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November 20, 2017  
HEALTH NEWS: Heart Failure Information Center
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What is Heart Failure?

In an effort to bring you the most detailed information on Heart Failure that we can, we hope to answer the most common questions surrounding this global health threat.
  • What is Heart Failure?
  • How does heart failure develop?
  • What are the causes of heart failure?
  • What are the symptoms of heart failure?
  • How is heart failure diagnosed and treated?
  • What is Heart Failure?

    Despite its name, heart failure does not mean that the heart suddenly stops or fails to function. Rather, heart failure is defined as a condition in which the heart cannot pump enough oxygen-carrying blood to meet the body's needs. Heart failure occures gradually over time and begins when the heart is weakened due to damage (e.g. heart attack or persistent high blood pressure).

    Over time, the heart no longer contracts as strongly or as coordinated as before. As a result, the heart gradually loses its ability to carry out its primary function, which is to pump enough blood to supply the body's need for oxygen.

    When the heart muscle is weakened, the heart needs to work harder to keep blood flowing to the body. This stresses the heart and, to compensate for this additional strain, the heart muscle becomes enlarged. The enlargement of the heart further weakens it and makes the problem worse.


    How does heart failure develop?

    Heart failure most commonly develops slowly, following damage to the heart that may be caused by a heart attack, coronary artery disease, chronic high blood pressure, diabetes or other disorders. As a consequence, the heart can no longer carry out its work, and heart failure develops.

    A healthy heart has a number of compensatory mechanisms that allow it to temporarily increase its pumping function to meet increased metabolic need (e.g. during exercise). In patients with heart failure, these compensatory mechanisms are continuously being used. It is the continuous use of compensatory mechanisms that causes the death of individual heart muscle cells. When the compensatory mechanisms are continuously used, there is litle reserve for activities, such as exercise.

    Heart failure is often not recognized until a more advanced stage, commonly referred to as congestive heart failure, develops. In this stage, fluid may leak into the lungs, feet, legs and, in some cases, the liver or abdominal cavity.

    There are two types of heart failure:

  • Systolic heart failure: decreased ability of the heart to contract and an inability of the heart to pump enough blood into circulation. This is the most common type of heart failure.

  • Diastolic heart failure: decreased ability of the heart to relax. Blood has difficulty entering the heart's chambers, and excess fluid builds up in different parts of the body.

  • What are the causes of heart failure?

    Although the cause of heart failure differs from patient to patient, the risk of developing heart failure increases with age and several other factors. Heart failure can strike at any age, but is most often seen in people over age 65. Risk factors for heart failure include:

  • Heart attack (myocardial infarction)
  • High blood pressure (hypertension)
  • Clogged arteries (atherosclerosis)
  • Diabetes
  • Chronic lung diseases, such as emphysema
  • Family history of heart disease or heart failure

  • What are the symptoms of heart failure?

    Heart failure can be difficult to diagnose because the symptoms may be subtle and are often mistaken for normal signs of aging. To help people understand and identify the symptoms of heart failure, the Heart Failure Society of America (HFSA) developed the acronym FACES:

  • Fatigue: caused because muscles and other tissues are receiving less oxygen and nutrition from the blood
  • Activities limited: difficulty participating in ordinary activities. Limitations in activities are dependent upon disease severity.
  • Chest Congestion: raspy breathing or wheezing
  • Edema: fluid build-up in the abdomen, lungs, feet or legs, which can lead to swelling.
  • Shortness of breath: resulting from excess fluid in the lungs. Breathing difficulties may occur at rest or during exercise and, in severe cases, can prevent or interrupt sleep.

  • How is heart failure diagnosed and treated?

    One of the most commonly used tools for diagnosis of heart failure is an echocardiogram (echo), which uses sound waves to produce images of the heart. An echo is used to measure the size of the heart and the ejection fraction (EF). The ejection fraction is a measurement of how well and how strongly the heart is pumping. According to HFSA, people with a healthy heart typically have an EF of more than 50 percent, while people with heart failure have, among other symptoms, an EF of less than 35 percent.

    To date, heart failure is usually treated pharmacologically. The most commonly used drugs (often in combination with each other) are:

  • ACE inhibitors: inhibit the production of a hormone that is responsible for the constriction of blood vessels and the retention of water and salt
  • Beta-blockers: reduce the heart size, increase the ejection fraction and slow down the heart rate
  • Digoxin: increases the ejection fraction and improves exercise tolerance
  • Diuretics: remove excess fluid in the body and reduce swelling in legs and ankles

  • Information provided by Guidant Corporation, part of the Boston Scientific Corporation

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