What is Heart Failure

Heart failure, also referred to as congestive heart failure, is a condition that occurs when the heart doesn’t pump blood properly. Conditions like narrowed arteries or high blood pressure can gradually weaken or stiffen the heart, eventually making it unable to pump blood efficiently.

Treatments can improve signs and symptoms of heart failure and help increase lifespan, though not all conditions that lead to heart failure can be reversed.

Symptoms and Complications

Heart failure can be either chronic (building over time) or acute (sudden). Signs and symptoms of heart failure include:

Shortness of breath during exertion or when lying down
Fatigue and weakness
Swelling in the legs, ankles and feet
Rapid or irregular heartbeat
Decreased ability to exercise
Persistent cough or wheezing with white or pink blood-tinged phlegm
Increased need to urinate at night
Swelling in the abdomen
Sudden weight gain due to fluid retention
Lack of appetite and nausea
Difficulty concentrating or decreased alertness
Sudden, severe shortness of breath and coughing up pink, foamy mucus
If caused by a heart attack, chest pain may be present

See your doctor if you are experiencing any of these symptoms. If you feel chest pain, fainting or severe weakness, rapid heartbeat, shortness of breath, chest pain, or coughing up mucus, seek immediate medical attention. These signs are not always indicative of heart failure, but could be due to other life-threatening conditions.

Complications from heart failure can include:

Kidney damage or kidney failure
Heart valve issues
Heart rhythm issues
Liver damage

Causes and Risk Factors

Heart failure is often caused by other conditions that have weakened the heart, but this is not always the case. It may also become stiff and stop filling properly between beats.

Heart failure can involve the left side of the heart (left ventricle), the right side of the heart (right ventricle), or both. It generally begins on your left side, the heart’s main pumping chamber. Some of the conditions that can cause heart failure include:

Coronary artery disease and heart attack. CAD is the most common form of heart disease and the most common cause of heart failure. It involves reduced blood flow to the heart due to buildups over time. A heart attack may also form a blood clot, blocking blood flow to the heart and weakening the muscle in some cases.
High blood pressure (hypertension): If blood pressure is too high, the heart has to work harder to circulate it, which can weaken the heart muscle.
Faulty heart valves
Cardiomyopathy: Damage to the heart muscle.
Myocarditis: Inflammation of the heart muscle
Congenital heart defects: Defects present at birth
Heart arrhythmias: Abnormal heart rhythms
Other disease: Including diabetes, HIV, hyperthyroidism, hypothyroidism, hemochromatosis (buildup of iron) or amyloidosis (buildup of protein) can contribute to heart failure.

There are numerous risk factors for heart failure, including:

High blood pressure
Coronary artery disease
Heart attack
Diabetes and some diabetes medications
Other medications
Sleep apnea
Congenital heart defects
Valvular heart disease
Viruses
Alcohol use
Tobacco use
Obesity
Irregular heartbeats

Diagnosis and Treatment

Diagnosing and properly classifying heart failure depends on your symptoms and risk factors. It begins with a physical exam, and may require a variety of potential tests.

Treatment for heart failure falls into two categories: Medications and surgeries/devices. Medication may include the following, sometimes more than one at a time:

ACE inhibitors: These widen blood vessels and lower blood pressure
Angiotensin II receptor blockers: Similar to ACE inhibitors, or an alternative for those who need one
Beta blockers: These slow heart rate, reduce blood pressure and can help reduce heart damage
Diuretics: Diuretics make you urinate more often and keep fluid from collecting in the body
Aldosterone antagonists: Diuretics with additional properties
Inotropes: Intravenous medications for people with severe heart failure
Digoxin (Lanoxin): Also called digitalis, this is a drug that increases heart muscle contraction strength

Surgical and device options include the following:

Coronary bypass surgery: Using blood vessels from elsewhere in the body to bypass a clogged artery
Heart valve repair or replacement: Repairing or replacing the heart valve
Implantable cardioverter-defibrillators (ICDs): A device similar to a pacemaker that monitors heart rhythm
CRT therapy: Another item similar to a pacemaker
Heart pumps: Mechanical devices implanted into the body to help the heart pump blood
Heart transplant: For people who are not helped by medication or surgery, a healthy donor heart replacement may be needed.

Prevention

Preventing heart failure involves eliminating your risk factors, which mainly comes from making lifestyle changes. Such changes may include:

Not smoking
Controlling conditions like high blood pressure and diabetes
Staying active
Eating a healthy diet and maintaining healthy weight
Reducing and managing stress

If you fear you have some of the signs of heart failure, contact your doctor or emergency medical services right away.

Our providers are board certified in general cardiology and interventional cardiology. We have over 30 providers with decades of experience in heart-related care. As a part of Utah’s largest independent physician group, we have a network of physicians who are able to care for all cardiology needs.

Sources:

“Heart failure.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/definition/con-20029801

“Heart Failure.” American Heart Association. http://www.heart.org/HEARTORG/Conditions/HeartFailure/Heart-Failure_UCM_002019_SubHomePage.jsp