What Is Heart Failure?

Heart failure is a condition in which the heart can’t pump blood the way it should. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t send blood to the rest of the body with enough force. Some people have both problems.

“Heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, it’s a serious condition that requires medical care.

Overview

Heart failure develops over time as the pumping of the heart grows weaker. It can affect the right side of the heart only or both the left and right sides of the heart. Most cases involve both sides of the heart.

Right-side heart failure occurs when the heart can’t pump blood to the lungs, where it picks up oxygen. Left-side heart failure occurs when the heart can’t pump enough oxygen-rich blood to the rest of the body.

Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen, and, rarely, the veins in the neck. Right-side and left-side heart failure also cause shortness of breath and fatigue (tiredness).

The leading causes of heart failure are diseases that damage the heart. These include coronary artery disease (CAD), high blood pressure, and diabetes.

Outlook

Heart failure is a very common condition. About 5 million people in the United States have heart failure, and it results in about 300,000 deaths each year.

Both children and adults can have heart failure, although the symptoms and treatments differ. This article focuses on heart failure in adults.

Taking steps to prevent CAD can help prevent heart failure. These steps include following a heart healthy diet, not smoking, doing physical activity, and losing weight if you’re overweight or obese. Working with your doctor to control high blood pressure and diabetes also can help prevent heart failure.

People who have heart failure can live longer and more active lives if it’s diagnosed early and they follow their treatment plans. For most, treatment includes medicines and lifestyle measures.

Currently, there’s no cure for heart failure. However, researchers are finding and testing new treatments. These treatments offer hope for better ways to delay heart failure and its complications.

Other Names for Heart Failure

  • Dropsy.
  • Left-side, or systolic, heart failure. This is when the heart can’t pump enough oxygen-rich blood to the body.
  • Right-side, or diastolic, heart failure. This is when the heart can’t fill with enough blood.

Some people have only right-side heart failure. But all people who have left-side heart failure also have right-side heart failure. Treatments for right-side heart failure alone differ from treatments for both right-side and left-side heart failure. Your doctor will plan your treatment based on your type of heart failure and your unique needs.

What Causes Heart Failure?

Conditions that damage the heart muscle or make it work too hard 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 other substances may be released into the blood. They have a toxic effect on the heart and blood flow, and they cause heart failure to worsen.

Major Causes

The most common causes of heart failure are coronary artery disease (CAD), high blood pressure, and diabetes. Treating these problems can prevent or improve heart failure.

Coronary Artery Disease

CAD occurs when a fatty material called plaque (plak) builds up in your coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the arteries, causing less blood to flow to your heart muscle. This can lead to chest pain, heart attack, and heart damage.

High Blood Pressure

Blood pressure is the force of blood pushing against the walls of the arteries. Blood pressure is “high” if it stays at or above 140/90 mmHg over a period of time. High blood pressure stiffens blood vessels and makes the heart work harder. Without treatment, the heart may be damaged.

Diabetes

This disease occurs when the level of sugar in the blood is high. The body doesn’t make enough insulin or doesn’t use its insulin properly. Insulin is a hormone that helps convert food to energy. High sugar levels can damage blood vessels around the heart.

Other Causes

Other diseases and conditions that can lead to heart failure are:

  • Heart muscle diseases. These diseases may be present at birth or due to injury or infection.
  • Heart valve disorders. These problems may be present at birth or due to infections, heart attacks, or damage from heart disease.
  • Arrhythmias (ah-RITH-me-ahs), or irregular heartbeats. These heart problems may be present at birth or due to heart disease or heart defects.
  • Congenital heart defects. These heart problems are present at birth.

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

  • Treatments for cancer, such as radiation and chemotherapy
  • Thyroid disorders (having either too much or too little thyroid hormone in the body)
  • Alcohol abuse
  • HIV/AIDS
  • Cocaine and other illegal drug use
  • Too much vitamin E

Heart damage from obstructive sleep apnea may cause heart failure to worsen. In obstructive sleep apnea, your breathing stops or gets very shallow while you’re sleeping. This can deprive the heart of oxygen and increase its workload. Treating this sleep problem may improve heart failure.

Who Is At Risk for Heart Failure?

About 5 million people in the United States have heart failure, and it results in about 300,000 deaths each year. The number of people who have heart failure is growing. Each year, another 550,000 people are diagnosed for the first time. Heart failure is more common in:

  • People who are 65 or older. Aging can weaken the heart muscle. Older people also may have had a disease for many years that causes heart failure. Heart failure is the #1 reason for hospital visits in this age group.
  • African Americans. African Americans are more likely than people of other races to have heart failure and to suffer from more severe forms of it. They’re also more likely than other groups to have symptoms at a younger age, get worse faster, have more hospital visits due to heart failure, and die from heart failure.
  • People who are overweight or obese. Excess weight puts a greater strain on the heart. It also can lead to type II diabetes, which adds to the risk of heart failure.

Men have a higher rate of heart failure than women. But in actual numbers, more women have the condition. This is because many more women than men live into their seventies and eighties when it’s common.

Children with congenital heart defects also can develop heart failure. Children are born with these defects when the heart, heart valves, and/or blood vessels near the heart don’t form correctly. This can weaken the heart muscle and lead to heart failure.

Children don’t have the same symptoms or get the same treatment for heart failure as adults. This article focuses on heart failure in adults.

What Are the Signs and Symptoms of Heart Failure?

The most common signs and symptoms of heart failure are:

  • Shortness of breath or trouble breathing
  • Fatigue (tiredness)
  • Swelling in the ankles, feet, legs, abdomen, and, rarely, the veins in your neck

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

As the 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 a condition called acute pulmonary (PULL-mun-ary) edema (e-DE-ma). This is when too much fluid is in your lungs. This severe condition requires emergency treatment.