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Health Information Center

Heart Failure

  • Rosalyn Carson-DeWitt, MD
Publication Type:


Heart Failure

(Congestive Heart Failure; Chronic Heart Failure; Left Ventricular Dysfunction; Left Ventricular Failure)


The heart is unable to pump the right amount of blood through the body. This causes blood to back up in the veins. It can lead to a buildup of excess fluid in places like the lungs and feet.

Heart failure can get worse with time. Vital organs can be damaged from low blood flow.

Blood Flow through the Heart.

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The leading causes of heart failure are:

Other common causes include:

Other less common causes include:

Risk Factors

Heart failure is more common in older adults. Other things that raise the risk of heart failure include:


Heart failure can cause:

  • Shortness of breath—at first it only happens with activity, then it progresses to having shortness of breath at rest
  • Unexplained weight gain
  • Swelling of feet, ankles, or legs
  • Needing 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
  • Belly pain


The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may note changes caused by heart failure such as fluid build up in legs. They may also hear abnormal sounds when they listen to the heart. Blood tests may be done to look for certain markers of change in the heart.

Tests can help show what parts of the heart are affected. They can also show changes in blood flow. This can be done with:

Doctors will use the test results to determine level of heart failure. This will help guide the treatment plan.


The goal of treatment is to keep the symptoms from getting worse. Treatment can ease symptoms and improve quality of life. Some may also have some improvement in heart strength. Heart failure will need lifelong care.

Treatment will vary by person and over time. Tracking weight and symptoms every day will help catch changes early. Treating these changes fast may help keep heart failure from getting worse.

Heart failure may be caused by another health issue. Treating this issue may improve heart failure or prevent it from getting worse. For any form of heart failure, treatment may include:

Severe symptoms may need hospital care. Those who have frequent hospitalizations may be referred to special care programs. They will focus on multiple ways to managing heart failure.


The best way to prevent heart failure is to reduce the risk of heart disease, high blood pressure, and diabetes. General steps include:

  • Aiming to be active 150 minutes each week
  • Quitting smoking
  • Limiting alcohol
  • Maintaining a healthy weight
  • Eating a healthy diet




  • Congestive heart failure and congenital defects. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Congestive-Heart-Failure_UCM_307111_Article.jsp#.Wbk5j7KGNQJ.
  • Explore heart failure. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/hf.
  • Heart failure with reduced ejection fraction (HFrEF). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/heart-failure-with-reduced-ejection-fraction-hfref.
  • Lifestyle changes for heart failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Lifestyle-Changes-for-Heart-Failure_UCM_306341_Article.jsp#.Wbk6sbKGNQJ.
  • Paterna, S., Parrinello, G., et al. Medium term effects of different dosage of diuretic, sodium, and fluid administration on neurohormonal and clinical outcome in patients with recently compensated heart failure. American Journal of Cardiology, 2009; 103 (1): 93-102.
  • Physical changes to report. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Physical-Changes-to-Report_UCM_306356_Article.jsp#.Wbk69LKGNQI.
  • Yancy, C.W., Jessup, M., et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 2013; 62 (16): e147-e239.
  • 4/2/2014 DynaMed Systematic Literature Surveillance https://www.dynamed.com/quality-improvement/choosing-wisely: Updated July 23, 2015.
  • 1/18/2017 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/coronary-artery-disease-cad: Emdin, C.A., Odutayo, A., et al. Meta-analysis of anxiety as a risk factor for cardiovascular disease. American Journal of Cardiology, 2016; 118 (4): 511-519.
  • 8/21/2023 DynaMed Systematic Literature Surveillance https://www.dynamed.com/management/heart-failure-structured-management-and-education: Heidenreich Paul A., Bozkurt Biykem, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, Journal of the American College of Cardiology, 2022;79(17) :e263-e421.


  • Michael J. Fucci, DO, FACC
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.