Can You Reverse Heart Failure? In Some Cases, Yes

If you have heart failure, it means that your heart has trouble pumping blood to the rest of your body. It’s a common problem that affects over 6 million people in the U.S. One in four people will eventually get heart failure. But with modern day treatments, people can still live long and healthy lives with the condition.

Some forms of heart failure are more likely to get better than others. In most cases, medical treatment and lifestyle changes can improve symptoms. And sometimes, the heart can recover. We’ll discuss the ways that heart failure can be slowed down, improved, and even reversed.

What causes heart failure?

There are many different causes of heart failure. Each cause can affect the heart a little differently. 

Some causes impact the left side of the heart, which is the part that pumps blood to the rest of the body. Common causes of left-sided heart failure include:

• Heart attacks and blocked heart arteries

• Uncontrolled high blood pressure

• Viral infections that attack the heart (myocarditis)

• Excessive alcohol use

• Drug and/or cannabis use

• Damaged heart valves

• Certain birth defects of the heart, also known as congenital heart disease

• Increased body weight

• Sleep apnea

• Certain genetic conditions

• Some electrical abnormalities of the heart, including left bundle branch block

• Pregnancy (in rare cases)

The right side of the heart, which pumps blood to the lungs, can also be affected by heart failure. Long-term left-sided heart failure can sometimes lead to right-sided failure. Other causes of right-sided heart failure include:

• Chronic obstructive pulmonary disease (COPD) and emphysema

• Blood clots in the lungs (pulmonary embolism)

• Sleep apnea

• Pulmonary hypertension

• Some forms of congenital heart disease

• Some genetic conditions

Given the variety of causes, it’s probably not surprising that each type of heart failure responds differently to treatment.

Can heart failure be reversed?

It depends. Because there are so many different causes of heart failure, there’s not a simple answer to this question. Sometimes heart failure can be reversed. But for many people, their heart function will never return to normal. 

It’s common for heart failure to reverse with medical treatment. This doesn’t mean the heart has fully recovered. In other words, the heart can regain its strength and start to pump normally again — as long as someone follows their treatment plan. For example, if you have a heart attack that damages the heart, your heart muscle may always have a scar. But often your heart’s function will improve with medication, a healthy lifestyle, and cardiac rehabilitation.

Other times, the problem may require surgery or a pacemaker. Regardless of the cause, the best chances for improvement in heart function are within the first 18 months of treatment. That’s one reason why it’s important to start treatment as early as possible. 

If you have heart failure, stopping medication can cause heart failure to reappear. So, it’s likely you will always need medication to prevent the problem from coming back or getting worse.

How long can you live with heart failure?

It depends on several factors, including your age, other medical conditions, and the cause of your heart failure. For example, people over age 65 who have heart failure tend to have more problems than younger people. 

Treatment also makes a big difference for prognosis. Over the last few decades, the treatment options for heart failure have improved dramatically. In the 1970s, less than 30% of people with heart failure lived more than 5 years. This number doubled in the following decades. 

But researchers have recently noted an increase in mortality rates for people with heart failure over the last several years. This could be due to many factors, such as the pandemic and longer survival with conditions that lead to heart failure.

Heart healthy lifestyle changes

Even if your heart failure isn’t fully reversible, there are ways to improve your symptoms. You can also take steps to prevent your heart failure from getting worse. 

To improve your chances of doing well, here are important things that you can do:

• Medication: Most people with heart failure will be on several medications. These are usually prescribed by your cardiologist (heart specialist).

• Exercise: Cardiac rehabilitation can help strengthen and improve your heart function. Regular exercise is important for most people with heart failure. But it’s important to check with your cardiologist before starting a new exercise program.

• Diet: A heart-healthy diet, like the Mediterranean or DASH diet, can help keep your heart healthier. These diets include plenty of plant-based foods, healthy fats from olive oil and fatty fish, and limit processed foods. Keeping salt intake to a minimum will also help.

• Sleep: Good quality sleep is important for a healthy heart. If you snore heavily, have episodes of paused breathing at night, or have daytime sleepiness, it’s important to get tested for sleep apnea. This can contribute to heart failure. Treating it can make a difference. 

• Body weight: Increased weight can cause or contribute to heart failure. If you’re trying to lose weight, your healthcare professional can help.

• Avoid tobacco smoke: Smoking (and secondhand smoke) can contribute to right-sided heart failure by causing COPD and emphysema. It’ll also raise your risk for coronary heart disease and left-sided heart failure. Your primary care professional can help you quit.

• Get your vaccinations: Heart failure often gets worse when you get sick with an infection. So, it’s important to stay up to date with your vaccinations.

• Limit alcohol: Excessive alcohol use can cause heart failure for some people. Keep alcohol intake to one drink every other day, or less.

• Avoid drug use: Cocaine, amphetamines, cannabis, and other personal drugs can all be harmful to your heart.

This long list may feel overwhelming. Remember that you don’t need to make all of these changes at once. And your primary care provider and/or cardiologist can help. If you’re struggling with the financial, logistical, or emotional aspects of heart failure, be sure to let someone know. Help is available.

When does heart failure become terminal?

Heart failure can often be successfully treated. But it can also worsen. If someone’s treatment is not working and they’re frequently in the hospital, these can be signs of end-stage heart failure. This can make it hard to function in daily life. But there are other treatment options besides the usual medications. 

These can include: 

• A permanent intravenous (IV) line to deliver medications directly into your veins 

• A device called a left ventricular assist device (LVAD), which is a mechanical pump that takes over some of the work of your heart 

• A heart transplant for certain people

Your cardiologist and their care team can work with you to determine the best way(s) to manage your symptoms and daily function. 

There are many things that people and their healthcare professionals can do to improve heart failure. But sometimes it progresses despite treatment, and there may be nothing more that can be done. In these cases, comfort measures and hospice care are often the best choices.

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Written by:

Sarah A. Samaan, MD

Sarah Samaan, MD, FACC, FACP, FASE is a board-certified cardiologist who practiced clinical cardiology for nearly 30 years. She is a member of the American College of Cardiology, the American College of Physicians, and the American Society of Echocardiography.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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