DR Zak speaks about spotting the signs of heart failure.

Heart Failure. What an awful terminology.

Yet thanks to charity Pumping Marvellous, with their catchy radio advert, is hoped that this will change and that individuals will be able to recognise the symptoms of heart failure (HF) as easily as they would a stroke.

The formula is beautifully simple. B stands for breathlessness, E for exhaustion, A; ankle swelling and T; time to test or indeed time to seek medical advice.

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The initial test for heart failure is a blood test which measures a single chemical, variously referred to as BNP, pro-BNP, or brain-natriuretic peptide to give it its full name.

This BEAT acronym is not only suitable for recognising undiagnosed heart failure, but also identifying those with established disease which has worsened or needs further treatment.

For heart failure, with its confusing name, is not where the heart stops beating completely.

This is cardiac arrest. In HF, the heart beats less effectively over time, due to a variety of conditions.

Some of these are inevitable. The older you get, the more likely you are to develop heart failure, in the same way a car engine may wear out at higher miles.

Yet it may be surprising to know that heart failure is on the rise in the younger age group.

Again, some risk factors cannot be prevented. Those with congenital heart disease are at higher risk of developing HF, with those suffering more complex congenital heart disease at higher chance.

However, recreational substance use, especially cocaine and methamphetamines, is leading to a rise in diagnoses of heart failure in people under the age of 40.

Worryingly, binge drinking has a similar effect. Alcohol is a toxin, which directly affects the heart muscle.

Apart from the above, the main causes of heart failure, that affect many people, are undiagnosed and untreated high blood pressure and raised cholesterol.

High blood pressure puts a strain on the heart muscle which thickens in response. Though it can cope for a while, it eventually stretches past the point of no return, like an elastic band.

At this point it becomes baggy, and cannot pump with the same force.

Similarly high cholesterol narrows the coronary arteries which supply the heart muscle itself.

This starves the heart of blood so it cannot pump as effectively. Severe blockages may lead to a heart attack, with acute heart failure as a result.

Although this sounds like doom and gloom, the important message is that although aging is inevitable, heart failure may not be.

A healthy lifestyle and attending regular check ups may identify your risk factors and prevent heart failure ever developing in the first place.

A very observant American cardiologist has produced a memorable mnemonic for reducing your chance of heart failure.

A is for activity – aim for 30 minutes of mild to moderate cardiovascular exercise, three to five times a week. B is for blood pressure – this needs to be controlled.

Some experts are now advising that we aim for numbers even lower than those currently advised, to reduce strain on the heart muscle.

C is for cholesterol and cigarettes. Cholesterol needs to be controlled to reduce the risk of heart blood vessel narrowing, and if you smoke, please seek help to stop.

D is for diabetes. Good diabetic control goes a long way to lowering the risk of many other conditions, heart failure included.

Treatment of heart failure is based on addressing the underlying cause. Though for a long time seen as the poor relation in cardiology, with many specialists seeing it as potentially thankless, it now has its own niche.

Once identified, many of the treatments for HF can be commenced by your GP. Referral to a specialist is for investigations that will look at the structure of the heart and its valves (echocardiography) and potentially to look at the coronary arteries (angiography).

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It would be hard to finish any article on heart failure without an honest explanation of prognosis.

For those with severe heart failure, particularly if it is frequently unstable or not controlled, the outlook is as bad as for some forms of cancer, and it is not unusual for HF patients to need palliative care.

However, if identified in a timely manner, it may remain stable, or indeed reverse to a degree, giving the person a good quality of life for many years.