Learn about this chronic disease that needs lifelong management. Find out what treatments help you live longer and may even strengthen your heart.
Heart failure occurs when the heart muscle doesn't pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath.
Certain heart conditions gradually leave the heart too weak or stiff to fill and pump blood properly. These conditions include narrowed arteries in the heart and high blood pressure.
Proper treatment may improve the symptoms of heart failure and may help some people live longer. Lifestyle changes can improve quality of life. Try to lose weight, exercise, use less salt and manage stress.
But heart failure can be life-threatening. People with heart failure may have severe symptoms. Some may need a heart transplant or a device to help the heart pump blood.
Heart failure is sometimes called congestive heart failure.
If you have heart failure, your heart can't supply enough blood to meet your body's needs.
Symptoms may develop slowly. Sometimes, heart failure symptoms start suddenly. Heart failure symptoms may include:
See your health care provider if you think you might have symptoms of heart failure. Call 911 or emergency medical help if you have any of the following:
These symptoms may be due to heart failure. But there are many other possible causes. Don't try to diagnose yourself.
At the emergency room, health care providers do tests to learn if your symptoms are due to heart failure or something else.
Call your health care provider right away if you have heart failure and:
Such changes could mean that existing heart failure is getting worse or that treatment isn't working.
Heart failure occurs when the heart muscle doesn't pump blood as well as it should. Blood often backs up and causes fluid to build up in the lungs and in the legs. The fluid buildup can cause shortness of breath and swelling of the legs and feet. Poor blood flow may cause the skin to appear blue or gray. Depending on your skin color, these color changes may be harder or easier to see. Some types of heart failure can lead to an enlarged heart.
Heart failure can be caused by a weakened, damaged or stiff heart.
The heart muscle can be damaged by certain infections, heavy alcohol use, illegal drug use and some chemotherapy medicines. Your genes also can play a role.
Any of the following conditions also can damage or weaken the heart and cause heart failure.
Coronary artery disease and heart attack. Coronary artery disease is the most common cause of heart failure. The disease results from the buildup of fatty deposits in the arteries. The deposits narrow the arteries. This reduces blood flow and can lead to heart attack.
A heart attack occurs suddenly when an artery feeding the heart becomes completely blocked. Damage to the heart muscle from a heart attack may mean that the heart can no longer pump as well as it should.
Causes of sudden heart failure also include:
Heart failure usually begins with the lower left heart chamber, called the left ventricle. This is the heart's main pumping chamber. But heart failure also can affect the right side. The lower right heart chamber is called the right ventricle. Sometimes heart failure affects both sides of the heart.
|Type of heart failure||Description|
|Source: American Heart Association|
|Right-sided heart failure||This type affects the lower right heart chamber, called the right ventricle. Fluid may back up into the belly, legs and feet, causing swelling.|
|Left-sided heart failure||This type affects the lower left heart chamber, called the left ventricle. Fluid may back up in the lungs, causing shortness of breath.|
|Heart failure with reduced ejection fraction (HFrEF), also called systolic heart failure||This is a type of left-sided heart failure. The left ventricle can't squeeze as strong as it should. The heart isn't strong enough to pump enough blood to the body.|
|Heart failure with preserved ejection fraction (HFpEF), also called diastolic heart failure||This is a type of left-sided heart failure. The left ventricle can't relax or fill fully. The heart has a problem filling with blood.|
A typical heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of the heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.
Diseases and conditions that increase the risk of heart failure include:
Medicines that may increase the risk of heart failure include:
Other risk factors for heart failure include:
If you have health failure, it's important to have regular health checkups, even if symptoms improve. Your health care provider can examine you and run tests to check for complications.
Complications of heart failure depend on your age, overall health and the severity of heart disease. They may include:
One way to prevent heart failure is to treat and control the conditions that can cause it. These conditions include coronary artery disease, high blood pressure, diabetes and obesity.
Some of the same lifestyle changes used to manage heart failure also may help prevent it. Try these heart-healthy tips:
To diagnose heart failure, your health care provider examines you and asks questions about your symptoms and medical history. Your provider checks to see if you have risk factors for heart failure, such as high blood pressure, coronary artery disease or diabetes.
Your care provider listens to your lungs and heart with a device called a stethoscope. A whooshing sound called a murmur may be heard when listening to your heart. Your provider may look at the veins in your neck and check for swelling in your legs and belly.
Treatment of heart failure may depend on the cause. Treatment often includes lifestyle changes and medicines. If another health condition is causing the heart to fail, treating it may reverse heart failure.
Some people with heart failure need surgery to open blocked arteries or to place a device to help the heart work better.
With treatment, symptoms of heart failure may improve.
A combination of medicines may be used to treat heart failure. The specific medicines used depend on the cause of heart failure and the symptoms. Medicines to treat heart failure include:
Diuretics. Often called water pills, these medicines make you urinate more frequently. This helps prevent fluid buildup in your body. Diuretics, such as furosemide (Lasix, Furoscix), also decrease fluid in the lungs, so it's easier to breathe.
Some diuretics make the body lose potassium and magnesium. Your health care provider may recommend supplements to treat this. If you're taking a diuretic, you may have regular blood tests to check your potassium and magnesium levels.
Potassium-sparing diuretics. Also called aldosterone antagonists, these drugs include spironolactone (Aldactone, Carospir) and eplerenone (Inspra). They may help people with severe heart failure with reduced ejection fraction (HFrEF) live longer.
Unlike some other diuretics, these medicines can raise the level of potassium in the blood to dangerous levels. Talk to your health care provider about your diet and potassium intake.
Your health care provider may need to change your medicine doses frequently. This is more common when you've just started a new medicine or when your condition is getting worse.
You may be admitted to the hospital if you have a flare-up of heart failure symptoms. While in the hospital, you may receive:
If you have severe heart failure, you may need to use supplemental oxygen for a long time.
Surgery or other treatment to place a heart device may be recommended to treat the problem that led to heart failure.
Surgery or other procedures for heart failure may include:
Heart valve repair or replacement. If a damaged heart valve causes heart failure, your provider may recommend repairing or replacing the valve. There are many different types of heart valve repair. The type needed depends on the cause of the heart valve problem.
Heart valve repair or replacement may be done as open-heart or minimally invasive surgery.
Implantable cardioverter-defibrillator (ICD). An ICD is used to prevent complications of heart failure. It isn't a treatment for heart failure itself. An ICD is a device similar to a pacemaker. It's implanted under the skin in the chest with wires leading through the veins and into the heart.
The ICD monitors the heartbeat. If the heart starts beating at a dangerous rhythm, the ICD tries to correct the beat. If the heart stops, the device shocks it back into regular rhythm. An ICD can also work as a pacemaker and speed up a slow heartbeat.
Ventricular assist device (VAD). A VAD helps pump blood from the lower chambers of the heart to the rest of the body. It's also called a mechanical circulatory support device. Although a VAD can be placed in one or both lower chambers of the heart, it's usually placed in the lower left one.
Your health care provider may recommend a VAD if you're waiting for a heart transplant. Sometimes, a VAD is used as a permanent treatment for people who have heart failure but who aren't good candidates for a heart transplant.
Heart transplant. Some people have such severe heart failure that surgery or medicines don't help. These people may need to have their hearts replaced with a healthy donor heart.
A heart transplant isn't the right treatment for everyone. A team of health care providers at a transplant center helps determine whether the procedure may be safe and beneficial for you.
Your health care provider may recommend special medical care to reduce symptoms and improve quality of life. This is called palliative care. Anyone who has a serious or life-threatening illness can benefit from this type of care. It can be used to treat symptoms of the disease or to ease the side effects of treatment.
In some people with heart failure, medicines no longer work and a heart transplant or device isn't an option. If this occurs, special end-of-life care may be recommended. This is called hospice care.
Hospice care allows family and friends — with the aid of nurses, social workers and trained volunteers — to care for and comfort a loved one. Hospice care is available in your home or in nursing homes and assisted living centers.
Hospice care provides the following for those who are sick and their loved ones:
Although it can be difficult, discussing end-of-life issues with your family and medical team is important. Part of this discussion will likely involve an advance care directive. This is a general term for spoken and written instructions you give concerning your medical care, should you become unable to speak for yourself.
If you have an ICD, one important consideration to discuss with your family and health care team is whether the ICD should be turned off so that it can't deliver shocks to make your heart continue beating.
Some people with heart failure may be told to take omega-3 fatty acid supplements. Some research shows that the supplements may help reduce the need for hospital stays.
Making certain lifestyle changes often improve heart failure symptoms. They may even stop the condition from getting worse.
The following changes are recommended to improve heart health:
Limit salt. Too much salt, also called sodium, can make the body hold onto water. This is called water retention. It makes the heart work harder. Symptoms include shortness of breath and swollen legs, ankles and feet.
Ask your health care provider if you should follow a no-salt or low-salt diet. Remember that salt is already added to prepared foods.
Reduce stress. Strong emotions such as anxiety or anger can make the heart beat faster. Breathing becomes heavier and blood pressure goes up. These changes can make heart failure worse.
Find ways to reduce emotional stress. Practicing mindfulness and connecting with others in support groups are some ways to reduce and manage stress.
Managing heart failure requires open communication between you and your health care provider. Be honest about any challenges concerning your diet, lifestyle and medicine use. Pay attention to your body and how you feel. Tell your provider when you're feeling better or worse. This helps your health care provider know what treatment works best for you.
These steps may help you manage heart failure:
If are worried about your heart failure risk, make an appointment with your health care provider. You may be referred to a doctor trained in heart diseases. This type of provider is called a cardiologist. If heart failure is found early, treatment may be easier and more effective.
Appointments can be brief. Because there's often a lot to discuss, it's a good idea to be prepared for your appointment. Here's some information to help you get ready.
Your time with your provider is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For heart failure, some basic questions to ask your health care provider include:
Don't hesitate to ask other questions.
Your health care provider is likely to ask many questions. Being ready to answer them may save time to go over any details you want to spend more time on. Your provider may ask:
It's never too early to make healthy lifestyle changes, such as quitting smoking, cutting down on salt and eating healthy foods. These changes can help prevent heart failure from starting or worsening.