What is Heart Failure?

Definition

With heart failure, the heart is unable to pump the right amount of blood throughout the body. This causes blood to back up in the veins. Depending on which part of the heart is affected, this can lead to a buildup of excess fluid in the lungs, feet, and elsewhere. Heart failure can worsen with time, which may lead to the use of many treatments. Because of this, doctors are aggressive in treating heart failure to try to prevent it from worsening.

Blood Flow through the Heart Copyright © Nucleus Medical Media, Inc.

Causes

The leading causes of heart failure are:

• Coronary artery disease (CAD)
• Heart attack

Other common causes include:

• Problems with the heart's valves due to:
  • Rheumatic heart disease
  • Bacterial endocarditis
  • Congenital defects
  • Calcium deposits from atherosclerosis
• High blood pressure
• Diabetes

Other less common causes include:

• Cardiomyopathy—weakened, damaged heart muscle
• Certain medications
• Abnormal heartbeats—arrhythmias
• Hyperthyroidism—overactive thyroid
• Amyloidosis
• Kidney failure and/or liver failure
• Thiamine (vitamin B1) deficiency

Risk Factors

Heart failure is more common in older adults, men, and people of African American descent.

Factors that increase your chances of getting heart failure include:

• Obesity
• Excess intake of salt and fat
• Excess alcohol intake
• Smoking
• Pregnancy
• High fever
• Severe infection, such as pneumonia
• Chronic lung disease—emphysema
• Chemotherapy
• Psychological disorders, such as depression or anxiety

Symptoms

Symptoms include:

• Shortness of breath—at first only with activity, then progressing to shortness of breath at rest
• Unexplained weight gain
• Swelling of feet, ankles, or legs
• Need to sleep propped up
• Fatigue, weakness
• Wheezing
• Cough—may be dry and hacking or wet sounding, may have a pink, frothy sputum
• Frequent urination, especially at night
• Abdominal pain

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

• Blood tests
• Urine tests

Your heart may be examined. This can be done with:

• ECG
• Echocardiogram
• Exercise stress test
• Nuclear scanning
• Coronary angiography

Treatment

Prevention

The best way to prevent heart failure is to reduce your risk of:

• Coronary artery disease
• High blood pressure
• Diabetes

Take these steps to reduce your risk:

• Begin a safe exercise program with the advice of your doctor.
• If you smoke, talk to your doctor about ways to quit.
• Limit alcohol.
• Lose weight if needed. After you have lost weight, maintain a healthy weight.
• Eat a healthy diet. The DASH diet, in particular, may reduce the risk of high blood pressure and heart failure, particularly in women. The DASH diet is:
  • Rich in fruits, vegetables, and low-fat dairy foods
  • Low in saturated fat, total fat, and cholesterol
• Eat whole-grain breakfast cereal. In addition to the other healthy habits, this may reduce your risk.