Heart failure is a serious but manageable chronic condition in which the heart can’t pump blood efficiently. Heart failure often progresses over time, even with treatment. However, you can take steps to improve your quality of life when living with heart failure.
Members of MyHeartDiseaseTeam have discussed living with heart failure. One member wrote, “I have good days and bad days … I have a question for everyone: Does heart failure always progress? Will it get worse? Since I am in the beginning stages and am being treated, does that mean I will not progress to the next stage?”
The American College of Cardiology and American Heart Association developed a system that divides heart failure into four stages, from A to D, based on heart function — the higher the letter, the more severe the condition. Over time, you may progress from having normal heart function and heart failure risk (stage A) to experiencing severe changes in heart function (stage D). You only go forward through these stages, but you can remain at any stage for many years.
People in stage A have not yet been diagnosed with heart failure but have a high risk of developing this condition.
Your risk of developing heart failure is based on a family history of cardiomyopathy (heart disease) and your other medical conditions. Medical conditions that increase your risk of heart failure include:
If you have any of these conditions, take your prescribed medications and follow your doctor’s instructions to keep symptoms under control. You should also get regular screenings to check for high blood pressure, high cholesterol, and type 2 diabetes. Some medications, such as certain cancer drugs, also can damage the heart.
Smoking and heavy use of alcohol or drugs can increase your risk of heart failure, so get support to help you manage alcohol consumption or to quit smoking or use of other drugs.
Incorporate regular physical activity into your daily routine. The American Heart Association advises logging a weekly total of at least 150 minutes of moderate aerobic exercise (like walking at a brisk pace) or 75 minutes of vigorous aerobic activity (like running). Additionally, aim for two strength-training sessions that involve lifting weights or performing body-weight exercises.
Don’t worry if you can’t meet these goals immediately. Start with what you feel comfortable doing, and slowly increase your exercise.
You can also take charge of your heart failure risk by:
If you are taking steps to keep your disease from getting worse, stage A pre-heart failure does not change your life expectancy compared with the general population. Many people with increased risk of heart failure never go past this stage.
People in stage B heart failure have changes in their heart function but don’t yet experience symptoms of heart failure.
People are often unaware they are in stage B unless changes in their heart function are discovered by their doctor. Many people in stage B heart failure have an ejection fraction (EF) below 40 percent. EF is measured by an echocardiogram and describes how much blood your heart pumps out with each heartbeat. Other common changes to the heart that may be discovered by your doctor are:
Treatments for stage B heart failure aim to treat the underlying conditions affecting heart function and keep people symptom-free. Typical therapies for stage B heart failure include:
If you are taking steps to manage your risk of disease progression, stage B silent heart failure does not change your life expectancy, compared with the general population.
People in stage C have been diagnosed with heart failure and experience symptoms.
Common symptoms of stage C heart failure depend on your type of heart failure. People with left-sided heart failure typically experience:
People with right-sided heart failure typically experience:
An individual with heart failure could experience any combination of these symptoms, some of which may be caused by conditions other than heart failure.
Treatments for stage C heart failure aim to control symptoms and stop heart failure from progressing to stage D. People in stage C should continue the lifestyle changes from stage A and treatments from stage B based on what their doctor recommends.
Additional treatments for stage C heart failure include:
Even if treatments for stage C heart failure cause your symptoms to improve or stop, you still need to follow your regimen to slow further disease progression.
Although heart failure lowers life expectancy, you can still live for several years with stage C heart failure if you manage your condition with treatment. Specifically, one study found that 75 percent of people with stage C heart failure survived at least five years past their diagnosis.
People in stage D don’t respond to standard treatments (described above for earlier stages) and may experience symptoms, even while resting.
A person in stage D heart failure can experience any of the symptoms described in stage C, but the symptoms will be more severe and persistent.
At this stage, treatments are intended to give a person the best possible quality of life for as long as possible. You should speak with your health care team to decide on your priorities for treatment. Options for advanced heart failure include:
Stage D heart failure significantly reduces your life expectancy. The average life expectancy for people with stage D heart failure is less than five years, but there is still hope — 20 percent of people in this stage survive more than five years, according to a study published in the journal Circulation.
Always speak with your cardiologist about any worsening symptoms, and discuss all your concerns, questions, and treatment options. Heart disease is a serious condition, but it can be managed with medical treatment and lifestyle changes.
On MyHeartDiseaseTeam, a social network for people with heart disease and their loved ones, over 52,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.
Are you living with progressing chronic heart failure? What has your experience been like, and do you have any tips for others with heart failure? Share your experience in the comments below, or start a conversation by posting on your Activities page.