What Is Heart Failure?


The term “heart failure” might make you think your heart is about to stop working. It really means that it isn’t pumping as well as it should.

A healthy heart pumps blood throughout the body to make sure it gets all the blood and oxygen it needs. Over time, if you have heart failure, the heart can’t give the body everything it needs.

Your heart might try to make up for it by enlarging, getting more muscle, or pumping faster. Blood vessels may get narrower, and your body may even stop sending blood to your less important organs and tissues. None of these fix the problems of heart failure.


Heart failure can involve just one side of the heart or both sides. In most cases, it affects the left side first. It’s usually broken down into several types:

Left-sided heart failure: The left ventricle is larger and pumps more of the heart’s blood. This type of heart failure is broken down into two categories:

  • Systolic failure, where the left ventricle is too weak to push enough blood
  • Diastolic failure, where the left ventricle is too stiff, can’t relax, and can’t fill with blood normally

Right-sided heart failure: This usually happens after the left side fails. More fluid pressure through the lungs damages the right side of your heart.

Congestive heart failure: When blood slows down as it leaves the heart, it also is slower when it comes back. That causes blood to back up in your veins, and there can be swelling all over your body. You might see it in your legs and ankles, but it can collect in your lungs, too. That can cause serious breathing problems.

If you have this, get medical help right away.


Many things can bring heart failure. They include:

  • Coronary artery disease and heart attack
  • High blood pressure
  • Heart valve problems
  • Heart muscle damage (called cardiomyopathy)
  • A heart defect you were born with
  • Abnormal heart rhythms (called arrhythmias)
  • Myocarditis (inflammation of your heart muscle)
  • Other diseases, such as:
    • Diabetes
    • HIV
    • Thyroid problems
  • The use of toxic substances, such as alcohol or drugs


    Some common signs of heart failure are:

    • Shortness of breath
    • Tiredness, weakness
    • Swelling in your feet, ankles, legs, or abdomen
    • Lasting cough or wheezing
    • Fast or irregular heartbeat
    • Dizziness, confusion
    • Having to go to pee more often at night
    • Nausea, lack of appetite


    To figure out if you have heart failure, your doctor will:

    • Examine you
    • Ask about your medical history
    • Run some tests

    Those tests might include:

    Blood tests: Abnormal levels of important substances can show strain to organs due to heart failure.

    Electrocardiogram (EKG): This records the electrical activity of your heart.

    Chest X-ray: It will let your doctor know if you have an enlarged heart. It can also show congestion.

    Echocardiogram: This uses sound waves to make a video image of your heart.

    Exercise test: You may hear this called a stress test. It measures how your heart responds when it has to work hard.

    Heart catheterization: In this test, you get dye injected through a small tube into a blood vessel. It will show any blockages or weakened arteries.

    Radionuclide ventriculography: You may also hear this called a MUGA scan. Radioactive materials go into your bloodstream. Then a device called a gamma camera takes pictures of your heart to show how well it’s working. The radioactive material is safe for most folks. Your kidneys will take care of it. However, if you’re pregnant or nursing, you shouldn’t have this test.


    Heart failure can’t be cured. Treatment can help ease symptoms and make your heart pump better. Methods include:

    Lifestyle changes: Your doctor will probably suggest that you:

    • Follow a heart-healthy diet
    • Exercise regularly
    • Aim for a healthy weight
    • Quit smoking

    Medication: You may need to take one or more drugs as part of your treatment. Common heart failure medications include:

    • ACE inhibitors
    • Diuretics
    • Beta-blockers
    • Digoxin

    Surgery and devices: In some cases, you may need surgery. Several procedures can treat heart failure. If your condition is more severe, your doctor may implant a device like a defibrillator or something called a left ventricular assist device (LVAD) in your body. Other times, a heart transplant may be the best choice. Your doctor will find the right course for you.

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