• Your heart is a muscle that pumps the blood around your body, providing the other organs with oxygen and other nutrients needed to keep your cells working.
• The heart has two chambers: the right and left chambers. Blood enters the right side of the heart, which then pumps it out to the lungs, where the blood gets loaded with oxygen.
• Enriched with oxygen, the blood then enters the right side of the heart, and then gets pumped through the aorta (the main artery) to the rest of the body.
• There are four valves in the heart to ensure that this circular flow of blood continues efficiently, in the right direction.
• The diagram illustrates the various chambers of the heart, and the arrows show the direction of the blood flow.

Heart failure is when the heart becomes less effective at pumping blood around the body. The term ‘heart failure’ can sound quite frightening, so it might be helpful to think of it as: ‘My heart is failing to work as well as it should, and needs medicine to help it work better.’

Many people with heart failure can have a good quality of life. You can have some control over your condition by taking your medicines and by making changes to your lifestyle. And for some people, other types of treatment can help.

• Shortness of breath when you are resting or being active: Being short of breath is a common symptom of heart failure. It’s most likely to happen when you’re active or when you’re lying flat in bed. You may get a cough, too. Being short of breath may actually wake you up at night, and you may need to sit up, using pillows to support you.
• Swelling of your feet, legs, ankles, abdomen (tummy area), or in the small of your back: People with heart failure often have swelling (oedema) of their ankles and feet. This may extend to your legs and groin, and there may also be swelling of the abdomen, or in the small of your back.
• Fatigue (feeling unusually tired and weak): A common problem for people with heart failure is loss of energy and feeling unusually tired, either while you’re resting or after you’ve done only a small amount of activity. The tiredness can be quite overwhelming, making you feel that it’s very difficult to carry on as normal. How tired you feel can depend on how severe your heart failure is and how well your symptoms are controlled.

People can often manage the symptoms of heart failure effectively – and improve their quality of life – by making changes to their lifestyle. Making these changes and taking your medicines as prescribed can help to slow down the progression of your heart failure.

The following are some of the things that you can do:

• Weigh yourself regularly.
• Watch the amount of fluid you have each day.
• Control your blood pressure.
• Cut down on salt.
• Limit your alcohol.
• Keep to a healthy body weight.
• If you smoke, stop.
• Keep active.

A heart attack is when a part of the heart muscle suddenly loses its blood supply. This is usually due to coronary heart disease.

Risk factors

• Smoking
• High LDL, or "bad" cholesterol, and low HDL, or "good" cholesterol
• Uncontrolled high blood pressure
• Physical inactivity
• Obesity (having a BMI greater than 25)
• Uncontrolled diabetes
• High C-reactive protein
• Uncontrolled stress, depression, and anger

Here are some things you can do to reduce the risk of heart disease:

• Have a healthy, balanced diet
• Maintain a healthy weight
• Reduce the amount of salt you eat
• Manage your fluid balance
• Control your blood pressure
• Keep your alcohol intake to the recommended limit
• Stop smoking
• Keep active

Most people with heart failure can continue to work as long as they feel well enough. However, you might need to make some adjustments because of your symptoms or the degree of your heart failure. For example, you might need to work shorter hours, or if you have a very physical job, you may need to consider reducing the workload or changing your job.

Women with heart failure can have an increased risk of problems during pregnancy and it can make your condition worse. The risk will vary from person to person and it’s possible that you may be advised against becoming pregnant.

If you have heavy shopping or regularly lift heavy items, take someone with you to help carry your parcels. Pushing or pulling heavy items will also increase the workload of your heart. Try to keep the distance you need to move things to a minimum.

It is very important to protect yourself against colds, flu and lung infections because you may be at risk of developing complications related to your heart failure.

A holiday can give you the chance to unwind and rest. Talk to your doctor about whether it’s OK for you to go away. When you go on holiday, you might want to think about staying in accommodation that’s easily accessible. Avoid hilly destinations unless you’re fit enough for that level of activity. And it’s a good idea to avoid very hot or very cold destinations. If you travel away from home, take details of your medical history, a recent clinic letter if you have one and a list of medications.

Caring for someone who has heart failure can be very demanding – both physically and emotionally. Understanding the condition can help you deal with it. It’s important to allow the person you’re caring for to do things for themselves. This can be difficult, but allowing them to make their own decisions can help them feel in control. Talk to them about how you can help them. As the carer, you might be entitled to extra support, services and benefits, to help you care for the person you’re looking after.

It’s important that you look after your own health and have regular breaks. Don’t be afraid to ask for help, and accept help if people offer it. Remember that doctors, nurses, social workers, relatives, friends and voluntary groups can all support you. You may be able to arrange for someone to come into your home and take over caring for the person for a few hours, or sometimes overnight, so that you can have some time for yourself. Or, some homes can provide short-term care for the person you look after. Talk to your doctor, nurse or social worker about how to arrange this.

If things are difficult, you may find it helpful to talk things over with someone, such as a friend, another carer or a counsellor.

What to do if you think someone is having a heart attack

1. Send someone to call 1313 for an ambulance immediately.
   If you are alone, go and call 1313 immediately and then come straight back to the person.
2. Get the person to sit in a comfortable position, stay with them and keep them calm.
3. Give the person an adult aspirin tablet (300mg) to chew if one is easily available, unless they’re allergic to aspirin or they’ve been told not to take it.
   If you don’t have an aspirin next to you, or if you don’t know if the person is allergic to aspirin, just get them to stay resting until the ambulance arrives.

If someone has had a cardiac arrest, they will be unconscious, and either not breathing or not breathing normally. The person needs immediate help or they will die within minutes.

First check that it is safe to approach the person.

To find out if the person is conscious, gently shake him or her, and shout loudly, ‘Are you all right?’ If there is no response, the person is unconscious.

You will need to assess the person’s airway and breathing.

Open the person’s airway by tilting their head back and lifting their chin.

Look, listen and feel for signs of normal breathing. Only do this for up to ten seconds. Don’t confuse gasps with normal breathing. If you’re not sure if their breathing is normal, act as if it is not normal.

Now remember: Call Push Rescue

Call for help.

If the person is unconscious and is either not breathing or not breathing normally, they are in cardiac arrest.

Call 1313 immediately.

• Send someone else to call 1313 for an ambulance while you start CPR.
• Or, if you are alone with the person, call 1313 before you start CPR.

Push hard and fast on the centre of the chest.

Start chest compressions.

• Place the heel of one hand in the centre of the person’s chest.
• Place the heel of your other hand on top of your first hand and interlock your fingers.
• Press down firmly and smoothly on the chest 30 times, so that the chest is pressed down between five and six centimetres each time. Do this at a rate of about 100 to 120 times a minute. That’s about two each second.

Give rescue breaths.

After 30 compressions, open the airway again by tilting the head back and lifting the chin, and give two of your own breaths to the person. These are called rescue breaths.

To do this, pinch the soft parts of the person’s nose closed. Take a normal breath, make a seal around their mouth with your mouth, and then breathe out steadily. The person’s chest should rise and fall with each breath. It should take no more than five seconds to give the two rescue breaths.

Then give another 30 chest compressions and then two rescue breaths.

Keep doing the 30 chest compressions followed by two rescue breaths until:

• the ambulance crew arrives and takes over, or
• the person starts to show signs of regaining consciousness, such as coughing, opening their eyes, speaking, or moving purposefully and starts to breathe normally, or
• you become exhausted.

If you prefer not to give rescue breaths

If you’d rather not give rescue breaths, call 1313 and then deliver hands-only CPR. Keep doing the chest compressions – at a rate of about 100 to 120 times a minute.