Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems.
The term “heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.
Heart failure develops over time as the heart’s pumping action grows weaker. The condition can affect the right side of the heart only, or it can affect both sides of the heart. Most cases involve both sides of the heart.
Right-side heart failure occurs if the heart can’t pump enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if 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 the veins in the neck. Right-side and left-side heart failure also may cause shortness of breath and fatigue (tiredness).
The leading causes of heart failure are diseases that damage the heart. These include coronary heart disease (CHD), also called coronary artery disease; high blood pressure; and diabetes.
Heart failure is a very common condition. About 5.7 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.
Currently, heart failure has no cure. However, treatments—such as medicines and lifestyle changes—can help people live longer and more active lives. Researchers continue to study new ways to treat heart failure and its complications.
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 other substances may be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.
The most common causes of heart failure are coronary heart disease (CHD), high blood pressure, and diabetes. Treating these problems can prevent or improve heart failure.
CHD is a condition in which a substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.
CHD can lead to chest pain or discomfort called angina, a heart attack, heart damage, or even death.
Blood pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup.
Blood pressure is considered high if it stays at or above 140/90 mmHg over time. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.
Diabetes is a disease in which the body’s blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.
In diabetes, the body doesn’t make enough insulin or doesn’t use its insulin properly. Over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.
Other diseases and conditions also can lead to heart failure, such as:
Other factors also can injure the heart muscle and lead to heart failure. Examples include:
Heart damage from obstructive sleep apnea may cause heart failure to worsen. Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. This can deprive your heart of oxygen and increase its workload. Treating this sleep problem may improve heart failure.
About 5.7 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.
Heart failure is more common in:
Additionally, men have a higher rate of heart failure than women.
Children who have congenital heart defects also can develop heart failure. These defects occur if the heart, heart valves, or blood vessels near the heart don’t form correctly while a baby is in the womb. Congenital heart defects can make the heart work harder and weaken the heart muscle, leading to heart failure.
Children don’t have the same symptoms or get the same treatments for heart failure as adults. This article focuses on heart failure in adults.
The most common signs and symptoms of heart failure are:
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 (e-DE-ma). This is a condition in which too much fluid builds up in your lungs. Acute pulmonary edema requires emergency treatment.
Early diagnosis and treatment can help people who have heart failure live longer, more active lives. Treatment for heart failure will depend on the type and stage of heart failure (the severity of the condition).
The goals of treatment for all stages of heart failure include:
Treatments usually include lifestyle changes, medicines, and ongoing care. If you have severe heart failure, you also may need medical procedures or surgery.
Simple changes can help you feel better and control heart failure. The sooner you make these changes, the better off you’ll likely be.
Following a heart healthy diet is a very important part of managing heart failure. In fact, not having a proper diet can make heart failure worse. Talk with your doctor and health care team to create an eating plan that works for you.
A heart healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.
Too much salt can cause extra fluid to build up in your body, making heart failure worse. Saturated and trans fats can cause unhealthy blood cholesterol levels, which are a risk factor for heart disease.
A balanced diet with varied nutrients can help your heart work better. Getting enough potassium is important for people who have heart failure. Some heart failure medicines deplete the potassium in your body. Lack of potassium may cause very rapid heart rhythms that can lead to sudden death.
Potassium is found in foods like white potatoes and sweet potatoes, greens (such as spinach), bananas, many dried fruits, and white beans and soybeans. Talk with your health care team about getting the correct amount of potassium.
For more information about following a healthy diet, see the National Heart, Lung, and Blood Institute’s Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” “Your Guide to Lowering Your Blood Pressure With DASH,” and “Your Guide to Lowering Cholesterol With TLC.” All of these resources include general information about healthy eating.
It’s very important for people who have heart failure to drink the right amounts and types of fluid. Drinking too much fluid can worsen heart failure. Also, if you have heart failure, you shouldn’t drink alcohol.
Talk with your doctor about what amounts and types of fluid you should have each day.
Taking steps to control risk factors for CHD, high blood pressure, and diabetes also will help control 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. The following medicines are commonly used to treat heart failure:
It’s important to watch for signs that heart failure is getting worse. For example, weight gain may mean that fluids are building up in your body. Discuss with your doctor how often to check your weight and when to report weight changes.
It’s also important to get medical care for other related conditions. If you have diabetes and/or high blood pressure, work with your health care team to control these conditions. Have your blood sugar level and blood pressure checked. Talk with your doctor about when you should have tests and how often to take measurements at home.
Try to avoid respiratory infections like the flu and pneumonia. Talk with your doctor or nurse about getting flu and pneumonia vaccines.
Many people who have severe heart failure may need treatment in a hospital from time to time. Your doctor may recommend oxygen therapy (oxygen given through nasal prongs or a mask). Oxygen therapy can be given in a hospital or at home.
As heart failure worsens, lifestyle changes and medicines may no longer control your symptoms. You may need a medical procedure or surgery.
If you have heart damage and severe heart failure symptoms, you may need a cardiac resynchronization therapy (CRT) device or an implantable cardioverter defibrillator (ICD).
In heart failure, the right and left sides of the heart may no longer contract at the same time. This disrupts the heart’s pumping. To correct this problem, your doctor may implant a CRT device (a type of pacemaker) near your heart. This device helps both sides of your heart contract at the same time, which may decrease heart failure symptoms.
Some people who have heart failure have very rapid, irregular heartbeats. Without treatment, the problem can cause sudden cardiac arrest. Your doctor may implant an ICD near your heart to solve this problem. An ICD checks your heart rate and uses electrical pulses to correct irregular heart rhythms.
People who have severe heart failure symptoms at rest, despite other treatments, may need:
Researchers continue to learn more about heart failure and how to treat it. As a result, treatments are getting better.
People who have heart failure often can be treated as part of research studies. These studies offer top care from heart failure experts and the chance to help advance heart failure knowledge and care.
If you have heart failure, you may want to take part in a heart failure registry, which tracks the course of disease and treatment in large numbers of people. The registry’s data help research move forward. You may help yourself and others by taking part. Talk with your health care team to learn more.
You can take steps to prevent heart failure. The sooner you start, the better your chances to prevent or delay the condition.
If you have a healthy heart, you can take action to prevent heart disease and heart failure. To reduce your risk of heart disease:
For more information about following a heart healthy diet, see the National Heart, Lung, and Blood Institute’s (NHLBI’s) Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” “Your Guide to Lowering Your Blood Pressure With DASH,” and “Your Guide to Lowering Cholesterol With TLC.” All of these resources include general information about healthy eating.
For more information about physical activity, see the Department of Health and Human Services’ “2008 Physical Activity Guidelines for Americans,” the Health Topics Physical Activity and Your Heart article, and the NHLBI’s “Your Guide to Physical Activity and Your Heart.”
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.
If you have heart damage but no signs of heart failure, you can still reduce your risk of developing the condition. In addition to taking the steps above, take your medicines as prescribed to reduce your heart’s workload.
For more information, visit the National Heart Lung and Blood Institute (NHLBI) at www.nhlbi.nih.gov.
