Heart failure

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 15, 2016
StartDiseasesHeart failure

Heart failure may also be known as congestive heart failure. There are several causes and conditions that can lead to heart failure. It is the one of the leading causes of death among Americans of all races and ethnic groups.


Definition and Facts

When the heart is unable to pump blood throughout the body as it should, the result is a chronic condition known as heart failure. There are two main forms. Diastolic heart failure occurs when the heart cannot be filled with blood and systolic heart failure is when the cardiac muscles are unable to pump blood out of the heart.

Symptoms & Complaints

Heart failure symptoms may manifest over a period of time or can have a sudden onset. Symptoms may vary depending on the cause of heart failure. The most common complaints include:

Those who experience fatigue and tiredness may also find that this affects their ability to exercise or perform certain activities. A rapid heartbeat indicates that the heart is trying to compensate for decreased blood flow by pumping harder. Patients who experience the following symptoms should seek prompt medical assistance:


Heart failure is usually the result of one of several conditions that impact the function of the heart and cardiovascular system. Many patients have an underlying condition that weakens the heart muscles leading to failure. These conditions include:

  • Coronary artery disease- This condition is caused when cholesterol and fat build up in the arteries and block the supply of blood to the heart. Over time and if left untreated this may lead to a heart attack.
  • High blood pressure- Hypertension that is left untreated causes the heart to work harder to properly distribute blood throughout the body. This causes the heart muscles to harden or become too weak to properly function.
  • Heart arrhythmia- An irregular heart beat forces the heart to work harder as it pumps. A faster heartbeat can harden the muscles while a slower heartbeat interferes with the right amount of blood getting to the heart.
  • Congenital heart defects- Birth defects in areas such as heart valves and chambers force healthy parts of the heart to compensate for their weaknesses which can cause heart failure.
  • Other diseases, such as diabetes, obesity, or HIV can contribute to heart failure

Diagnosis & Tests

Heart failure may first be detected after a patient has a heart attack or if a symptom is discovered during a routine check-up. If heart failure is suspected after a patient's medical history is examined, several tests may be ordered to confirm the diagnosis and determine the exact cause of heart failure.

A stethoscope used during a routine physical examination is able to detect sounds of congestion as well as irregularities in the heart rhythm. Fluid build-up in the legs can be detected by feeling the ankles. If heart failure is suspected the following imaging tests may be performed to get a better look inside the heart.

  • X-Ray- This allows doctors to see the heart and lungs as well as any congestive build up or another condition that can be causing symptoms.
  • Electrocardiogram (ECG)- An ECG monitors heartbeat with electrodes placed on the skin around the heart. A print-out of the test is then made that allows doctors to locate any irregularities.
  • Echocardiogram- This bounces sound waves off the heart, helping distinguish between diastolic or systolic heart failure as well as determining the strength of the heart muscle.

Treatment & Therapy

Treating heart failure requires a life-long management regime. In some cases which are caused by birth defects, repairs such as valve repairs and replacements may not require further treatment other than monitoring. In other cases, lifestyle changes are necessary to reduce the effects of heart failure and help strengthen the heart.

Helpful medications that may be prescribed are ACE inhibitors or beta blockers which help control heart rate and strengthen heart muscles. Diuretics may also be prescribed to reduce fluid retention and build-up.

In more severe cases, surgery may be required to correct the causes of heart failure. Coronary artery bypass surgery redirects blood vessels from the arms, legs and chest around a severely blocked artery and allows blood to flow more easily through the heart again. Implantable devices may be used, such as an artificial cardiac pacemaker or an implantable cardioverter-defibrillator.

If none of the above treatment methods are appropriate, a heart transplant may be suggested. While a transplant may do much to improve a patient's quality of life, it carries the risk for complications, and the patient will need to take anti-rejection therapy for the rest of his or her life.

Prevention & Prophylaxis

Preventing heart failure or conditions that cause it involves dedication to healthy living. Controlling and treating diabetes and high blood pressure helps the heart stay healthy while managing these conditions.

Making positive lifestyle choices such as quitting smoking or not smoking, eating healthy foods, physical activity, managing weight and stress all help in preventing heart failure.

For patients with a greater risk of heart failure, working with their doctors to create a routine to prevent against heart failure is the best option as doctors can determine what is safe for their specific condition or risk.