Heart failure, sometimes also called congestive heart failure, may sound like the heart has stopped beating, but it actually means that the heart muscle is not pumping blood as well as it should. Heart failure is a serious chronic condition that affects about 5.1 million people in the United States. If you have been diagnosed with heart failure, it’s important to learn about the condition.
What Is It Again?
An easy way to understand the condition is by looking at the heart as a pump. It receives “used” blood from the body and pumps it to the lungs so it picks up oxygen – it then receives the “oxygenated” blood back from the lungs and pumps it back out to the body.
When the heart is damaged or weakened, it is not able to do its job as well. But because the body still needs its supply of blood, oxygen and nutrients, it will compensate to keep up with the demand. For example, the heart might stretch out or thicken or try to pump faster so that it can continue to pump blood. The blood vessels may also narrow to keep up the pressure or send blood to more important organs. But the heart can do this only for so long. Eventually these workarounds don’t work as well, and the heart becomes less effective (or weaker) over time.
Heart failure can affect the left side of the heart, the right side, or both.
Left-sided heart failure: the heart cannot pump enough oxygenated blood to the body; there are 2 types of left-sided heart failure: systolic – heart cannot pump with enough force to push blood back to the body, and diastolic – heart becomes stiff and cannot relax properly to allow enough blood fill into the chamber
Right-sided heart failure: the heart cannot pump enough blood to the lungs to be oxygenated; usually occurs as a result of left-sided heart failure, and blood backs up in the veins
Essentially, heart failure is a condition in which the heart is not able to pump enough blood to the body, or the heart muscle does not relax completely to fill with enough blood.
How Do You Know You Have Heart Failure?
There is no single test to confirm a diagnosis of heart failure. Though signs and symptoms are not always prominent, heart failure is often suspected initially based on the symptoms a person experiences. Symptoms can vary depending on the type and severity of heart failure; however, the most common symptoms include:
Shortness of breath or trouble breathing
Swelling in the ankles, legs, feet or abdomen
Other signs and symptoms may include increased heart rate, loss of appetite, coughing or wheezing, chest pain, abdominal swelling and confusion
Doctors will evaluate a person’s complete history and conduct a physical examination in addition to lab tests (e.g., blood tests, liver and kidney function tests, cholesterol/lipid measurements, chest x-ray, EKG [electrocardiogram]).
As you can imagine, if the heart cannot pump enough blood, it affects the entire body.
The effects of heart failure can include: increase in heart’s pressure, reduced blood supply in the kidneys, congestion in the liver and swelling in the extremities.
It’s important to keep in mind that heart failure symptoms can be mild or severe. In fact, for unknown reasons, some people with heart failure will not experience any symptoms at all.
Who’s At Risk?
Heart failure occurs as a result of having a weakened or damaged heart. The most common causes of heart failure include coronary artery disease, high blood pressure and diabetes. Other conditions that can lead to heart failure include: infections in the heart, heart defects from birth, abnormal heartbeat, thyroid disorder, alcohol or drug abuse, and use of certain medications (e.g., cancer drugs).
Heart failure is more common in people with the following risk factors:
Being 65 years or older
Having had a previous heart attack
Why Is It Important To Treat?
Heart failure can have severe consequences. Symptoms may worsen over time. Heart failure can lead to kidney or liver failure, sudden cardiac arrest (heart stops beating suddenly) and death.
In most cases, heart failure is a chronic condition that needs lifelong maintenance. Lifestyle changes and medication use can help slow the progression of the condition, reduce symptoms and improve quality of life. It’s important to work with your doctor to treat heart failure.
John Vincent, MD, PhD, is a Senior Director in Clinical Affairs at Pfizer.