Denis Collen felt like a "slow puncture" was ruining his lungs...
It started in January 2010, when the Englishman just couldn't seem to shake a pesky chest infection despite three rounds of antibiotics.
Three months later, Collen knew he had to go back to the doctor... He could barely walk. His feet and ankles had ballooned so badly that he couldn't even squeeze on his shoes.
At the doctor's, he got the shocking news: he had heart failure.
As he shared with the British Heart Foundation, "The way I describe the onset of heart failure is like you've got a slow puncture. It happened to me gradually and crept up on me."
The term "heart failure" is terrifying. But, contrary to what many folks think, it doesn't mean that your heart has completely stopped working.
Rather, it means that your heart isn't working as well as it should. And as a result, it's working harder to pump blood throughout your body and could use some support to work better.
Heart failure can afflict folks at any age. Like Collen's experience, some of the symptoms are subtle, so many people living with heart failure aren't even aware that they have it.
It's an incredibly common condition – and a growing problem in the U.S.
According to the American Heart Association, about 6.7 million adults aged 20 and over are living with this condition. And that number is expected to hit more than 8 million in just five years.
And in 2020, nearly 700,000 people died from heart disease. Heart failure is responsible for 1 in every 8 deaths. Plus, it's the No. 1 cause of hospitalization for folks aged 65 and older.
When your heart is not working well, any of three main types of heart failure can manifest: right-sided (or right ventricular), left-sided (or left ventricular), and congestive heart failure.
There are also four different stages of heart failure, based on the severity of the condition:
Class 1 – You don't experience any symptoms during normal physical activity.
Class 2 – You're comfortable while resting, but your normal physical activity triggers symptoms.
Class 3 – You're comfortable when at rest, but minor physical activity triggers symptoms.
Class 4 – You're unable to carry out any physical activity without discomfort and may even experience symptoms while resting.
The symptoms of heart failure can develop either quickly or gradually, depending on the cause of the problem. Common signals include:
- Swelling, especially in the feet, ankles, or abdomen
- Unexplained weight gain
- Shortness of breath
- Coughing
- Fatigue
- Nausea
- Confusion
Sometimes, folks who have shortness of breath, coughing, or fatigue don't know that these are signs of heart failure. These warning signs get overlooked because many just associate them with getting older or other nonthreatening issues, like a cold.
The bottom line is, if you start feeling unusual, like you're not yourself, talk to your health care provider about getting checked for heart failure.
Some of the risk factors for heart failure include having had a heart attack in the past, high cholesterol, and diabetes. Clogged arteries, high blood pressure, and an irregular heartbeat can also lead to heart failure.
Here's the good news... Despite its scary name, heart failure isn't necessarily a death sentence.
After the diagnosis, Collen "went into survival mode"... He started eating healthier and exercising. Six weeks later, his heart function began improving. Fast-forward to today, he's helping to lead a community exercise program and enjoying cycling (my favorite high-intensity workout). The now-60-year-old Collen shared his heart-failure story recently in April, too.
If you stay vigilant when it comes to your heart health and take the right precautions, you can live in good health for years and years even after being diagnosed with this catastrophic-sounding condition.
Aside from sticking with your appointments, recommended dietary changes, and prescribed medications, I encourage you to get moving every day.
Exercise strengthens your heart muscle. However, don't forget about the severity of your condition. Talk with your health care team about the best ways for you to get your body moving every day. You need to move, but you also need to do it safely. And that means you must listen to your body.
Otherwise, some of the best exercises to help strengthen your heart are aerobic activities. So go walking, ride a bike, swim, row, or take water aerobics.
One University of Michigan Medical School study showed that patients with systolic heart failure who engaged in moderate levels of exercise – like walking – reduced their risk of being hospitalized for heart failure or dying due to heart problems by 65%.
But "gentler" ways of exercising also wield some mighty benefits...
I'm talking about combining physical activity with meditation – namely, mindfulness.
Mindfulness is basically noticing – and being curious about – what's happening to you right this moment. You're aware of what's going on inside and around you.
If that sounds like nonsense, well, medical researchers are fully on board with the power of mindfulness. Studies have shown it can...
- Make you physically healthier in general
- Help manage pain
- Help treat smoking and substance misuse
- Lower the likelihood of relapse in those suffering from major depression
- Decrease depression, anxiety, and, of course, stress
The key is to not judge whatever emotions are running through you.
Again, you're simply noticing what's going through your head and not reacting. In other words, you're directing your attention to and accepting what's happening in the present – like your breathing and feelings running through you.
Mindfulness means that when you're faced with a stressor, you can have more flexibility and creativity with coping strategies so you feel more in control of a tough situation like heart failure.
Now, circling back to walking... longtime readers know that a daily staple of mine is getting in a 20- to 30-minute walk.
And if it just so happens that I'm in a quiet area, I love bringing in the power of mindfulness. I turn my brisk powerwalk to a slightly slower stroll and start tuning inwards... I focus on my breaths and the sensation of taking each step in different parts of my body.
As it turns out, this kind of "mindful walking" is great for folks living with heart failure...
Published last month in the Frontiers in Cardiovascular Medicine, a small study of 86 adults with atrial fibrillation and chronic heart failure split into two groups, where both groups had routine cardiac rehabilitation aftercare which included exercising (like walking or tai chi) based on their condition but with no specific requirements for how long and how intensely they should exercise.
However, one group added mindful walking. After 24 weeks, that group significantly improved their self-reported anxiety and depression scores, compared with the control group. And the mindful walkers also had better measures of heart fitness and even grip and muscle strength.
Here's a little look at what the mindful-walking group did...
- Find a quiet path, if possible.
- Look forward as you start walking, with your hands swinging naturally (or held behind your back).
- Keep a natural pace – don't try to walk faster or slower.
- Focus on every movement and sensation without judgment. For example, you'd focus on the feeling of lifting the foot, having your foot in the air, and landing the foot.
- Pause every 10 to 15 steps. (There's no time limit for each pause – you can decide how long you want to pause.)
- If your mind starts wandering, gently bring your attention back to the sensations and movements.
Want to mix things up a bit? Yoga and tai chi are also great ways to move mindfully for your heart health. Both exercises have you focusing on and being aware of your breathing and sensations in the present moment as you move your body slowly, but deliberately.
Tai chi is often referred to as "meditation in motion" or "moving meditation." A 2022 study found that practicing 24 weeks of tai chi significantly improved the functional health of a group of people with coronary heart disease.
Whichever one you try – mindful walking, yoga, or tai chi – you're getting in some practice on tuning in and patiently listening to your body to better support your heart health.
P.S. If you or your loved one is dealing with heart failure, share what has worked – or hasn't worked... Shoot us a message at feedback@healthandwealthbulletin.com. For more on heart failure, check out this issue of Retirement Millionaire. Not a subscriber? Why not give it a whirl?
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Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
July 10, 2025