Heart Failure

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs.

The weakening of the heart's pumping ability causes

  • Blood and fluid to back up into the lungs
  • The buildup of fluid in the feet, ankles and legs - called edema
  • Tiredness and shortness of breath

Common causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are overweight, and people who have had a heart attack. Men have a higher rate of heart failure than women.

Your doctor will diagnose heart failure by doing a physical exam and heart tests. Treatment includes treating the underlying cause of your heart failure, medicines, and heart transplantation if other treatments fail.

You can take steps to prevent heart failure. The sooner you start, the better your chances of preventing or delaying the condition.

For People Who Have Healthy Hearts

If you have a healthy heart, you can take action to prevent heart disease and heart failure. To reduce your risk of heart disease:

  • Avoid using illegal drugs.
  • Be physically active.
  • Follow a heart-healthy eating plan.
  • If you smoke, make an effort to quit.
  • Maintain a healthy weight.

For People Who Are at High Risk for Heart Failure

Even if you’re at high risk for heart failure, you can take steps to reduce your risk. People at high risk include those who have coronary heart disease, high blood pressure, or diabetes.

  • Follow all of the steps listed above.
  • Treat and control any conditions that can cause heart failure. Take medicines as your doctor prescribes.
  • Avoid drinking alcohol.

For People Who Have Heart Damage but No Signs of Heart Failure

If you have heart damage but no signs of heart failure, you can still reduce your risk of developing the condition. In addition to the steps above, take your medicines as prescribed to reduce your heart’s workload.

About 5.7 million people in the United States have heart failure. The number of people who have this condition is growing.

Heart failure is more common in:

  • People who are age 65 or older. Aging can weaken the heart muscle. Older people also may have had diseases for many years that led to heart failure. 
  • Blacks are more likely to have heart failure than people of other races. They’re also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure.
  • People who are overweight. Excess weight puts strain on the heart. Being overweight also increases your risk of heart disease and type 2 diabetes, which diseases can lead to heart failure.
  • People who have had a heart attack. Damage to the heart muscle from a heart attack and can weaken the heart muscle.

Children who have congenital heart defects also can develop heart failure. 

Conditions that damage or overwork the heart muscle can cause heart failure. Over time, the heart weakens. It isn’t able to fill with and/or pump blood as well as it should. As the heart weakens, certain proteins and substances might be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.

Causes of heart failure include:

  • Coronary heart disease
  • Diabetes
  • High blood pressure

Other conditions and diseases also can lead to heart failure, such as:

  • Arrhythmia. Happens when a problem occurs with the rate or rhythm of the heartbeat.
  • Cardiomyopathy. Happens when the heart muscle becomes enlarged, thick, or rigid.
  • Congenital heart defects. Problems with the heart’s structure are present at birth.
  • Heart valve disease. Occurs if one or more of your heart valves doesn’t work properly, which can be present at birth or caused by infection, other heart conditions, and age.

Other factors also can injure the heart muscle and lead to heart failure. Examples include:

  • Alcohol abuse or other drug use
  • HIV/AIDS
  • Thyroid disorders
  • Too much vitamin E
  • Treatments for cancer, such as radiation and chemotherapy

The most common signs and symptoms of heart failure are:

  • Shortness of breath or trouble breathing
  • Fatigue 
  • Swelling in the ankles, feet, legs, abdomen, and veins in the neck

All of these symptoms are the result of fluid buildup in your body. When symptoms start, you may feel tired and short of breath after routine physical effort, like climbing stairs.

As your heart grows weaker, symptoms get worse. You may begin to feel tired and short of breath after getting dressed or walking across the room. Some people have shortness of breath while lying flat.

Fluid buildup from heart failure also causes weight gain, frequent urination, and a cough that's worse at night and when you're lying down. This cough may be a sign of acute pulmonary edema, a condition in which too much fluid builds up in your lungs. 

Your doctor will diagnose heart failure based on your medical and family histories, a physical exam, and test results. The signs and symptoms of heart failure also are common in other conditions. Thus, your doctor will:

  • Find out whether you have a disease or condition that can cause heart failure, such as coronary heart disease, high blood pressure, or diabetes
  • Rule out other causes of your symptoms
  • Find any damage to your heart and check how well your heart pumps blood

Early diagnosis and treatment can help people who have heart failure live longer, more active lives.

Your doctor will ask whether you or others in your family have or have had a disease or condition that can cause heart failure.

Your doctor also will ask about your symptoms. He or she will want to know which symptoms you have, when they occur, how long you've had them, and how severe they are. 

 

During the physical exam, your doctor will:

  • Listen to your heart for sounds that aren't normal
  • Listen to your lungs for the sounds of extra fluid buildup
  • Look for swelling in your ankles, feet, legs, abdomen, and the veins in your neck

 

No single test can diagnose heart failure. If you have signs and symptoms of heart failure, your doctor may recommend one or more tests.

Early diagnosis and treatment can help people who have heart failure live longer, more active lives. Treatment for heart failure depends on the type and severity of the heart failure.

Treatments usually include lifestyle changes, medicines, and ongoing care. If you have severe heart failure, you also may need medical procedures or surgery.

Your doctor may recommend heart-healthy lifestyle changes if you have heart failure. Heart-healthy lifestyle changes include:

  • Heart-healthy eating
  • Maintaining a healthy weight
  • Physical activity
  • Quitting smoking

Your doctor may recommend a heart-healthy eating plan, which should include:

  • Fat-free or low-fat dairy products
  • Fish high in omega-3 fatty acids
  • Fruits
  • Legumes
  • Vegetables
  • Whole grains

Maintaining a healthy weight is important for overall health and can lower your risk for heart failure and coronary heart disease.

Routine physical activity can lower many coronary heart disease risk factors, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL ("good") cholesterol level. 

Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.

If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen heart failure.

Your doctor will prescribe medicines based on the type of heart failure you have, how severe it is, and your response to certain medicines.

You should watch for signs that heart failure is getting worse. For example, weight gain may mean that fluids are building up in your body. Ask your doctor how often you should check your weight and when to report weight changes.

As heart failure worsens, lifestyle changes and medicines may no longer control your symptoms. You may need a medical procedure or surgery.

 

Currently, heart failure has no cure. You'll likely have to take medicine and follow a treatment plan for the rest of your life.

Despite treatment, symptoms may get worse over time. You may not be able to do many of the things that you did before you had heart failure. However, if you take all the steps your doctor recommends, you can stay healthier longer.