What is Heart Failure?

Definition

Heart failure occurs when your heart muscle is not able to pump enough blood to meet your body’s needs. As a result, you may feel tired, lack energy, experience shortness of breath and notice excess fluid collecting in your body.

SYMPTOMS OF HEART FAILURE

Heart failure is a progressive condition, meaning it will gradually worsen. At first you might not experience any symptoms, but over time your heart’s pumping ability will continue to weaken and you may experience some or all of the following symptoms:

• Chronic lack of energy
• Shortness of breath
• Swelling of feet and legs
• Swollen or tender abdomen with loss of appetite
• Difficulty sleeping at night due to breathing problems
• Increased urination at night
• Confusion and/or impaired memory
• Cough with frothy sputum

CAUSES OF HEART FAILURE

Heart failure usually develops slowly after an injury to the heart. There is no single cause, and sometimes the cause is unknown. Some of the most common causes of heart failure are:

• Previous heart attack (myocardial infarction)
• Coronary artery disease
• High blood pressure (hypertension)
• Heart valve disease
• Infection of the heart (myocarditis)
• Congenital heart disease (condition you were born with)
• Endocarditis (infection of the heart’s inner lining)
• Diabetes (the body does not produce or properly use insulin)

RISK FACTORS

Some people are more likely than others to develop heart failure. No one can predict for certain who will develop it. Being aware of the risk factors and seeing a doctor for early treatment are good strategies for managing heart failure. Heart failure risk factors include:

• High blood pressure (hypertension)
• Heart attack (myocardial infarction)
• Abnormal heart valves
• Enlargement of the heart (cardiomyopathy)
• Family history of heart disease
• Diabetes

Diagnosis

Only your doctor can tell if you have heart failure and how far the condition has progressed. Your doctor will review your medical history, including past and present illnesses, family history, and lifestyle. As part of your physical examination, your doctor will check your heart, lungs, abdomen, and legs to see if signs of heart failure are present.

To rule out or confirm the diagnosis of heart failure, your doctor may order one or several of these diagnostic tests:

• Echocardiogram
• Electrocardiogram (ECG)
• Chest x-ray
• Exercise test (stress test)
• Cardiac catheterization

If you have heart failure, your doctor may also track your ejection fraction over time. Ejection fraction is the percentage of blood that is pumped out of the heart during each beat. It's a key indicator of your heart's health and doctors frequently use it to determine how well your heart is functioning as a pump.

Watch the animation and download the infographic to learn more about heart failure

TREATING HEART FAILURE

Heart failure is a progressive condition. Your doctor may prescribe a variety of treatment options that may slow the progression of the disease, strengthen your heart and improve your quality of life. Some of these treatments may include medications, lifestyle changes, exercise, device therapy or a combination of these.

LIFESTYLE CHANGES

Your doctor may recommend lifestyle changes such as quitting smoking, limiting your sodium intake, losing weight, or reducing your stress level. These changes can help relieve some of the symptoms associated with heart failure and reduce strain on your heart.

HEART MEDICATIONS

Many types of medications are being used to manage Heart Failure and are usually prescribed simultaneously and combined – sometimes even in the same pill. Your doctor may prescribe medications that lower your blood pressure (e.g. angiotensin converting enzyme, angiotensin II receptor or neprilysin inhibitors) or slow down your heart rate (e.g. beta blockers). Some of these medications may also have additional protective effects like dilating the vessels of your body to reduce the amount of resistance your heart needs to overcome. Diuretics are also commonly used since they reduce the amount of water your heart need to move at every cycle. Finally, medications that make each muscle contraction stronger (e.g. catecholamines like dobutamine) are also used but usually reserved for later stages of disease because they are commonly administered intravenously.

Many kinds of medications are used for treating heart failure. Your doctor may prescribe ACE inhibitors, beta-blockers, blood thinners, and diuretics, among others. In general, a combination of heart medications is typically used.

CARDIAC RESYNCHRONIsATION THERAPY

In some people with heart failure, the lower chambers of the heart don't beat at the same time, forcing the heart to work harder. These people may benefit from cardiac resynchronization therapy (CRT), which is an implantable heart device, like a pacemaker.

CRT is a clinically proven treatment option for some individuals with heart failure. It sends small electrical impulses to both lower chambers of the heart to help them beat together in a more synchronized pattern. This may improve the heart’s ability to pump blood and oxygen to your body.

HEART SURGERY

If your heart failure is caused or made worse by a weak valve, your doctor may consider heart surgery to repair or replace the valve. If your heart failure is serious and irreversible, heart transplant surgery may be considered.

Talk to your doctor about which treatment options are right for you.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.