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Heart Failure

What Is Heart Failure?

Heart failure is characterized by the heart’s inability to pump an adequate supply of blood. Without sufficient blood flow, all major body functions are disrupted. Heart failure is a condition or a collection of symptoms that weaken your heart.

In some people with heart failure, the heart has difficulty pumping enough blood to support other organs in the body. Other people may have a hardening and stiffening of the heart muscle itself, which blocks or reduces blood flow to the heart. Heart failure can affect the right or left side of your heart, or both at the same time. It can be either an acute (short-term) or chronic (ongoing) condition.

In acute heart failure, the symptoms appear suddenly but go away fairly quickly. This condition often occurs after a heart attack. It may also be a result of a problem with the heart valves that control the flow of blood in the heart.

In chronic heart failure, however, symptoms are continuous and don’t improve over time. The vast majority of heart failure cases are chronic.

About 5 million Americans have heart failure. Most of these people are men. However, women are more likely to die from heart failure when the condition goes untreated.

Heart failure is a serious medical condition that requires treatment. Early treatment increases your chances of long-term recovery with fewer complications. Call your doctor right away if you’re having any symptoms of heart failure.

What Are the Symptoms of Heart Failure?

The symptoms of heart failure may include:

  • excessive fatigue
  • sudden weight gain
  • a loss of appetite
  • persistent coughing
  • irregular pulse
  • heart palpitations
  • abdominal swelling
  • shortness of breath
  • leg and ankle swelling
  • protruding neck veins

What Causes Heart Failure?

Heart failure is most often related to another disease or illness. The most common cause of heart failure is coronary artery disease, which is a disorder that causes narrowing of the arteries that supply blood and oxygen to the heart. Other conditions that may increase your risk for developing heart failure include:

  • cardiomyopathy, which is a disorder of the heart muscle that causes the heart to become weak
  • a congenital heart defect
  • a heart attack
  • heart valve disease
  • certain types of arrhythmias, or irregular heart rhythms
  • high blood pressure
  • emphysema, a disease of the lung
  • diabetes
  • an overactive or underactive thyroid
  • HIV
  • AIDS
  • severe forms of anemia, which is a deficiency of red blood cells
  • certain cancer treatments, such as chemotherapy
  • drug or alcohol abuse

Types of Heart Failure

Heart failure can occur in either the left or right side of your heart. It’s also possible for both sides of your heart to fail at the same time.

Left-Sided Heart Failure

Left-sided heart failure is the most common type of heart failure. The left heart ventricle is located in the bottom left side of your heart. This area pumps oxygen-rich blood to the rest of your body. Left-sided heart failure occurs when the left ventricle doesn’t pump efficiently. This prevents your body from getting enough oxygen-rich blood. The blood backs up into your lungs instead, which causes shortness of breath and a buildup of fluid.

Right-Sided Heart Failure

The right heart ventricle is responsible for pumping blood to your lungs to collect oxygen. Right-sided heart failure occurs when the right side of your heart can’t perform its job effectively. It’s usually triggered by left-sided heart failure. The accumulation of blood in the lungs caused by left-sided heart failure makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail. Right-sided heart failure can also occur as a result of other conditions, such as lung disease.

Heart failure is also classified as either diastolic or systolic.

Diastolic Heart Failure

Diastolic heart failure occurs when the heart muscle becomes stiffer than normal. The stiffness, which is usually due to heart disease, means that your heart doesn’t fill with blood easily. This is known as diastolic dysfunction. It leads to a lack of blood flow to the rest of the organs in your body. Diastolic heart failure is more common in women than in men.

Systolic Heart Failure

Systolic heart failure occurs when the heart muscle loses its ability to contract. The contractions of the heart are necessary to pump oxygen-rich blood out to the body. This problem is known as systolic dysfunction, and it usually develops when your heart is weak and enlarged. Systolic heart failure is more common in men than in women.

Both diastolic and systolic heart failure can occur on the left or right sides of the heart. You may have either condition on both sides of the heart.

What Are the Risk Factors for Heart Failure?

Heart failure can happen to anyone. However, there are certain factors that may increase your risk of developing this condition.

African-American women are at the highest risk of having heart failure compared to other genders and races. Still, men are overall more susceptible to this condition across all ethnicities.

People with diseases that damage the heart are also at an increased risk. Diseases that can lead to heart failure include:

  • anemia
  • hyperthyroidism, or an overactive thyroid
  • hypothyroidism, or an underactive thyroid
  • emphysema

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

  • smoking
  • eating foods high in fat or cholesterol
  • living a sedentary lifestyle
  • being overweight

How Is Heart Failure Diagnosed?

An echocardiogram is the most effective way to diagnose heart failure. It uses sound waves to create detailed pictures of your heart, which help your doctor evaluate the damage to your heart and determine the underlying causes of your condition. Your doctor may use an echocardiogram along with other tests, including the following:

  • Chest X-rays can provide images of the heart and the surrounding organs.
  • An electrocardiogram (EKG) measures the electrical activity of the heart. It’s usually done in your doctor’s office.
  • An MRI produces images of the heart without the use of radiation.
  • During a nuclear scan, a very small dose of radioactive material is injected into your body to create images of the chambers of your heart.
  • A catheterization or coronary angiogram is a type of X-ray exam in which the doctor inserts a thin tube called a catheter into your blood vessel, usually in the groin or arm. They then guide it into the heart. This test can show how much blood is currently flowing through the heart.
  • During a stress exam, an electrocardiogram machine monitors your heart function while you run on a treadmill or perform another type of exercise.
  • Electrode patches can be placed on your chest and attached to a small machine called a Holter monitor. This machine records the electrical activity of your heart for at least 24 to 48 hours.

Your doctor may also perform a physical exam to check for physical signs of heart failure. For instance, leg swelling, an irregular heartbeat, and bulging neck veins may make your doctor suspect heart failure almost immediately.

How Is Heart Failure Treated?

Treating heart failure depends on the severity of your condition. Early treatment can improve symptoms fairly quickly, but you should still get regular testing every three to six months. The main goal of treatment is to increase your lifespan.


Early stages of heart failure may be treated with medications to help relieve your symptoms and prevent your condition from getting worse. 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

Always speak with your doctor before taking new medications. Some medications are completely off-limits to people with heart failure, including naproxen and ibuprofen.


Some people with heart failure will need surgery, such as coronary bypass surgery. During this surgery, your surgeon will take a healthy piece of artery and attach it to the blocked artery. This allows the blood to bypass the blocked, damaged artery and flow through the new one.

Your doctor may also suggest an angioplasty. In this procedure, a tube, or catheter, with a small balloon attached is inserted into the blocked or narrowed artery. Once the catheter reaches the damaged artery, your surgeon inflates a balloon to open the artery. Your surgeon may need to place a permanent stent into the blocked or narrowed artery. A stent is a wire mesh tube that permanently holds your artery open. A stent can help prevent further narrowing of the artery.

Other people with heart failure will need pacemakers to help control heart rhythms. These small devices are placed into the chest. They can slow your heart rate down when the heart is beating too quickly or increase heart rate if the heart is beating too slowly. Pacemakers are often used along with bypass surgery as well as medications.

Heart transplants are used in the final stages of heart failure when all other treatments have failed. During a transplant, your surgeon removes all or part of your heart and replaces it with a healthy heart from a donor.

Preventing Heart Failure

A healthy lifestyle can help treat heart failure and prevent the condition from developing in the first place. Losing weight and exercising regularly can significantly decrease your risk of heart failure. Reducing the amount of salt in your diet can also lower your risk.

Other healthy lifestyle habits include:

  • reducing alcohol intake
  • quitting smoking
  • avoiding foods high in fat
  • getting an adequate amount of sleep

Complications of Heart Failure

Untreated heart failure can eventually lead to congestive heart failure, a condition in which blood builds up in other areas of your body. In this potentially life-threatening condition, you may experience fluid retention in your limbs as well as in your organs, such as the liver and lungs.

Heart Attack

A heart attack may also occur as a result of a heart failure-related complication.

Call 911 right away if you have:

  • crushing chest pain
  • discomfort in the chest, such as squeezing or tightness
  • discomfort in the upper body, including numbness or a coldness
  • excessive fatigue
  • dizziness
  • rapid heart rate
  • vomiting
  • nausea
  • cold sweats

Long-Term Outlook for People with Heart Failure

Heart failure is usually a long-term condition that requires ongoing treatment to prevent complications. When heart failure is left untreated, the heart can weaken so severely that it causes a life-threatening complication.

It’s important to recognize that heart failure can happen to anyone. You should take lifelong preventive measures to stay healthy. Always contact your doctor if you suddenly have any new and unexplained symptoms that may indicate a problem with your heart.

Since heart failure is most often a chronic condition, your symptoms will likely get worse over time. Medications and surgeries can help relieve your symptoms, but such treatments may not help if you have a severe case of heart failure. In some cases, heart failure can even be life-threatening.

Early treatment is key in preventing the most serious cases of heart failure. Call your doctor right away if you’re showing signs of heart failure or if you believe you have the condition. 

Content licensed from:

Written by: Kristeen Moore and Erica Roth
Medically reviewed on: Dec 09, 2015: Debra Sullivan, PhD, MSN, RN, CNE, COI

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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