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Heart Failure
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Blood Heart Circulation

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.

Frequently Asked Questions

If you develop sudden severe shortness of breath at rest, chest pain, fainting, rapid or irregular heartbeat, sudden swelling of the legs or abdomen, or you feel confused or unable to stay awake, treat it as an emergency and call 911 immediately.
Most clinicians recommend limiting total fluid intake to about 1.5–2 liters (about 50–68 ounces) per day, but the exact amount depends on your weight, kidney function, and how much fluid you retain; follow the specific limit your heart‑failure team gives you.
Key drugs often include an ACE inhibitor or ARB, a beta‑blocker, a diuretic, and sometimes a mineralocorticoid receptor antagonist. If you miss a dose of a daily medication, take it as soon as you remember unless it’s close to the time for the next dose—don’t double up. For diuretics, if you miss a dose, you may retain fluid; contact your provider for guidance.
Yes, regular low‑intensity aerobic activity such as walking, stationary cycling, or water walking is usually safe and can improve symptoms. Start with 5–10 minutes a day, gradually increasing to 30 minutes most days, and always check your weight and symptoms before and after exercise; stop if you become unusually short of breath, dizzy, or develop chest pain.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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