What Is Heart Failure? (original) (raw)

Heart failure occurs when your heart is unable to pump an adequate supply of blood to the body. It may require ongoing treatment to keep your body’s major functions working properly.

Approximately 6.2 million people have heart failure in the United States, according to the Centers for Disease Control and Prevention (CDC).

Heart failure often happens when there is a problem with the ventricles, which are two chambers located in the lower part of your heart. They’re responsible for pumping blood out of your heart.

Heart failure can be classified by the side of the heart that’s affected (left or right). Both sides are often affected.

Congestive heart failure (CHF) is sometimes used synonymously with heart failure since the symptoms of both right- and left-sided heart failure include congestion.

In right-sided heart failure, there is congestion with fluid buildup in the abdomen and lower extremities. In left-sided heart failure, fluid builds up in the lungs.

Heart failure is a serious health condition that requires immediate medical treatment. Early treatment decreases your risk of complications over time.

The most common symptoms of heart failure include:

• Shortness of breath: This is more common during activities. However, it may occur when you’re resting or come on suddenly at night.
• Fatigue: You may feel tired all the time, especially during daily activities like walking, shopping, or getting up.
• Edema (swelling): You may experience a fluid buildup in your body, especially in the legs, feet, and ankles.
• Feeling faint, weak, or lightheaded: Because the heart cannot pump enough blood to all your body’s tissues, it prioritizes blood supply to your heart and brain, which can leave your body feeling tired.

Other symptoms of heart failure may include:

• sudden weight gain
• a loss of appetite
• bloating
• confusion, memory loss, or impaired thinking
• persistent coughing
• heart palpitations
• abdominal swelling
• protruding neck veins

Heart failure is a chronic condition. This type of condition requires ongoing, lifelong management.

However, you may experience acute heart failure, which is when symptoms come on suddenly. This is sometimes referred to as heart failure exacerbation or flares.

It may happen as an initial symptom when heart failure is diagnosed for the first time. Or, it may happen on top of chronic heart failure when your symptoms worsen.

Since heart failure may affect either side of the heart, the types of heart failure are right-sided heart failure and left-sided heart failure. Both types lead to the activation of hormones and the nervous system, which causes the body to retain fluid, leading to symptoms of congestion.

Left-sided heart failure

Left-sided heart failure occurs when the left ventricle in the bottom left of your heart doesn’t pump blood out efficiently. Heart failure in this ventricle prevents your body from getting enough oxygen-rich blood.

There are two types of left-sided heart failure:

• Systolic: This occurs when the heart muscle weakens and loses its ability to contract. A weaker left ventricle cannot generate enough force to pump oxygen-rich blood through the body. This may cause blood to back up into your lungs, leading to fluid buildup. This is known as congestive heart failure.
• Diastolic: This occurs when the heart muscle stiffens and impairs the heart’s ability to relax. It prevents your heart from filling with enough oxygenated blood, resulting in less efficient blood flow to the body.

Systolic heart failure is more common in males. Diastolic heart failure is more common in females.

Right-sided heart failure

The right ventricle is located in the bottom right side of your heart. It’s responsible for pumping blood to your lungs to collect oxygen.

Left-sided heart failure usually triggers right-sided heart failure. The accumulation of blood in the lungs makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail.

Heart failure happens when your heart muscle gets weak or stiff. This may then block or reduce blood flow to the heart.

The most common cause of heart failure is coronary artery disease (CAD). It happens when fatty deposits build up in your arteries, reducing the supply of blood and oxygen to the heart.

Other conditions that may increase your risk of developing heart failure include:

• heart attack
• inherited heart disease
• a condition that weakens the heart muscle, like cardiomyopathy
• heart inflammation, like myocarditis
• high blood pressure, also called hypertension
• arrhythmia, which is an irregular heart rhythm
• viral infection
• congenital heart disease
• diabetes
• obesity
• pressure in your lungs, called pulmonary hypertension
• overactive thyroid, also known as hyperthyroidism

Certain behaviors may also increase your risk of developing heart failure, including:

• smoking
• drinking alcohol
• eating foods high in fat or cholesterol
• not getting enough physical activity

A will doctor start by performing a physical exam and assessing your medical history to check for signs of heart failure.

They may also use an echocardiogram. This test is the most effective way to diagnose heart failure. It uses sound waves to create detailed pictures of your heart. An echocardiogram can help a doctor evaluate the damage to your heart and how it’s functioning.

Other tests to help diagnose heart failure or its underlying causes include:

• chest X-ray
• heart MRI
• nuclear scan
• cardiac catheterization
• coronary angiogram
• stress test
• Holter monitoring
• BNP blood test

Treating heart failure depends on the severity of your condition and the type of heart failure you have.

Early treatment can improve symptoms fairly quickly. However, you should still get regular testing and follow up with a healthcare professional at least every 6 months.

The main goal of treatment is to increase your life span, prevent complications, and improve your quality of life.

Medication

Medications may treat early stages of heart failure. They can help relieve your symptoms and prevent your condition from worsening.

Certain medications are prescribed to:

• improve your heart’s ability to pump blood
• reduce blood clots
• reduce your heart rate when necessary
• remove excess sodium and replenish potassium levels
• reduce cholesterol levels
• reduce adverse hormones and reactions that occur in your body that can make the heart weaker

These medications can include:

• angiotensin-converting enzyme (ACE) inhibitors
• angiotensin II receptor blockers (ARBs)
• angiotensin receptor-neprilysin inhibitors (ARNIs)
• beta-blockers
• mineralocorticoid receptor antagonists
• sodium-glucose cotransporter-2 (SGLT2) inhibitors
• nitrates
• hydralazine
• ivabradine
• Verquvo (vericiguat)
• cholesterol-lowering medications
• blood thinners

Speak with a doctor before taking new medications. People with heart failure should avoid some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin). These can worsen fluid retention in heart failure.

Surgery

You may require surgery if you have heart failure. Options include:

• Bypass surgery: A surgeon takes a healthy piece of an artery or vein and attaches it to the blocked coronary artery. This allows the blood to bypass the blocked, damaged artery and flow through the new one.
• Percutaneous coronary intervention (PCI): A catheter with a small balloon attached to it is inserted into the blocked or narrowed artery. When it reaches the damaged artery, a surgeon inflates the balloon to open the artery.
• Transplant surgery: Heart transplants are used in the final stages of heart failure when all other treatments have not worked. A surgeon removes all or part of your heart and replaces it with a heart from a donor.

Devices

You may require surgery to implant a device to help monitor your heart rhythm.

Pacemakers

These small devices are placed into the chest to help control heart rhythms. They may slow your heart rate when the heart is beating too quickly or increase your heart rate if it’s beating too slowly.

Left ventricular assist device (LVAD)

An LVAD helps your left ventricle pump blood out to the rest of your body.

Implantable cardioverter defibrillator (ICD)

This battery-powered device keeps track of your heart rate. It shocks your heart if it detects an abnormal heart rhythm. This restores the heart rate to a normal rhythm.

Doctors suggest an ICD for people with an ejection fraction of less than 30–35%. An ejection fraction refers to how much blood your heart pumps out of the left ventricle with each contraction. A normal range is 55–70%.

Some lifestyle measures can help treat heart failure and prevent the condition from developing.

• getting regular physical activity
• maintaining a moderate weight
• limiting alcohol intake
• eating a well-balanced diet
• not smoking
• getting the right amount of sleep

Untreated heart failure can eventually lead to CHF, which could be life threatening. This is when blood builds up in other areas of your body. You may experience fluid retention in your limbs and organs, such as the liver and lungs.

Additional complications of heart failure include:

• stroke
• kidney dysfunction
• liver dysfunction
• thromboembolism
• arrhythmias, like ventricular arrhythmias
• heart attack

Can congestive heart failure be detected early?

Yes, and early diagnosis gives your doctor more time to find the best treatment for you and gives you time to treat the condition before it becomes critical. Early diagnosis involves recognizing the sometimes subtle signs and the main symptoms of heart failure:

• shortness of breath
• fatigue
• edema (swelling)
• feeling faint, weak, or lightheaded

Other signs and symptoms may include:

• sudden weight gain
• loss of appetite
• bloating
• persistent coughing
• heart palpitations
• abdominal swelling
• confusion, memory loss, or impaired thinking

Does congestive heart failure show up in blood tests?

Yes. A B-type natriuretic peptide (BNP) blood test measures the levels of a hormone called the BNP hormone in your blood.

BNP helps keep your veins and arteries dilated and has a role in keeping salt and fluid balance in the body. If you have heart failure, your heart produces more BNP, and it’s visible on a BNP blood test.

What’s the most accurate test for congestive heart failure?

Congestive heart failure is diagnosed using a combination of history and physical examination, blood testing, and imaging tests. Imaging tests provide details about the type and cause of heart failure.

An echocardiogram is performed to look at the heart’s structure and function. This test uses sound waves to produce pictures of the heart. Cardiologists can look at the heart’s structure, including heart muscle, chambers, and valves, along with the heart’s pumping and filling.

Other tests that cardiologists may use to investigate heart failure include stress echocardiogram, nuclear imaging, cardiac magnetic resonance imaging (MRI), and cardiac computed tomography (CT).

What are possible signs your heart is quietly failing?

Heart failure may not cause obvious signs or symptoms initially. Some people may have vague or quiet signs and symptoms that come on slowly, making it hard to recognize a problem.

Some of these subtle signs include:

• edema
• fatigue
• reduced stamina
• shortness of breath
• cough

If you notice these, contact a doctor for a checkup.

What are the 4 stages of heart failure?

The four stages of heart failure are A, B, C, and D. These refer to the severity of symptoms and how your heart is functioning as your condition progresses:

• Stage A: You have no symptoms but may be at risk of heart failure.
• Stage B: You have atypical changes in your heart’s structure or function but no symptoms of heart failure.
• Stage C: You have symptoms of heart failure.
• Stage D: Your symptoms of heart failure affect your daily life and may require repeated hospital admissions.

How long can a person live with heart failure?

The authors of a 2019 review of studies found that approximately 60% of people were alive 5 years after their chronic heart failure diagnosis. After 10 years, approximately 1 in 3 people were still alive.

Survival rates are just estimates. Your outlook depends on several factors, such as age, lifestyle habits, other medical conditions, and stage at diagnosis.

What are the serious signs of heart failure?

The most common signs of heart failure include:

• fatigue
• edema (swelling)
• shortness of breath
• exercise intolerance

For someone with heart failure, any progression of symptoms is serious. Contact your cardiologist if you notice worsening symptoms. Some particularly concerning symptoms include:

• worsening shortness of breath
• chest discomfort
• lightheadedness and dizziness

What’s the difference between heart failure and congestive heart failure?

Congestive heart failure (CHF) is another term used for heart failure. It emphasizes the congestion that occurs due to a backup of blood flow, which causes fluid retention, swelling, and pulmonary edema (fluid in the lungs).

Heart failure happens when your heart is unable to pump enough blood throughout your body.

It’s typically a chronic condition that requires ongoing treatment to prevent complications and increase your quality of life.

Your outlook and treatment of heart failure varies depending on the type of heart failure you have. Early treatment is key in preventing the most serious cases of heart failure.