Can Heart Failure Get Better? Or Does It Only Get Worse?

By Dr Jodie-Ann Senior | Cardiologist & Heart Failure Specialist

Can heart failure get better, or does it only get worse? Every patient wants to ask this question. Some are afraid to. But it's better to confront this head on for most people. The answer is more hopeful than most people expect, and also more nuanced than a simple yes or no. This guide explains what “better” can mean, when the heart itself can recover, and why continuing treatment matters even when you feel well and even if it looks like your heart function might not improve.

Three kinds of “better”

What is ejection fraction?

Ejection fraction (EF) is the percentage of blood your heart ejects with each beat. It is not a score out of 100. A normal heart sits at around 55 to 65 percent. In some people with heart failure, with the right treatment, EF rises. When the improvement is large enough, doctors describe it as heart failure with improved ejection fraction.

The scaffolding picture

Think of your heart as a building that has been damaged. Your medications are the scaffolding. They are not the repair itself. They hold everything steady while the repair happens, and repair is usually measured in months, not weeks. Take the scaffolding down too early and the wall can fall. We want the walls to be supported.

Why you should not stop medications when you feel better

In a study in which people whose hearts had recovered had their heart failure medications carefully withdrawn under supervision, nearly half relapsed within six months. An improved heart is not a cured heart. It is a heart doing better because of treatment, and the medications are what hold that improvement in place. Never stop or reduce medications on your own. Discuss any change with your cardiologist.

Who is more likely to improve?

It depends a lot on the cause. Your cardiologist can tell you what is realistic for you.

This table is a general guide only. Individual outcomes vary, and some people stay stable or get worse over time even with good treatment. What you do, from taking your treatment to monitoring yourself and acting early, genuinely influences the direction.

Your EF is a snapshot, not a verdict

Your EF tells us how your heart was pumping on the day of the scan. It does not tell us how it will pump in six months, and it does not define who you are or what your life can look like.

The one question to ask

At your next appointment, ask: “Is there a chance my heart could improve, and what would we look for to know it's happening?” It turns a worry into a plan, and it tells your doctor you want to be part of the journey.

The bottom line

Heart failure is not a one-way street. It can get better, it can stay stable, and for some people it gets worse, but your choices matter. Keep your treatment going, keep monitoring, and keep asking questions.

Aligned with the NHFA/CSANZ 2018 Guidelines for the Prevention, Detection and Management of Heart Failure in Australia.

This article is general education and not a substitute for personal medical advice. Never stop or change medications without speaking to your doctor.

Heart Failure Help Now|drjodieannsenior.com|Dr Jodie-Ann Senior, Heart Failure Specialist