Heart failure
A condition where the heart cannot pump blood as effectively as the body needs, causing fluid to build up and less oxygen to reach the tissues. It brings breathlessness, tiredness and swollen ankles. It is long-term but very treatable, and modern treatment greatly improves symptoms and outlook.
What it is
Heart failure does not mean the heart has stopped; it means the heart cannot pump blood efficiently enough to meet the body's needs. This can be because the heart muscle is weak and does not squeeze well, or because it is stiff and does not fill properly. The commonest causes are a previous heart attack or coronary artery disease, long-standing high blood pressure, heart valve problems, abnormal heart rhythms such as atrial fibrillation, and diseases of the heart muscle itself. When the heart underperforms, blood and fluid back up — into the lungs, causing breathlessness (especially on exertion or lying flat), and into the legs and abdomen, causing swelling. The body's compensating responses (fluid retention, hormone changes) initially help but eventually worsen the strain. Typical symptoms are breathlessness, fatigue, reduced exercise tolerance, swollen ankles and legs, and waking at night short of breath. Diagnosis combines the clinical picture, an ultrasound of the heart (echocardiogram) and blood tests, notably the natriuretic peptide NT-proBNP, which rises when the heart is under strain. Heart failure is a long-term condition, but a wide range of effective treatments now relieve symptoms, reduce hospital admissions and prolong life.
Key lab markers
- NT-proBNP (or BNP) — released when the heart is under strain; a key blood test to support the diagnosis and gauge severity.
- Troponin — checked to look for heart muscle injury, such as a contributing heart attack.
- Kidney function (creatinine, eGFR) — closely tied to heart failure and to its treatments.
- Sodium and potassium — a low sodium can occur, and potassium must be watched with the medications used.
- Full blood count, thyroid and glucose — for anaemia, thyroid disease and diabetes that can drive or worsen it.
Symptoms
- Breathlessness — on exertion, and later at rest or lying flat
- Waking at night short of breath
- Fatigue and reduced exercise tolerance
- Swollen ankles, legs or abdomen
- Rapid weight gain from fluid retention
- A persistent cough or wheeze
- Palpitations or a fast, irregular heartbeat
Related symptoms
Related lab panels
When to discuss with a doctor
New or worsening breathlessness, unexplained fatigue, or swelling of the ankles and legs — particularly waking at night short of breath or a rapid weight gain from fluid — should be assessed by a doctor, who can arrange an echocardiogram and an NT-proBNP to look for heart failure. Once diagnosed, it is managed long-term with medications that improve symptoms and outlook, alongside monitoring of weight, kidney function and electrolytes. Seek urgent care for severe or sudden breathlessness, breathlessness at rest, chest pain, or coughing up frothy or blood-tinged sputum. Mediora.AI can flag a raised NT-proBNP together with the kidney and electrolyte pattern that fits heart failure, but the diagnosis rests on the clinical picture and heart imaging; management belongs with your doctor and cardiology team.