Heart Failure
Heart failure occurs when the heart cannot pump enough oxygen-rich blood to meet the body's needs, often resulting from long-term medical conditions.
Overview
Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. It does not mean your heart has stopped or is about to stop beating, but without enough blood flow, organs may not work well.
- Right-sided heart failure: The heart is too weak to pump enough blood to the lungs to get oxygen.
- Left-sided heart failure: The heart can't pump enough oxygen-rich blood out to the body. This is more common than right-sided failure.
Causes
Heart failure often develops slowly from long-term conditions, including:
- Arrhythmia, cardiomyopathy, or coronary artery disease
- Heart attack or heart valve diseases
- High blood pressure or diabetes
- Congenital heart defects
- Lung diseases like COPD
- Obesity or blood clots in the lung
Risk Factors
Your chance of developing heart failure increases if you are 65 or older, have a family history, or have specific genetic changes. Other risk factors include:
- Lifestyle habits: Smoking, high-fat/high-sodium diet, inactivity, alcohol use disorder, or illegal drug use.
- Medical conditions: Serious lung diseases, infections (HIV, COVID-19), obesity, diabetes, sleep apnea, chronic kidney disease, anemia, thyroid disease, or iron overload.
- Cancer treatments: Radiation and chemotherapy.
- Race: African Americans are more likely to develop heart failure and have more serious cases at younger ages.
Symptoms
Symptoms are caused by reduced blood flow and fluid buildup (edema). They include:
- Shortness of breath during activity
- Fatigue or weakness
- Coughing
- Swelling and weight gain in the ankles, legs, or abdomen
- Difficulty sleeping when lying flat
- Nausea and loss of appetite
- Swelling in neck veins
- Frequent urination
Diagnosis
Providers diagnose heart failure by reviewing medical and family history, performing a physical exam, and ordering heart and blood tests, such as a brain natriuretic peptide (BNP) test. You may be referred to a cardiologist.
Treatment & Management
While there is no cure, treatment helps patients live longer with fewer symptoms. Plans typically include:
- Medication and lifestyle changes (low sodium, limited fluids, quitting smoking, stress management, and physical activity).
- Treating underlying conditions.
- Surgery or devices, such as an implantable cardioverter defibrillator, biventricular pacemaker, or a mechanical heart pump (VAD).
- Heart transplant in severe, life-threatening cases.