Heart failure with reduced function

This section is for patients that have been told by their clinician, heart specialist nurse or GP that they have a reduced function heart failure condition.

Support from our Community nursing team

Advice about medicine management

Useful resource

BFH logoRead about the symptoms, causes, management, treatment and more.

Visit British Heart Foundation

Fluid management

Why fluid management is important

Fluid management is crucial in heart failure.

By keeping fluid levels under control you can:

  • reduce strain on the heart – less fluid makes it easier for the heart to pump and can improve its function
  • ease the breathing – removing fluid from the lungs improves oxygen intake and relieves shortness of breath
  • decrease swelling and discomfort – reduced fluid levels, lessens swelling and pain in the legs and ankles
  • lower the risk of complications – keeping fluid levels stable can help prevent infections and other complications
Methods for fluid management
  • Diuretics – these medications also known as water tablets help the kidneys remove excess fluid from the body through urine
  • If you are struggling with fluid retention, moderating your intake to around 1.5-2 litres (up to 3.5 pints) a day can help, but this intake should not be reduced further as the kidneys need you to be hydrated to work effectively
  • Weighing yourself – This can help detect fluid build-up early , 1-2kgs (2-4lbs) over 3 days is an indication that you are retaining fluid and need to take action
  • Symptoms – pay attention to any changes in your breathing, swelling or general wellbeing and obtain advice from your heart Failure Nurse or GP
  • Limiting dietary Sodium – Sodium (SALT) retains fluid so reducing your intake can help control fluid levels (Avoid LO Salt as this is high in Potassium)
  • Maintain a healthy weight can help to reduce fluid build up
  • Attend all your appointments – to ensure you are on the best possible treatment plan for you My Marvellous Symptom Checker | Pumping Marvellous

Breathing and relaxation

Breathing techniques

Several techniques can help you breathe easier and improve your quality of life.

Elevation
Prop yourself up with pillows when sleeping or resting, this will allow fluid to drain from your lungs and make your breathing easier.

Sitting upright and slightly forward helps your lungs expand fully and can improve your oxygen intake.

If you are waking up in the night or needing increasing amounts of pillows to sit upright and ease your breathing, this could be a sign that your heart failure symptoms are getting worse and you need to report this to your heart failure specialist nurse.

Pursed-lip breathing
Breathe in slowly through your nose and then exhale slowly through pursed lips – like blowing out a candle. This technique slows your breathing rate and controls anxiety.

Diaphragmatic breathing
Focus on breathing from your belly instead of your chest, place one hand on your chest and the other on your abdomen – as you breath in your abdomen should rise and your chest should remain relatively still. This deep breathing engages your diaphragm muscle increasing oxygen intake.

Holding a small fan to your face can help with feelings of air hunger and can reduce panic when your breathing is difficult. Or try standing by an open window/door where the airflow is higher.

If you start to develop changes in the colour of your phlegm or your develop a new cough or the amount of phlegm increases, you need to report this to your heart failure specialist nurse.

If you think you may be developing a chest infection, please report this to your GP as you may need antibiotics.

If you feel that you are increasingly short of breath and the distance you can walk on the flat or upstairs starts to decrease or change, please inform you heart failure specialist nurse.

Relaxation techniques
  • Meditation – focusing on your breath and quieting your mind can reduce stress and anxiety
  • Yoga – gentle poses can improve flexibility and strengthen your diaphragm muscle leading to better breathing
  • Progressive muscle relaxation – tensing and relaxing different muscle groups in your body can help release tension and improve overall well-being including breathing

Frequently asked questions

Why a healthy lifestyle is important

If you have heart failure, it’s important to look after your own health and wellbeing, with support from those involved in your care. Eating a healthy, balanced diet is an important part of maintaining good health and can help you feel your best. This means eating a wide variety of foods in the right proportions and consuming the right amount of food and drink to achieve and maintain a healthy body weight.

Weight management, Bradford Council

For more information regarding healthy eating please use the link below. If you require additional support, then please talk to your Heart Failure Nurse and referral to the dietician can be made.

8 tips for healthy eating, NHS.UK

Too much salt in your diet can increase blood pressure and fluid retention. Don’t cook with salt or add it to your food, and use the traffic light labels on food packaging to help you. If you’d like to add flavour to your food you can replace salt with a variety of herbs and spices. (BHF 2024). Watch: Why is too much salt bad for you? – Heart Matters magazine.

Sometimes your heart medication combined with your diet can elevate potassium levels, this can mean it is difficult for your heart nurse to optimise your medications and improve your symptoms. Please use the link below to help you avoid/reduce food that are rich in potassium. Potassium Matters Leaflet (PDF)

Diet Recommendations When Living With Heart Failure, Pumping Marvellous

How does alcohol affect my heart?

There is a very clear link between regularly drinking too much alcohol and having high blood pressure (bhf.org.uk). Over time, high blood pressure (hypertension) puts strain on the heart muscle and can lead to cardiovascular disease (bhf.org.uk), which increases your risk of heart attack (bhf.org.uk) and stroke (bhf.org.uk).

Those who drink regularly and consume more than the lower risk guidelines are likely to be advised to cut down or stop drinking completely.

Drinking alcohol to excess can cause other serious health conditions, such as cardiomyopathy (bhf.org.uk) (where the heart muscle is damaged and can’t work as efficiently as it used to) and arrhythmias (abnormal heart rhythms (bhf.org.uk)). Some of these conditions can increase your risk of stroke.

If you already have a condition that causes arrhythmias, alcohol may increase that risk. This can be especially dangerous in those who have inherited heart rhythm conditions.

Heavier drinking (binge drinking) can also bring on a first episode of arrhythmia; once this has happened for the first time, you’re at an increased risk in the future.

Drinkaware

Help with alcohol or drug misuse, Bradford Council

How to manage my stress and anxiety?

It’s normal to feel stressed sometimes and a certain amount of stress can be healthy. But if you’re feeling stressed more and more over time and you’re struggling to cope, it’s time to make some changes. Learn how to manage stress (bhf.org.uk).

If you are feeling stressed or anxious about your heart condition, then please talk to your heart failure nurse and a referral can be made to the psychologist.

What about the impact on sex and relationships?

Many people with heart failure are not sure if they should have sex because of their condition and may feel embarrassed to raise this question with their doctor or nurse. The good news is that most people with heart failure can continue to enjoy sexual relations once their symptoms are under control. Read more about Sex and heart failure (heartfailurematters.org).

Can I travel and fly with heart failure?

If you have recently been unwell, had surgery or have just been discharged from hospital, you should wait until you have made a full recovery and your doctor has confirmed that you are fit before you travel. Whether your condition is stable or unstable, you should always consult your GP well in advance of departure.

Please make sure that you have adequate travel insurance that covers you for your condition.

Look at the links below for more advice:

How smoking affects my heart?

Smoking is one of the worst things a person can do for their health and smokers are almost twice as likely to have a heart attack compared with people who’ve never smoked.

Inhaling cigarette smoke increases your risk of getting heart disease, including having a stroke or a heart attack because it forces your heart to work harder than it should have to. It’s especially risky if you already have a heart condition.

Smoking tobacco in cigarettes, roll ups or in any way at all:

  • damages the lining of your arteries, leading to a build-up of fatty material – this makes them narrower and harder to get blood through
  • reduces the amount of oxygen in your blood
  • makes your heart beat faster and raises your blood pressure
  • causes your blood to clot more easily
How do recreational drugs affect my heart?

Illegal drugs and so-called ‘Legal Highs’ can have dangerous effects on your heart and body. If you’re on heart medication, drugs can interact with these and cause damage. It’s important to know what they can do to your heart so you can make sensible decisions.

The drugs that can put a strain on your heart causing irregular heartbeats, heart attacks and strokes are:

  • LSD (acid, blotter, liquid acid, micro dot, smilies, tabs, trips)
  • Cocaine (coke, charlie, crack, snow, blow)
  • Amphetamines (speed, fet, base, billy, whizz)
  • Ketamine (Special K, K, ket)
  • Crystal meth (Ice, glass, Christine, Tina)
  • Mephedrone (meow meow, miaow miaow, MCAT, meph)
  • Cannabis (hash, weed, grass, skunk, marijuana, dope, puff, ganja, pot, joint, reefer, kazoo, blunt, zoot)

Help with alcohol or drug misuse, Bradford Council

How to cope with dizziness?

Occasional dizziness can be a part of living with a heart condition, and can be caused by different things, including medication (bhf.org.uk). Many of the drugs used to treat heart disease are designed to lower blood pressure (bhf.org.uk) or heart rate (bhf.org.uk), in order to reduce the workload of the heart. Although most people take these medications with no problems, they can make some people feel lightheaded or dizzy.

There may be things to try that could help you improve or avoid this. Simple thing like adjusting the timings of your tablets, sitting to standing slowly and ensure you are drinking the correct amount can help with this.

The recommended fluid intake is usually around 2 litres a day.

If you are new to this kind of medication, you may find that in time your body becomes used to the new drug. Try to give it at least two or three weeks, but if you are noticing that you are not improving or feeling worse, let your doctor or heart nurse know so that they can review your medications.

How to better managing money?

Useful links from the British Heart Foundation:

Useful links from GOV.UK:

Can I drive with heart failure?

Driving a car with heart failure, you do not always need to inform DVLA, however if you have a PSV or HGV license you will have restrictions to consider.

For more information, see Cardiovascular disorders: assessing fitness to drive (GOV.UK).

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