What is Heart Failure?
Heart failure means your heart does not pump as much blood as your body needs. For most, it is a chronic heart condition that can be addressed with medication and lifestyle changes. When your heart does not pump blood as well as it should, fluid builds up in your body, and you may feel weak and out of breath. This fluid build-up is called congestion. That’s why heart failure is also called congestive heart failure.
Types of Heart Failure
Heart failure can develop in different places in the heart and look different depending on which part of the heart is affected. Heart failure usually starts in the left ventricle, the heart chamber that pumps oxygen-rich blood to the rest of the body. There are different treatments for the different types of heart failure.
- Left-sided heart failure with reduced ejection fraction (HFrEF, or systolic failure). The left ventricle doesn’t contract or squeeze, to pump enough blood into your body
- Left-sided heart failure with preserved ejection fraction (HFpEF, or diastolic failure). The left ventricle can contract, but it doesn’t relax completely and fill up with blood before the next contraction. As a result, it pushes less blood into circulation
- Right-sided heart failure. Left-sided heart failure often results in increased pressure on the right side of the heart, damaging it. When the right side of the heart can’t pump efficiently, blood backs up in the body’s veins, leading to swelling in the legs, ankles, and other parts of the body.
- Congestive heart failure. During congestive heart failure, ventricles on both sides of the heart can’t pump enough blood to the rest of the body, resulting in an urgent medical condition. Fluid builds up in the abdomen, liver, lower body, and legs.
Stages of Heart Failure
Doctors classify heart failure in a series of stages based on risk factors, symptoms, and test results. The diagnosed stage of your heart failure helps guide treatment.
Stages of congestive heart failure are:
- Stage A includes people at risk of heart failure with no heart failure symptoms and no test results that would indicate heart muscle injury. High blood pressure, diabetes, and obesity are among the things that increase heart failure risk.
- Stage B includes people who have no heart failure symptoms, but their test results show heart disease, including injury to the heart muscle and other abnormalities
- Stage C includes people who have heart disease and heart failure symptoms such as shortness of breath, persistent cough, swelling in the legs, feet, or abdomen, fatigue, and nausea
- Stage D indicates advanced heart failure, with symptoms that interfere with daily life and require treatment in a hospital
Signs and Symptoms of Heart Failure
Damage to the heart muscle happens before you have any symptoms of congestive heart failure. For a while, your body can make up for your heart not pumping as well as it should. But at some point, your heart and body will no longer be able to keep up. Then, fluid will start to build up in your body, and you will begin to have symptoms like feeling weak or out of breath.
Congestive heart failure symptoms include:
- Feeling tired easily
- Shortness of breath
- Feeling like your heart is pounding or racing
- Feeling weak or dizzy
- Swelling (edema), especially in your legs, ankles, and feet
- Sudden weight gain
- Coughing or wheezing, primarily when you lie down
- Feeling bloated or sick to your stomach
- Confusion or memory loss
When to see a doctor
If your signs and symptoms of heart failure become worse, or if you develop a new symptom, call your doctor right away. The following symptoms of heart failure require immediate treatment.
Call your physician or call 911, and say that you have a diagnosis of heart failure if you have:
- Sudden weight gain of more than 2 to 3 pounds in 24 hours (or 5 pounds in a week)
- Shortness of breath at rest
- Frequent dry, hacking cough
- Increased swelling in the lower body
- New or worsening confusion, dizziness, or feeling of sadness
- Loss of appetite
- Increased difficulty sleeping
What Causes Heart Failure?
Any condition that damages or weakens the heart can cause heart failure. Heart failure can be caused by:
- Coronary artery disease
- Previous heart attack(s)
- High blood pressure
- History of alcohol abuse
- Taking medication that can damage the heart muscle, including some cancer drugs
- Infection or inflammation of the heart muscle
- Heart problems from birth (congenital heart disease)
- Damaged heart valves
- Atrial fibrillation
- Cardiac amyloidosis
- Pulmonary hypertension
Risk Factors for Heart Failure
Heart failure is usually the result of another underlying health problem, often coronary artery disease or high blood pressure. Anything that increases your risk for one of those conditions also increases your risk for heart failure.
Risk factors for heart failure include:
- Old age
- High cholesterol
- Family history of heart disease
- Sedentary lifestyle
- Family history of high blood pressure
Heart Failure Prevention
You can help prevent heart failure by taking care of related health problems that increase your risk of developing heart failure. Take these steps to prevent heart failure:
- Get regular check-ups with your primary care doctor
- Check blood pressure regularly, and take medications as prescribed
- Don’t smoke
- Control cholesterol
- Eat a heart-healthy diet
- Exercise regularly
- Limit alcohol intake
- Maintain a healthy weight
Trust NewYork-Presbyterian for Heart Failure Care
NewYork-Presbyterian’s exceptional team of cardiologists and cardiac surgeons treat more heart patients than any other hospital in the country. Contact us to learn more about our treatment options for congestive heart failure. We provide complete cardiovascular care for heart failure, coronary artery disease, congenital heart disease, and all other heart conditions.