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What You Should Know About Heart Failure

What You Should Know About Heart Failure

Learn about the causes and symptoms of this common condition and how it can be managed.

Contrary to popular belief, heart failure doesn’t mean that your heart suddenly stops beating. “Heart failure is when your heart cannot adequately deliver oxygen-rich blood to other organs,” says Ram Wadehra, MD, a cardiologist with Our Lady of Lourdes Medical Center in Camden, New Jersey.

Some people may also assume that heart failure isn’t treatable, but this isn’t the case. Heart failure is debilitating and can be deadly in the long term. But in many cases, it can be prevented and managed. A healthy diet, adequate exercise, not smoking, avoiding drugs, limiting alcohol and managing stress can all protect your heart health and help prevent heart failure.

What causes heart failure?
Heart failure is most commonly caused by other heart disease or heart disease risk factors. Coronary artery disease (CAD), a condition in which plaque builds up in the arteries and reduces blood flow, is one of the most common causes. High blood sugar levels seen in diabetes also damages the blood vessels in and around the heart and can weaken the muscle. High blood pressure can weaken the heart, as well.  

Other causes of heart failure can include heart rhythm problems or damage to the heart muscle, such as from a heart attack. “Sometimes there’s a viral infection that can weaken the heart,” Dr. Wadehra explains. “Other times it’s too much alcohol. Some chemotherapy medicines can also cause heart failure.”

Recognizing the signs and symptoms
Heart failure may cause fluid to seep into the lungs, legs or abdomen. This can lead to coughing, wheezing or shortness of breath. It can also result in swelling of the legs or belly.   

Those with heart failure may also experience:

  • Fatigue
  • Loss of appetite
  • Confusion

The symptoms of heart failure could be mistaken for those of other conditions, Wadehra points out. “People sometimes think they have pneumonia or asthma when there’s congestion in the lungs,” he says. “Swelling is also a symptom of chronic liver disease. It’s not any one thing and it depends on the patient’s symptoms, but heart failure is sometimes confused with other conditions that cause poor blood flow or fluid retention.”

Different types of heart failure
A quick anatomy lesson can help explain the different ways in which the heart can fail.

The heart has two chambers on top, called the right and left atria, and two on the bottom, the right and left ventricles. Between these chambers are valves that allow blood to flow in and out.

Blood collects on the right side of the heart and is pushed to the lungs to be replenished with oxygen. The blood then returns from the lungs to the left side of the heart, where it’s pumped out into the arteries that carry it to the rest of the body.

“There are many different types of heart failure,” Wadehra notes. Both the right and left sides of the heart can weaken and fail, and each case has slightly different symptoms.

“Right-sided heart failure can often manifest in leg and abdominal swelling, more fluid retention and weight gain symptoms,” he explains. “Left-sided heart failure often relates to fluid in the lungs.” One type of heart failure can lead to the other, he adds.

Left-sided heart failure can also come in two different varieties. Either the heart becomes too weak to push enough blood out during the contraction (systolic heart failure), or it becomes too stiff to fully relax and fill with blood (diastolic heart failure). Heart failure can develop slowly over time, or it can come on and worsen quickly.

Managing heart failure
An estimated 50 percent of people with heart failure will die within five years of being diagnosed. But early diagnosis and treatment can improve the quality and length of life for people who have the condition.

Complications from heart failure can include kidney damage or failure, liver damage and heart valve problems. (More than 40 percent of people with heart failure have kidney disease.) Arrhythmias—or abnormal heart rhythms, such as atrial fibrillation—often appear alongside heart failure, as well.

But there is some good news: There are a number of treatment options for heart failure.

“Our goal with heart failure is to improve heart function with medications and medical and lifestyle interventions,” Wadehra says.

Controlling your salt intake and your weight can help keep heart failure from getting worse and will reduce how hard the heart has to work. Certain medications, including diuretics, ACE inhibitors, beta-blockers and nitrates can also help. Some people who have severe heart failure or serious arrhythmias may benefit from an implanted device, such as a pacemaker or implantable cardioverter defibrillator (ICD). In some cases, surgery may also be an option. 

“Heart failure is something we can treat and improve with medication, good care and good follow-up,” Wadehra says.

Medically reviewed in November 2020. Updated in December 2020.

Sources:

Virani SS, Alonso A, Benjamin EJ, et al. "Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association." Circulation. 2020;141(9):e139-e596.
Emory Healthcare. "Heart & Vascular: Conditions & Treatments. Heart Failure Statistics." Published 2019.
Mayo Clinic. "Heart Failure." Published May 29, 2020.
American Heart Association. "Types of Heart Failure." Published May 31, 2017.
The National Heart, Lung, and Blood Institute (NHLBI). "Heart Failure."
Centers for Disease Control and Prevention. "Diabetes and Your Heart." Published January 31, 2020.
Centers for Disease Control and Prevention. "Facts About Heart Failure in the United States." Published September 8, 2020.
American Heart Association. “Devices and Surgical Procedures to Treat Heart Failure.” Published May 31, 2017.

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