heart failure

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Overview

Heart failure—sometimes called congestive heart failure—occurs when the heart muscle cannot pump blood properly. When this happens, blood often backs up and fluid builds up in the lungs, causing shortness of breath.

Certain heart diseases, such as narrowing of the arteries in the heart (coronary artery disease) or high blood pressure, gradually make the heart too weak or stiff to fill and pump blood properly.

Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer. Lifestyle changes—such as losing weight, exercising, reducing salt (sodium) in your diet, and managing stress—can improve your quality of life. However, heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may need a heart transplant or a ventricular assist device (VAD).

One way to prevent heart failure is to prevent and control conditions that can lead to heart failure, such as coronary artery disease, high blood pressure, diabetes, and obesity.

symptom

Heart failure may last (chronic) or start suddenly (acute).

Signs and symptoms of heart failure may include:

Shortness of breath when moving or lying down
fatigue and weakness
swelling of legs, ankles, and feet
fast or irregular heartbeat
Decreased athletic ability
Persistent coughing or wheezing with white or pink bloody mucus
Swelling in the abdomen (abdomen)
Fluid accumulation leading to rapid weight gain
Nausea and loss of appetite
Difficulty concentrating or decreased alertness
If heart failure is chest pain caused by a heart attack

when to see the doctor

If you think you may be experiencing signs or symptoms of heart failure, see your doctor. Call 999 or emergency medical help if you have any of the following conditions:

chest pain
Fainting or severe weakness
Fast or irregular heartbeat associated with shortness of breath, chest pain, or fainting
Sudden severe shortness of breath and coughing up white or pink frothy mucus

While these signs and symptoms may be caused by heart failure, there are many other possible causes, including other life-threatening heart and lung conditions. Don't try to diagnose yourself.

Emergency room doctors will try to stabilize your condition and determine whether your symptoms are caused by heart failure or another cause.

If you have been diagnosed with heart failure and any symptoms worsen suddenly or new signs or symptoms appear, it may mean that existing heart failure is getting worse or not responding to treatment. This may also be the case if you gain 5 pounds (2.3 kg) or more over a few days. Contact your doctor promptly.

reason

Heart failure usually occurs after other diseases damage or weaken the heart. However, heart failure can also occur if the heart becomes too stiff.

In heart failure, the heart's main pumping chambers (ventricles) may become stiff and not fill properly between beats. In some people, the heart muscle may become damaged and weakened. The ventricles may stretch to the point where the heart cannot pump enough blood throughout the body.

Over time, the heart can no longer meet the typical demands of pumping blood to the rest of the body.

Your doctor can determine how well your heart pumps blood by measuring how much blood it pumps with each heartbeat (ejection fraction). Ejection fraction is used to help classify heart failure and guide treatment. In a healthy heart, the ejection fraction is 50% or higher - meaning more than half of the blood that fills the ventricles is pumped out with each beat.

But heart failure can occur even with a normal ejection fraction. This occurs if the heart muscle becomes stiff due to a condition such as high blood pressure.

Heart failure may involve the left side (left ventricle), right side (right ventricle), or both sides of the heart. Generally, heart failure starts on the left side, specifically the left ventricle - the heart's main pumping chamber.

Types of heart failure

Types of heart failure	describe
left-sided heart failure	Fluid may back up into the lungs, causing shortness of breath.
right sided heart failure	Fluid may back up into the abdomen, legs, and feet, causing swelling.
Systolic heart failure (also called heart failure with reduced ejection fraction)	The left ventricle is unable to contract vigorously, indicating a pumping problem.
heart failure with preserved ejection fraction	The left ventricle cannot relax or fill completely, indicating a filling problem.

Any of the following conditions can damage or weaken your heart and may lead to heart failure. Some of these may appear without your knowledge:

Coronary artery disease and heart attack. Coronary artery disease is the most common form of heart disease and the most common cause of heart failure. The disease is caused by the buildup of fatty deposits in the arteries, which can reduce blood flow and lead to heart attacks.

Heart disease occurs suddenly when a coronary artery is completely blocked. Damage to the heart muscle caused by a heart attack may mean your heart can no longer pump blood properly.
hypertension. If your blood pressure is high, your heart has to work harder to circulate blood throughout your body. Over time, this extra movement can cause your heart muscle to become too stiff or too weak to pump blood properly.
Heart valve failure. Heart valves keep blood flowing in the right direction. Damaged valves from a heart defect, coronary artery disease, or heart infection force the heart to work harder, which can weaken it over time.
Damage to myocardium. Heart muscle damage can occur for a variety of reasons, including certain diseases, infections, heavy drinking, and the toxic effects of drugs (such as cocaine or certain drugs used in chemotherapy). Genetic factors can also play a role.
Inflammation of the heart muscle (myocarditis). Myocarditis is most commonly caused by viruses, including the COVID-19 virus, and can lead to left-sided heart failure.
A heart problem you are born with (congenital heart defect). If your heart and its chambers or valves are not formed correctly, the healthy parts of the heart have to work harder to pump blood, which can lead to heart failure.
Arrhythmias (arrhythmias). Abnormal heart rhythms may cause your heart to beat too fast, putting extra work on your heart's shoulders. A slow heartbeat can also lead to heart failure.
other illnesses. Long-term conditions—such as diabetes, HIV, an overactive or underactive thyroid, or a buildup of iron or protein—can also lead to chronic heart failure.

Causes of sudden (acute) heart failure also include:

allergic reaction
any disease that affects the whole body
pulmonary blood clots
severe infection
using certain medications
Viruses that attack the heart muscle

risk factors

A single risk factor may be enough to cause heart failure, but a combination of factors can also increase your risk.

Risk factors for heart failure include:

Coronary artery disease. Narrowed arteries may limit the heart's supply of oxygen-rich blood, causing the heart muscle to weaken.
heart attack. A heart attack is a sudden onset of coronary artery disease. Damage to your heart muscle from a heart attack may mean your heart can no longer pump blood properly.
Valvular heart disease. Heart valves that do not work properly increase the risk of heart failure.
hypertension. If your blood pressure is high, your heart works harder than it has to.
Irregular heartbeat. These abnormal rhythms, especially if they are very frequent and rapid, can weaken the heart muscle and lead to heart failure.
Congenital heart disease. Some people with heart failure are born with problems that affect the structure or function of their heart.
diabetes. Having diabetes increases your risk of high blood pressure and coronary artery disease. Do not stop taking any medicine on your own. Ask your doctor if you should make changes.
Some diabetes medications. The diabetes drugs rosiglitazone (Avandia) and pioglitazone (Actos) have been found to increase the risk of heart failure in some people. However, do not stop taking these medications on your own. If you are taking them, ask your doctor if any changes need to be made.
Certain other drugs. Some medications may cause heart failure or heart problems. They include nonsteroidal anti-inflammatory drugs (NSAIDs); certain narcotic drugs; and used to treat high blood pressure, cancer, blood disorders, irregular or abnormal heartbeats, neurological disorders, mental health conditions, lung and urinary system problems, Certain medicines for inflammatory diseases and infections.
Alcohol use. Excessive alcohol consumption can weaken the heart muscle and lead to heart failure.
sleep apnea. Not being able to breathe properly while sleeping can lead to an increased risk of low blood oxygen levels and irregular heartbeats. Both problems can weaken the heart.
Smoking or using tobacco. If you smoke, quit. Smoking increases the risk of heart disease and heart failure.
obesity. Obese people are at higher risk of heart failure.
Virus. Certain viral infections can cause heart muscle damage.

complication

Complications of heart failure depend on the severity of the heart disease, your overall health and other factors such as your age. Possible complications include:

Kidney damage or failure. Heart failure reduces blood flow to the kidneys and, if left untreated, can eventually lead to kidney failure. Kidney damage from heart failure may require dialysis.
Heart valve problems. If your heart is enlarged or the pressure in your heart is very high due to heart failure, the heart valves that keep blood flowing in the right direction may not work properly.
Heart rhythm problems. Heart rhythm problems may cause or increase your risk of heart failure.
Liver damage. Heart failure can cause fluid to build up, putting too much pressure on the liver. This fluid backup can cause scarring, making it harder for your liver to work properly.

prevention

The key to preventing heart failure is reducing your risk factors. You can control or eliminate many risk factors for heart disease by making healthy lifestyle changes and taking medications prescribed by your doctor.

You can make lifestyle changes to help prevent heart failure, including: