Heart failure

We received many questions after our webinar related to heart failure and so we’ve put together a list of the most frequently asked questions to provide you with further information on heart failure.

Why do I feel so tired?

Heart failure is a syndrome that affects the whole body and not just the heart. In response to an episode of heart failure your body goes into crisis mode, diverting blood from where it is not needed at that time i.e. the muscles in your arms and legs to the more crucial areas of your heart and brain. When you recover from the initial episode of fluid build-up your arteries are not as responsive as before. This will make you feel like you have very little ‘get up and go’. You will also be pushing against this resistance in your arteries during your daily activities meaning you will tire easily.

Yes, I do get tired when I am doing any activity but also feel specific fatigue in my muscles – what is this?

Vasoconstriction occurs during heart failure and is the narrowing of arteries to limit flow of blood to certain areas of the body including the muscles in your arms and legs as we previously discussed. Your body is trying to overcome this making your muscles fatigue quickly.

The second reason for specific muscle fatigue is the predominance of sprint fibres in your muscles. Sprint fibres are muscle fibres that activate quickly but then equally tire as quickly. Those with heart failure have been found to have a far greater number of sprint fibres in their muscles than those
with healthy hearts. This means you will be able to do an activity for a short period of time but then ‘hit a wall’ and become very tired.

Sometimes I get more breathless than I expect for a given activity even though I am not retaining fluid?

It is interesting that you feel like this and there is a solution. In our system we have an ergo reflex e which responds to increased waste products in your body. As we build up waste products in our body this reflex stimulates our breathing centre to increase our breath rate during periods of
increased activity to blow off carbon dioxide. As previously mentioned, you will have an increased number of sprint fibres in your muscles which leads to a build-up of waste products quickly. By strengthening your muscle and therefore reducing your waste products you will reduce your feelings of breathlessness.

No one seems to understand my level of tiredness?

Understanding the level of tiredness experienced by those with heart failure is hard to imagine for someone who is not going through it. When your tiredness hits you can explain to your family that it feels similar to hitting the wall at the 21 st mile during a marathon run. It is unshakable and profound.
Your family may never fully understand the level of tiredness you are going through, but it is important to put it into perspective for them.

What can I do to help myself?

Heart failure management is 50% medical treatment and 50% exercise training. Start off being generally more active in the house and increase your step count. Next, we recommend introducing some strength work to your regime. We have prepared a short video for you on some exercises that you can do at home where we recommend doing 10 reps of each exercise, 3 times daily, 5 days a week.

When you are generally more active with a step count of 5,000 or above you can start 10 minute bouts of walking and gradually build that up to 30 minute by adding 5 minutes per week.

For more specialist advice see your cardiac physiotherapist.