What is Heart Failure?
Heart failure is a condition in which the heart isn't pumping as well as it should.
While the term "heart failure" (also known as congestive heart failure) may sound like the heart has stopped working, that isn't actually the case.
Still, heart failure is a serious condition that is often the end stage or final outcome of many cardiovascular conditions. (1)
The American Heart Association (AHA) reports that the number of adults living with heart failure in the United States increased from 5.7 million people from 2009 to 2012 to approximately 6.5 million in 2011 to 2014.
The AHA estimates that by 2030, more than 8 million Americans will have heart failure. (2)
While there's no cure for heart failure, medication and healthy lifestyle changes can help manage the condition and allow people to maintain a good quality of life.
When the Heart Doesn’t Pump Effectively
Congestive heart failure occurs when there's a reduction in blood flow to the body and a backup (congestion) of fluid into the lungs, liver, abdomen, and lower extremities.
But not all heart failure is congestive: A person might have shortness of breath or weakness due to heart failure and not have any fluid buildup.
During heart failure, the body tries to compensate for reduced blood flow in other ways by:
- Enlarging the Heart ChamberDoing so, it can stretch more and contract more strongly in order to pump more blood. An enlarged heart can cause your body to retain fluid, your lungs to become congested with fluid, and your heart to beat irregularly.
- Developing More Muscle MassThis happens because the contracting cells of the heart get bigger. This initially lets the heart pump more strongly.
- Pumping FasterThis is to increase your heart's output.
- Diverting BloodThis means taking blood away from other tissues and organs such as the kidneys, the heart, and brain.
These compensations may mask heart failure temporarily, but eventually heart failure gets worse, and people start to experience fatigue, breathing problems, and other symptoms.
This may explain why it takes some people years to realize that they have heart failure. (3)
Which Chambers of the Heart Are Affected?
The heart's left side, right side, or both sides can be affected by heart failure. But the left side is usually affected first.
Left-Sided Heart FailureThe left ventricle is larger than the other chambers and essential for normal function because it provides most of the heart's pumping power.
In left-sided (also called left ventricular) heart failure, the left side of the heart must work harder to pump the same amount of blood.
There are two types of left-sided heart failure:
- Systolic FailureAlso called heart failure with reduced ejection fraction (HFrEF), this occurs when the left ventricle's ability to contract declines. The heart can't pump with enough force to maintain adequate circulation for a given demand.
- Diastolic FailureAlso called diastolic dysfunction, heart failure with preserved ejection fraction, or HFpEF, diastolic failure occurs when the left ventricle becomes so stiff the heart can't properly fill with blood during the resting period between each beat.
Right-Sided Heart FailureRight-sided (also called right ventricular) heart failure usually occurs because of left-sided failure.
When the left ventricle fails, increased fluid pressure is transferred back through the lungs, causing increased stress and ultimately damage to the heart's right side.
When the right side loses pumping power, blood backs up in the body's veins, causing swelling or congestion in the legs, ankles, gastrointestinal tract, and liver. (3)
What Causes the Condition?
The following conditions can cause heart failure, yet many people aren't aware that they have them:
Lifestyle and Genetic Factors Can Increase Your Risk of Disease
Having any of the following conditions can increase your risk for heart failure:
- High blood pressure
- Past heart attack
- Sleep apnea
- Congenital heart defects
- Valvular heart disease
- Alcohol use
- Tobacco use
- Irregular heartbeats (5)
Life Expectancy After Heart Failure
Your life expectancy after heart failure depends on the cause of your condition, as well as other factors, including age.
Still, the AHA reports that about half of people who develop heart failure die within five years of diagnosis.
Video: Heart Failure Warning Signs and Symptoms
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