Exercise and self-management in heart failure

It can seem safer to rest when you are breathless or tired. The BHF says that keeping active is a recognised part of lifestyle management and has been proven to boost energy and improve sleep and quality of life. Inactivity tends to weaken muscles, which makes everyday tasks feel harder.

That does not mean pushing through any symptom. The aim is a safe, individually set level of activity, which is why an assessment through cardiac rehabilitation is the recommended starting point.

The NHS says everyone diagnosed with heart failure should be offered cardiac rehabilitation. Programmes may include an assessment and advice about how to exercise safely, exercise classes or a personal exercise programme, guidance and information about lifestyle changes such as healthy eating, and support groups where you can share experiences with others who have heart failure.

If you have not been offered a place, ask your GP or heart failure nurse. Some areas provide home-based or online versions for people who cannot attend, and the BHF publishes guided exercise videos.

The BHF says sudden weight gain may mean too much fluid is building up in the body and needs treatment. The NHS likewise advises regular weighing. A practical routine is to weigh first thing, after using the toilet and before breakfast, on the same scales, and to write the result down.

Your heart failure team will tell you what change should prompt a call, since thresholds differ between people. Swollen ankles, a tighter waistband or more breathlessness are other signs to report.

The BHF says to watch the amount of fluid you drink each day if your medical team recommends it. Not everyone needs fluid restriction, so follow the advice given for you rather than a general rule.

On alcohol, the BHF recommends staying below 14 units a week, and the NHS and BHF both advise stopping smoking. A dietitian or heart failure nurse can talk through salt and meals in more detail.

The NHS lists diuretics, which reduce fluid, vasodilators, which ease the heart workload, and beta blockers, which slow the heart rate, among treatments. Surgery may improve blood flow, repair valves or implant devices such as pacemakers or defibrillators, and severe cases may qualify for assist devices or transplant.

The NHS includes taking medicines consistently and having recommended vaccinations, particularly flu, in its self-care advice. Never stop a tablet because you feel well, and ask a pharmacist before buying over-the-counter painkillers or supplements.

The NHS says to see a GP if you have heart failure symptoms, call NHS 111 urgently for breathlessness when lying down, a pink frothy cough or sudden weight gain, and call 999 for severe breathing difficulty, skin discolouration or loss of consciousness. The BHF adds that gasping for breath, choking or blue lips need 999.

The BHF also says to contact your doctor or NHS 111 if you are struggling to manage your condition at home.

The BHF says there is no cure for heart failure, but treatment can help manage symptoms and improve quality of life. The NHS says treatment and lifestyle changes can help keep heart failure stable for many years. Prognosis varies, and questions about life expectancy are best discussed with your own team.