What is heart failure?

Heart failure is a condition in which the heart is unable to pump enough blood to keep up with the body’s needs. It’s a chronic condition that can worsen over time.

The heart pumps blood through the body with each heartbeat. During this process, it relaxes and fills with blood, then contracts and pumps the blood out of the heart. The left ventricle, one of the heart’s four chambers, receives oxygen-rich blood from the lungs and pumps it to other parts of your body through arteries.

With heart failure, the weakened heart muscle has trouble pumping enough blood for your body’s needs. You may feel tired and short of breath, especially when you’re active or doing something that makes you breathe faster and harder than usual, such as climbing stairs or walking quickly.

Heart failure may be caused by coronary artery disease (CAD), high blood pressure (hypertension), abnormal heart valve function or damage from a heart attack or other chest injury. In some cases, no cause is found (idiopathic). Risk factors include age older than 65 years; diabetes; high cholesterol levels; high blood pressure; high triglyceride levels in your blood; cigarette smoking; obesity; family history of heart disease (especially if it occurs early in life).

How common is heart failure?

Heart failure is one of the most common heart problems. It occurs when the heart muscle can’t pump blood as well as it should. It’s not a specific disease but rather a collection of symptoms caused by different heart conditions.

Heart failure can make you feel tired, short of breath and like your heart is beating too fast. Over time, it may cause other problems such as swelling in the legs or feet.

According to the American Heart Association (AHA), about 5 million Americans have heart failure. The condition becomes more common with age, affecting about 500,000 people over age 65 and about 1 million people over age 85.

What are the types of heart failure?

Left-sided heart failure is a condition in which the left side of your heart — the chamber that receives blood from the veins and pumps it into the arteries — can’t do its job properly. As a result, fluid backs up into your lungs or other parts of the body. This may cause shortness of breath, fatigue and swelling in your ankles and legs.

Right-sided heart failure is a condition in which the right side of your heart — the chamber that sends blood out to be oxygenated by your lungs — fails to pump enough blood through your lungs so that it can be oxygenated. This usually results from damage to the upper half of your heart (atria) or lower half (ventricles).

What is congestive heart failure?

Congestive heart failure (CHF) is a condition in which the heart’s pumping ability is inadequate to maintain an adequate blood supply to meet the body’s needs. It includes such diverse conditions as cardiac insufficiency, dyspnea, pulmonary edema and venous backflow from congested lungs.

The term “congestive” refers to a build-up of fluid in the body’s tissues. The most common cause of congestive heart failure is a weakening of the heart muscle. When this happens, the heart cannot pump blood as effectively as it should. The weakened heart also doesn’t relax between beats as well as it should, which can cause shortness of breath when you are active.

Other causes of congestive heart failure include:

• Coronary artery disease
• High blood pressure (hypertension)
• High cholesterol levels (hypercholesterolemia)

What are the complications of heart failure?

-Pulmonary edema. Pulmonary edema occurs when the heart can’t pump enough blood to meet the body’s needs. Blood backs up into the lungs, causing them to fill with fluid. This can cause breathlessness and chest pain.

-Heart failure. Heart failure is a condition where your heart can’t pump enough blood to meet your body’s needs. It usually happens because of damage to the heart muscle or valves caused by a heart attack, high blood pressure, or other conditions that affect how your heart works.

-Heart attack (myocardial infarction). A heart attack occurs when your coronary arteries become blocked and cut off all or part of your heart’s blood supply, bringing oxygen-rich blood to parts of your heart muscle that need it most.

What are the heart failure stages?

Stage 1: Mildly reduced pumping ability of the heart that may be caused by coronary artery disease (CAD), high blood pressure, or other factors.

Stage 2: Moderately reduced pumping ability of the heart that may be caused by CAD, high blood pressure, or other factors.

Stage 3: Severely reduced pumping ability of the heart that may be caused by CAD, high blood pressure, or other factors.

Stage 4: Very severe reduction in pumping ability of the heart as a result of CAD or other factors leading to severely decreased cardiac output (CO) that may lead to cardiogenic shock and death if not treated promptly; sometimes referred to as end-stage heart failure or end-stage cardiomyopathy.

What are the symptoms of heart failure?

The symptoms of heart failure can vary from person to person and may develop slowly over time. The most common symptoms of heart failure include:

• Shortness of breath (dyspnea) with activity, especially lying flat in bed at night
• Fatigue or tiredness
• Coughing up blood (hemoptysis)
• Leg swelling (edema), especially in the ankles and feet
• Rapid weight gain from fluid retention
• Chest pain when exercising, also known as angina

What causes heart failure (congestive heart failure)?

Congestive heart failure (CHF) is the end stage of a variety of cardiovascular diseases. The heart muscle may fail to relax properly, so that blood is not pumped efficiently through the body, or the heart may fail to pump enough blood to meet the body’s needs. This results in fluid backup (congestion) in the lungs and other parts of the body, leading to shortness of breath, dizziness and fatigue.

CHF is caused by damage to the heart muscle from a variety of causes:

• Coronary artery disease
• Heart attack
• High blood pressure that damages the heart muscle
• Valve problems (especially mitral valve prolapse)

Heart Failure Diagnosis

Heart failure is diagnosed by several methods:

1. Physical exam
2. Laboratory tests
3. Imaging tests

What types of tests are used to diagnose heart failure?

Blood tests. Blood tests can show the protein level in your blood, which may indicate heart failure.

Electrocardiogram (ECG or EKG). An ECG shows how fast your heart is beating and whether it’s in a normal rhythm. It also measures how well your heart muscle is working by checking for signs of damage from a heart attack or other conditions.

Chest X-ray. This test uses small amounts of radiation to produce images of internal tissues, bones, and organs onto film or a computer screen. An X-ray technician takes the pictures while you hold your breath and keep still for just a few seconds. You may be asked when you last ate before the test to avoid getting an image that would be blurry because food was in your esophagus during the X-ray procedure.

Exercise stress test (also called exercise tolerance test). During this test, you walk on a treadmill while attached to monitors that measure your heart rate and blood pressure during exercise. The test measures how much oxygen gets into your blood while exercising at various speeds and inclines until you reach exhaustion or near exhaustion (the point when you can’t continue anymore).

How is heart failure treated?

Lifestyle changes

Heart failure can be treated with diet and exercise. Heart failure is often associated with obesity, so losing weight can improve symptoms. Losing weight can also help prevent complications from heart failure, such as diabetes or high blood pressure.

Medications

Aspirin or clopidogrel (Plavix) reduce the risk of heart attack or stroke related to heart failure. ACE inhibitors (such as lisinopril) and beta blockers (such as metoprolol) are used to treat high blood pressure and reduce symptoms of heart failure. Diuretics (water pills) help the body get rid of extra fluid that builds up in the lungs and other organs due to poor circulation. In severe cases, diuretics may be used along with ACE inhibitors or beta blockers to control fluid retention.

How can I prevent heart failure?

The good news is that you may be able to prevent heart failure with healthy lifestyle choices. Here are some tips for preventing heart failure:

Eat a healthy diet low in saturated fat. Limiting your intake of saturated fat may help reduce your risk of developing heart disease. Saturated fats include foods like red meat, butter, cheese and fried foods such as chips and French fries. Instead, try eating more fruits, vegetables and whole grains.

Maintain a healthy weight. Being overweight can increase your risk of developing heart disease and high blood pressure — two leading contributors to heart failure. If you’re overweight or obese, talk with your doctor about ways to lose weight safely through exercise or changing your diet.

Exercise regularly. Physical activity helps strengthen the muscles of your body — especially those used during exercise (like your arms) — which improves blood flow through your body while lowering stress levels.