Heart Failure

What is heart failure?

The heart is a muscle that pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart can’t pump as well as it should. Or the heart muscle can’t relax and fill the pumping chamber with blood. Blood and fluid may back up into the lungs. This causes congestive heart failure. And it causes pulmonary edema. Some parts of the body also don’t get enough oxygen-rich blood. This means they can’t work well. These problems lead to the symptoms of heart failure.

What causes heart failure?

Heart failure may result from:

  • Heart valve disease
  • High blood pressure
  • Active infections of the heart valves or heart muscle, such as endocarditis
  • A past heart attack
  • Coronary artery disease
  • Disease of the heart muscle (cardiomyopathy)
  • Heart disease or problems that are present at birth (congenital)
  • Heart rhythm problems (arrhythmias) that lead to ongoing fast heart rates
  • Long-term (chronic) lung disease and pulmonary embolism
  • Some medicines
  • A reaction to medicines such as those used for chemotherapy
  • Anemia and too much blood loss
  • Complications of diabetes
  • Obstructive sleep apnea
  • Alcohol and drug abuse
  • Certain viral infections

What are the symptoms of heart failure?

The most common symptoms of heart failure are:

  • Shortness of breath while resting, exercising, or lying flat
  • Weight gain from water retention
  • Visible swelling of the legs and ankles from fluid buildup. Sometimes the belly (abdomen) may swell.
  • Severe tiredness (fatigue) and weakness
  • Loss of appetite, nausea, and belly pain
  • Cough that doesn’t go away. It can cause blood-tinged or frothy sputum.

The severity of the condition and symptoms depends on how much of the heart’s pumping ability has been affected. The first step in managing heart failure symptoms is knowing your baselines or what’s normal for you. How much do you weigh? Are you gaining weight but eating the same amount? How much can you do before you feel short of breath? Do your socks and shoes fit comfortably? Knowing what’s normal for you will help you see when symptoms are getting worse. Once you know your baselines, watch for changes daily.

The symptoms of heart failure may look like other health problems. Always see your healthcare provider for a diagnosis.

How is heart failure diagnosed?

Your healthcare provider will ask about your health history. He or she will give you a physical exam. You may need tests such as:

  • Chest X-ray. This test makes images of internal tissues, bones, and organs on film. This test shows the size and shape of your heart. Fluid in the lungs will also show up on X-ray.
  • Echocardiogram. This test is also called echo. It uses sound waves to assess the motion of the heart’s chambers and valves. The sound waves make an image on the screen as an ultrasound transducer is passed over the heart. This shows how well the heart pumps and relaxes. It also shows the thickness of the heart walls, and if the heart is enlarged. It is one of the most useful tests because it shows a lot of information about the heart’s function. And it helps guide treatment choices.
  • Electrocardiogram (ECG). This test records the electrical activity of the heart. It shows abnormal rhythms. It can sometimes find heart muscle damage.
  • BNP testing. B-type natriuretic peptide (BNP) is a hormone released from the ventricles that occurs with heart failure. BNP levels are useful in the quick assessment of heart failure. The higher the BNP levels, the worse the heart failure. BNP is measured from a blood sample.
  • Cardiac MRI. This test uses a magnetic field to make images of the heart and its nearby tissues. It can assess how the heart muscle and valves are working.