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What is heart failure?
 Heart failure (HF) sometimes called congestive heart failure (CHF), is a serious condition affecting 5.2 million men and women in the United States. According to the American Heart Association and government sources, more than 5 million Americans suffer from heart failure. About 550,000 cases are diagnosed each year. The estimated mortality in 2004 from heart failure in the US adult population was 57,000. Statistics show that 88% of men and 75% of women under the age of 65 with heart failure will die within 8 years. Sudden cardiac death occurs at 6 to 9 times the rate of the general population. There is no cure for heart failure. (AHA 2007 update)
Heart failure is a condition sometimes referred to as pump failure because the heart cannot pump enough blood and oxygen to meet the needs of other body organs. Heart failure does not mean that the heart has stopped. It means that the failing heart cannot pump blood the way it should. This causes patients with heart failure to easily become tired and short of breath with little exertion.
Heart failure can be classified as either a pump problem, where not enough blood is squeezed out of the heart to the body, known as systolic dysfunction, or a filling problem due to a stiff heart, known as diastolic dysfunction. Systolic failure can lead to blood backing up into the lungs, causing shortness of breath, also known as pulmonary edema. Problems with the heart's pump function can also create problems for the rest of the body, such as kidney problems, liver problems, fluid retention, and lower extremity edema.
Even when the heart's pump function is normal, if the heart is thickened and stiff, congestive problems can arise. Specifically, if it takes higher pressure to fill the heart, then the lungs again can become full of fluid and shortness of breath can occur. Though heart failure may be limited to either systolic or diastolic dysfunction, having one type often leads to having the other as well.
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To learn more about heart failure, click on the links below:
Heart Failure: Symptoms and Signs
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shortness of breath -
fatigue -
wheezing -
cough -
difficulty breathing while lying down -
weight gain -
swelling in ankles, legs abdomen or back -
low blood pressure -
rapid heart rate -
cold, sweaty skin -
rales in the lungs -
engorged veins in the neck
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Heart Failure: Diagnosis and Treatments
As with all forms of heart and cardiovascular disease, early detection is very important. Heart failure can be diagnosed with a physical examination, medical history, blood tests, and/or heart tests. Testing is necessary to determine the type, cause, and severity of the condition and identify the best treatments.
Treatment may include lifestyle changes, medications, and treatment of underlying causes, such as coronary artery disease, heart valve disease, high blood pressure, and arrhythmias. Surgery may be chosen to reduce or control structural changes in the heart or, in some patients with the most severe form of heart failure, heart transplant may be an option.
Lifestyle changes
Rest, healthy diet, changing activity levels, or other simple lifestyle changes may be necessary. Another important factor in reducing symptoms and mortality of congestive heart failure is quitting smoking. Within two years of quitting, symptoms and death rates fall in smokers with heart failure.
Medications
There are various drugs used to treat congestive heart failure. The choice of medication will depend upon the specific individual's needs. ACE inhibitors and vasodilators expand blood vessels, decrease blood pressure, and allow the heart to pump easier and with greater efficiency. Beta blockers reduce heart rate and thus increase the filling time of the left lower heart chamber (left ventricle), which may, in turn, increase the amount of blood that is subsequently pumped out with each heart beat (stroke volume). Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water.
Treatment of underlying causes
In some cases, heart failure can be treated by treating high blood pressure. Other times, if the cause of heart failure is due to an abnormal heart valve, the valve can be surgically replaced. When abnormal heart rhythms cause heart failure, often implanted devices can be used to control problematic arrhythmias. Such devices include pacemakers to treat a too-slow heart rate and implantable cardioverter defibrillators (ICDs) to stop a too-rapid heart rate that could be life threatening. Cardiac resynchronization therapy (CRT) is a technique in which a special type of pacemaker is implanted to coordinate, or synchronize, muscle contractions in the ventricles.
Early diagnosis is essential to improve the chances of successful treatment. Most people with mild and moderate congestive heart failure can be treated. While there is no cure for heart failure, the quality of life for those with heart failure can often be improved.
If the heart becomes so damaged that it can't be repaired, a heart transplant is sometimes an option.
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Learn more about heart failure from
The American Heart Association related publications:
For more information see AHA Scientific Statements:
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