Types of Heart Failure

HEART FAILURE

What Is Heart Failure?

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Doctor using stethoscope on African American patient Heart failure, also known as congestive heart failure, is a condition that develops when your heart doesn’t pump enough blood for your body’s needs. This can happen if your heart can’t fill up with enough blood. It can also happen when your heart is too weak to pump properly. The term "heart failure" does not mean that your heart has stopped. However, heart failure is a serious condition that needs medical care.

More than 6 million adults in the United States have heart failure, according to the Centers for Disease Control and Prevention. Children can also have heart failure, but this health topic focuses on heart failure in adults.

Heart failure can develop suddenly (the acute kind) or over time as your heart gets weaker (the chronic kind). It can affect one or both sides of your heart. Left-sided and right-sided heart failure may have different causes. Most often, heart failure is caused by another medical condition that damages your heart. This includes coronary heart disease, heart inflammation, high blood pressure, cardiomyopathy, or an irregular heartbeat. Heart failure may not cause symptoms right away. But eventually, you may feel tired and short of breath and notice fluid buildup in your lower body, around your stomach, or your neck.

Heart failure can damage your liver or kidneys. Other conditions it can lead to include pulmonary hypertension or other heart conditions, such as an irregular heartbeat, heart valve disease, and sudden cardiac arrest.

Your doctor will diagnose heart failure based on your medical and family history, a physical exam, and results from imaging and blood tests.

Currently, heart failure is a serious condition that has no cure. However, treatment such as healthy lifestyle changes, medicines, some devices, and procedures can help many people have a higher quality of life. Visit the Living With section to learn more.

Visit The Heart Truth to learn about heart disease in women.

HEART FAILURE

Symptoms

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Symptoms of heart failure depend on the type of heart failure you have and how serious it is. If you have mild heart failure, you may not notice any symptoms except during hard physical work. Symptoms can depend on whether you have left-sided or right-sided heart failure. However, you can have symptoms of both types. Symptoms usually get worse as your heart grows weaker.

One of the first symptoms you may notice is feeling short of breath after routine activities like climbing stairs. As your heart grows weaker, you may notice this while getting dressed or walking across the room. Some people have shortness of breath while lying flat.

Older adults who do not get much physical activity may not experience shortness of breath. However, they may feel tired and confused.

People who have left-sided heart failure may have the following symptoms.

Trouble breathing

Cough

Fatigue (extreme tiredness even after rest)

General weakness

Bluish color of finger and lips

Sleepiness and trouble concentrating

Inability to sleep lying flat

People who have right-sided heart failure may also have the following symptoms:

Nausea (feeling sick in the stomach) and loss of appetite

Pain in your abdomen (area around your stomach)

Swelling in your ankles, feet, legs, abdomen, and the veins in your neck

Needing to pee often

Weight gain

What problems can heart failure cause?

Heart failure can cause some serious problems.

Kidney or liver damage is caused by reduced blood flow and fluid buildup in your organs.

Fluid may build up in or around your lungs.

Malnutrition from nausea and swelling in your abdomen (the area around your stomach) can make it uncomfortable for you to eat. Reduced blood flow to your stomach can make it harder to absorb nutrients from your food.

Other heart conditions such as an irregular heartbeat, leaking heart valves, or sudden cardiac arrest can be caused by heart failure.

HEART FAILURE

Diagnosis

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How will I find out if I have heart failure?

Your doctor will diagnose heart failure based on your medical history, a physical exam, and test results. Bring a list of your symptoms to your appointment, including how often they happen and when they started. Also, bring a list of any prescription and over-the-counter medicines you take. Let your provider know if you have any risk factors for heart failure.

You may also be referred to a cardiologist for these tests and treatment. A cardiologist is a doctor who specializes in diagnosing and treating heart diseases.

Diagnostic tests and procedures

Pulmonary hypertension may also be caused by this condition.

Blood tests

Your provider may order blood tests to check the levels of certain molecules, such as brain natriuretic peptideexternal link (BNP). These levels rise during heart failure. Blood tests can also show how well your liver and your kidneys are working.

Tests to measure your ejection fraction

Your provider may order an echocardiography (echo) or other imaging tests to measure your ejection fraction. Your ejection fraction is the percent of the blood in the lower left chamber of your heart (the left ventricle) that is pumped out of your heart with each heartbeat. Ejection fraction measures how well your heart pumps. This helps diagnose the type of heart failure you have and guides your treatment.

If 40% or less of the blood in your left ventricle is pumped out in one beat, you have heart failure with reduced ejection fraction.

If 50% or more of the blood in your left ventricle is pumped out in one beat, you have heart failure with preserved ejection fraction.

If your ejection fraction is somewhere in between 41% to 49%, you may be diagnosed with heart failure with borderline ejection fraction.

Other tests

Other imaging tests show how well your heart is working, such as a cardiac CT scan, cardiac MRI, or nuclear heart scan. You may also need cardiac catheterization with coronary angiography to look inside the arteries in your heart and see if they are blocked.

Tests for your heart’s electrical activity may also be necessary. This might include an electrocardiogram (EKG) or a Holter or event monitor that you wear for 24 to 48 hours or more while going about your normal activities.

A stress test measures how much exercise your body can handle and how well it works during physical activity. Some heart problems are easier to diagnose when your heart is working hard and beating fast.