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Heart failure occurs when your heart can’t pump enough blood to meet your body’s demand. This can be chronic, meaning it happens slowly over time. Or it can be acute, meaning it happens suddenly.
According to a 2014 study, approximately 26 million people worldwide were living with heart failure at the time. In the United States, heart failure is the a major cause of people over 65 being admitted to the hospital. This may be because people are living longer with heart disease, which can lead to heart failure over time.
Shortness of breath is the most common symptom of acute heart failure. From there, the condition shares many of the same symptoms as chronic or severe heart failure.
These symptoms may be much more pronounced with acute heart failure though. Your legs and abdomen may suddenly swell, and you could rapidly gain weight from retaining fluid. This could mean 2 to 3 pounds in a 24-hour period, or 5 pounds over the course of a week. You may also feel nauseous or lose your appetite.
Other symptoms of both acute and chronic heart failure include:
If not treated, heart failure can lead to a heart attack. A heart attack is typically caused by a blockage in an artery. The blockage prevents oxygen from reaching the heart, leading it to pump erratically or not at all. If you’re having a heart attack, you may also have chest pain.
Older adults may have several health conditions. This can make it difficult to isolate symptoms of a heart problem from those caused by other conditions.
If you’re experiencing any of these symptoms and are unsure why, seek emergency medical treatment.
According to a 2008 study, people hospitalized with acute heart failure had an average delay time of 13.3 hours between noticing symptoms and getting treatment. The faster that you identify your symptoms and seek medical attention, the better your outlook.
Acute or chronic failure can begin on either the left or right side of your heart, or both sides may fail at the same time. The chambers where your blood is pumped are called ventricles. These may stiffen so that they no longer fill properly. If your heart muscle is too weak, the ventricles can stretch out and fail to work efficiently.
These are a few types of heart failure:
This occurs when your left ventricle isn’t pumping efficiently. Instead of pumping blood through your body, the blood backs up into your lungs. You may become short of breath as a result.
There are two types of left-sided heart failure:
Systolic heart failure is the most common cause of heart failure. It happens when your heart is weak or enlarged. During systolic heart failure, the muscle in your left ventricle is unable to contract or shorten. This prevents blood from being pumped throughout your body.
Diastolic heart failure happens when blood isn’t able to properly fill your left ventricle. Because of this, your heart pumps less blood to your body than normal. This low blood flow is likely caused by the ventricle stiffening.
Symptoms of diastolic heart failure are indistinguishable from those of systolic heart failure. Because of this, diagnosis can only be performed using Doppler echocardiography.
This usually happens simultaneously with left-sided heart failure. Failure of your left ventricle results in increased pressure and subsequent damage to the right side of your heart. This can prohibit the right side of your heart from pumping efficiently.
If the right side of your heart is unable to pump correctly, fluid can accumulate in your veins. This may cause your legs and feet to swell.
Although you may seem healthy, it’s possible to experience a sudden heart event that results in failure.
Causes of acute heart failure include:
Having one risk factor may be enough to trigger heart failure, and having a combination of risk factors increases that risk.
Risk factors include:
Many conditions weaken or damage the heart over time. This can lead to chronic heart failure. Some result from internal factors, such as disease or a birth defect. Others come from external factors, such as a poor diet and lack of exercise.
Conditions leading to chronic heart failure include:
With all these conditions, the heart adapts over time until it just can’t adapt anymore. Then it fails. Sometimes one of these chronic conditions leads to an acute event.
To diagnose acute heart failure, your doctor will run certain tests. Your doctor can then classify the severity of your condition using a symptom- or stage-based scale to find the right treatment.
Your doctor will assess your medical history and perform a physical exam. They’ll listen to your heart and lungs with a stethoscope to detect any congestion or abnormal heart rhythms. Your doctor may also check for fluid buildup in your abdomen, legs, and the veins in your neck.
In addition, your doctor might order some combination of the following tests:
If you’re diagnosed with heart failure, your doctor may categorize the severity of your condition on one of two scales. This classification can help guide your treatment and recovery.
The New York Heart Association classification is a symptom-based scale. It classifies heart failure in one of four categories:
The American Heart Association classification is a stage-based system. It’s used to classify your risk for or level of heart failure. The letters A to D convey the stage that you’re in:
Doctors often use these two classification systems together to determine the best treatment or prevention plan for you.
If you experience acute heart failure, you’ll be hospitalized until you’re in stable condition. During this time, you may be put on oxygen. You might also need supplemental oxygen in the long term.
Acute heart failure can have lasting effects on your body. Because of this, treatment is centered on managing symptoms and preventing future heart failure.
In some cases, acute heart failure can be caused by undiagnosed chronic heart failure. The cause of your acute heart failure will determine your treatment plan. Treatment for acute heart failure and chronic heart failure is often the same.
Treatment typically includes a combination of medication, surgery, and medical devices.
In many cases, a combination of at least two medications is necessary to manage heart trouble.
Some of these medications include:
You may also need medicines to lower your cholesterol or treat chest pain. Your doctor may prescribe a blood thinner to avoid blood clots.
Depending on the cause of your heart failure, your doctor may also prescribe an antibiotic to treat infection.
Surgery is also widely used to treat heart failure. Some common types of heart surgery include:
Heart valve replacement or repair: If your heart fails because of a problematic heart valve, your doctor may want that valve repaired or replaced. There involves either repairing your own valve or getting an artificial valve.
Coronary bypass surgery: In this surgery, your surgeon will remove a blood vessel from another part of your body. This blood vessel is fashioned into a new pathway to work around a clogged artery.
Your doctor may use one of the following devices to help restore function:
If your condition is severe, your doctor may recommend a heart transplant. This is typically a last resort and only explored if other treatments aren’t working. The demand for donor hearts is usually far greater than the supply.
Changing certain behaviors can reduce your heart failure symptoms. This may also lessen your risk for future instances of heart failure.
If you smoke, ask your doctor for help quitting. Smoking increases your heartbeat, decreases the amount of oxygen in your blood, and elevates your blood pressure. If you smoke, you won’t be considered for a heart transplant.
Your outlook depends on your overall health, the cause, and degree of your heart failure. Many people are able to manage their symptoms with heart medications or implanted medical devices.
Your outlook may be further complicated if your heart failure leads to kidney or liver damage or problems with your heart valves. Blood clots are also common after heart failure.
Work with your doctor to determine your risk for these complications. They can devise a treatment plan that both alleviates your symptoms and reduces your risk for future incidents.
Some risk factors, such as genetics or chronic illness, can’t be avoided. The key to preventing heart failure is to reduce the risk factors that you can control.
Many of the lifestyle changes recommended for heart failure recovery can also reduce or eliminate conditions that lead to heart failure. These conditions include high blood pressure and high cholesterol.
If you’re at risk for heart failure, you should consider these lifestyle changes:
Be sure to have regular checkups and report any unusual symptoms to your doctor.
Written by: Teresa Bergen
Medically reviewed on: Dec 02, 2016: Debra Sullivan, PhD, MSN, CNE, COI
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