieve your symptoms of heart failure. Different medicines treat different symptoms, so you may need to take more than one. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or doctor for advice.

    Angiotensin-converting enzyme (ACE) inhibitors 

    ACE inhibitors widen your blood vessels and make it easier for your heart to pump blood around your body. Side-effects may include a dry cough and low blood pressure, which can make you feel dizzy.

    Angiotensin II receptor blockers 

    Angiotensin II receptor blockers (ARBs), also called angiotensin receptor antagonists, work in a similar way to ACE inhibitors. They lower your blood pressure and stop your symptoms from getting worse. Your doctor may prescribe this medicine if you can’t take ACE inhibitors because of the side-effects.


    Beta-blockers slow down your heart rate, which helps to lower your blood pressure and the amount of work your heart does. They can also make your heart pump blood more forcefully. Your doctor will prescribe you a low dose of beta-blocker to begin with and might slowly increase this. It can take a few weeks or months for beta-blockers to work. You might think your symptoms are getting worse to begin with but try and stick with them. If you have asthma or other heart problems, you might not be able to take beta-blockers. Side-effects can include tiredness, cold hands and feet, trouble sleeping and impotence in men.


    Diuretics can treat swollen feet and ankles, and prevent fluid build-up on your lungs, which will allow you to be more active and to breathe better. Diuretics cause your body to get rid of excess fluid by making you go to the toilet more often. Your heart won’t have to work as hard if there’s less fluid to pump around your body. Tell your doctor if you have gout, as diuretics can make it worse. They can also lower your blood pressure, which may make you feel dizzy.

    Aldosterone antagonists 

    Spironolactone or eplerenone are two types of aldosterone antagonists that are used to treat the symptoms of heart failure. They work in a similar way to diuretics by affecting the balance of water and salts going into your urine. These medicines can make you lose your hair and may affect how well your kidneys work. In men, they can cause painful breasts (gynaecomastia). Your GP may ask you to have regular blood tests to check how well your kidneys are working if you take this medicine.


    Digoxin helps if you have a rapid or irregular heartbeat as it slows down your heart rate. Side-effects can include feeling sick and diarrhoea.

    Anticoagulants and antiplatelets 

    These affect how well your blood can clot and prevent harmful blood clots from forming. You’re more likely to get blood clots with heart failure and this risk is even higher if you have atrial fibrillation. Blood clots can cause a stroke if they block narrow blood vessels and stop blood getting to your brain.

  • Pacemakers and ICDs Pacemakers and ICDs for heart failure

    Cardiac re-synchronisation therapy 

    Cardiac re-synchronisation therapy can improve how well your heart is able to pump blood around your body. A pacemaker is fitted under your skin at the top of your chest. This sends electrical currents to leads that are connected to the different parts of your heart so they contract in synchronisation with each other. 

    Implantable cardioverter defibrillator 

    An implantable cardioverter defibrillator (ICD) is a device that’s usually implanted under your skin below your collarbone. An ICD can monitor your heart rhythm. If it detects a serious problem with this, it will deliver an electric shock to return your heartbeat and rhythm back to normal.

  • Surgery Surgery for heart failure


    If you have very severe heart failure, you might be able to have a heart transplant. Heart transplants can be very successful but they aren’t suitable for everybody because of the risks of surgery. There’s also a limited number of donor hearts available. Ask your doctor if a heart transplant is an option for you. 

    Valve replacement 

    If one or more of the valves in your heart aren’t working properly, it can cause heart failure. You might be able to have an operation to replace them, which should improve your symptoms. For more information about what the operation involves, see Related information. 

    Coronary artery bypass graft 

    If your heart failure is caused by coronary heart disease, you may be offered a coronary artery bypass graft. This aims to bypass your blocked arteries to increase the blood flow to your heart. For more information about this procedure, see Related information.

  • Causes Causes of heart failure

    Heart failure can be caused by:

    • damage to your heart muscle
    • a problem with a valve in your heart
    • an irregular heartbeat, which is called an arrhythmia 

    Lots of things can cause these problems, which include:

  • Complications Complications of heart failure

    If you have heart failure, it can affect your quality of life because it’s harder to carry out everyday activities. You might have problems with other areas of your life too, such as with sex. This might be because you get tired and feel weak, or because of side-effects from the medicines you’re taking.

    It can be difficult to live with heart failure. Up to a third of people with heart failure also have depression – if you feel you need support, talk to your GP. There are also support groups that give you the opportunity to get in touch with other people with heart failure. This might be a good source of advice and tips on how to cope with heart failure.

    Other complications of heart failure include:

    • losing weight and muscle loss, which is called cachexia
    • an irregular heartbeat (arrhythmia)
    • sudden cardiac death – but the number of people dying from heart failure is getting lower
  • Prevention Prevention of heart failure

    You’re less likely to get heart failure if you have a healthy lifestyle. This includes:

    • not smoking
    • losing weight (if you’re overweight, of course)
    • doing regular physical activity
    • eating a healthy, balanced diet without too much salt
    • not drinking too much – see our Related information for a guide on the limits

    If you have a health condition that might cause heart failure in the future, such as high blood pressure, it’s important to get treatment. You might be able to prevent heart failure developing.

  • FAQ: Driving or travelling with heart failure Can I drive my car or travel with heart failure?

    You may be able to carry on driving but this will depend on how serious your heart failure is. You might need to let the Driver and Vehicle Licensing Agency (DVLA) know about your condition. If your heart failure is under control, you can probably still fly.

    More information

    You can drive as long as you don’t have any symptoms that could distract you. If you drive lorries or buses, you may need to have regular exercise tests to make sure you’re well enough to continue. If your symptoms are more serious, you might need to stop driving. If you feel unwell, dizzy or your symptoms get worse, don’t drive.

    Most people with heart failure can fly but tell the airline that you’re travelling with beforehand. During the flight, your legs and ankles may swell and you might find it more difficult to breathe if you have severe heart failure. Try to do some stretches and walk around the cabin regularly. Places at high altitude and places that are hot or humid may make your symptoms worse.

    It’s important to take your medicines as you usually would when you travel. If you’re flying, check with your airline about taking medicines on your flight. Make sure your travel insurance covers you too.

  • FAQ: Exercise and heart failure Do I have to stop exercising if I have heart failure?

    Most people with heart failure can still exercise. In fact, exercise can improve your symptoms. But it’s a good idea to talk to your GP before you start anything new.

    More information

    How much you can exercise will depend on how serious your heart failure is and what treatment you’re having. If you have heart failure, keeping active may improve your quality of life because it enables you to do everyday activities more easily.

    It’s a good idea to exercise as part of a rehabilitation programme. This involves going to a number of sessions that are designed to be specific to your needs. They usually involve group-based education and exercise sessions. The education sessions will give you advice and support in many lifestyle areas including managing your weight, giving up smoking, and relaxation techniques.

    Speak to your GP if you’d like more information about cardiac rehabilitation programmes.

  • FAQ: Easing symptoms of heart failure What can I do to help ease my symptoms of heart failure?

    Medicines can help but there are lots of things you can do yourself to try to manage your symptoms.

    More information

    The most common symptoms people get with heart failure are breathlessness, tiredness, and swollen feet and ankles. Here are some practical tips on how to cope with these.

    • If you have difficulty breathing and sleeping while lying on your back, keep yourself propped up with pillows. This should help you to breathe more easily and stop breathlessness disturbing your sleep. If you’re wheezing and coughing, cut back on salt in your diet. Too much salt makes your body hold on to more fluid than usual, which can cause congestion in your lungs and make you short of breath. 
    • If you feel tired all the time, pace yourself and give yourself plenty of time to do everyday activities. Try breaking up big tasks into small parts and ask for help from your friends and family.
    • If you have swollen feet and ankles, don’t sit or stand for a long time. And raise your feet when you rest – use a stool or chair to rest your feet on. Wear comfortable shoes and socks that aren’t too tight. It’s also important to keep active by walking and regularly moving your legs.
  • FAQ: Taking medicines for heart failure Will I need to take medicines for the rest of my life for my heart failure?

    Yes, you’ll probably need to take one or more medicines for the rest of your life. They’ll help to ease the symptoms of heart failure but won’t cure your condition. Most medicines can cause side-effects and your doctor will monitor you closely. Don’t stop taking your medicines or change how much or how often you take them without speaking to your doctor first.

  • Other helpful websites Other helpful websites


    • Acute heart failure: diagnosis and management in adults. National Institute for Health and Care Excellence (NICE), 3 December 2015.
    • Chronic heart failure in adults. National Institute for Health and Care Excellence (NICE), 29 June 2011.
    • Chronic heart failure in adults: management. National Institute for Health and Care Excellence (NICE), 25 August 2010.
    • Heart failure – chronic. NICE Clinical Knowledge Summaries., published May 2015
    • An everyday guide to living with heart failure. British Heart Foundation., published 2012
    • Heart failure diagnosis and investigation. PatientPlus., reviewed 19 July 2012
    • Heart failure management. PatientPlus., reviewed 19 July 2012
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press., accessed 15 February 2016
    • Heart failure. Medscape., published 11 January 2016
    • Implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure. National Institute for Health and Care Excellence (NICE), 25 June 2014.
    • Cardiac rehabilitation. PatientPlus., reviewed 18 February 2011
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Tools and calculators Tools and calculators

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, Bupa Heath Content Team, March 2016.

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Natalie Heaton – Specialist Editor, User Experience
  • Pippa Coulter – Specialist Editor, Content Library
  • Alice Rossiter – Specialist Editor, Insights
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Editorial Assistant

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.