Main symptoms
- •Shortness of breath on exertion then at rest
- •Orthopnoea (difficulty breathing while lying down)
- •Lower-limb oedema
- •Chronic fatigue
- •Palpitations
- •Night cough
- •Rapid weight gain (fluid retention)
- •Reduced exercise capacity
Risk factors
- ⚠️ Hypertension (#1 cause in Morocco)
- ⚠️ Coronary disease, previous heart attack
- ⚠️ Diabetes
- ⚠️ Valvular disease
- ⚠️ Cardiomyopathies
- ⚠️ Age over 65
- ⚠️ Smoking, alcoholism
- ⚠️ Obesity
Management and treatments
**First-line drugs**: ACE inhibitors (ramipril, enalapril) or ARBs (losartan), beta-blockers (bisoprolol, carvedilol), diuretics (furosemide), aldosterone antagonists (spironolactone). **New treatments**: ARNI (sacubitril/valsartan — Entresto), **gliflozins** (dapagliflozin, empagliflozin) effective even without diabetes. Available in Morocco, ALD 100% reimbursed. **Severe cases**: cardiac resynchronisation pacemaker, defibrillator, heart transplant (developing in Morocco). ALD recognition.
Prevention
Control of BP (< 140/90), cholesterol, diabetes, stop smoking, 150 min/week of physical activity, low-salt diet (< 5 g/day), healthy weight, stress management, early treatment of coronary disease.
Frequently asked questions
Is heart failure reversible?+
Not fully but stabilisable with optimal treatment. Some causes (hypertension, corrected valvular disease) can significantly improve cardiac function.
Can you exercise?+
Yes, and recommended — appropriate activity improves prognosis. Supervised cardiac rehab programmes in CHUs. Avoid unsupervised intense sports.
Heart failure = imminent death?+
No — a technical medical term. With modern treatment, median survival > 10 years for non-end-stage disease. Vigilance and adherence are essential.
Can I take ibuprofen?+
NO — NSAIDs (ibuprofen, diclofenac) worsen heart failure (water/sodium retention, kidney impairment). Paracetamol preferred.