Heart Failure

Definition

Heart failure is not a sudden or complete stop of heart activity. Rather it occurs when the heart loses its ability to pump enough blood through the body to meet the body’s requirements. 

In some cases, heart failure occurs when the heart muscle is weak (systolic). In other cases, the heart muscle is stiff and unable to fill sufficiently with blood (diastolic).

Causes

There are many causes of heart failure. As we age, nearly everyone’s heart loses some pumping capacity. Heart failure affects about 10% of people over age 80.

The most common cause of heart failure in this country is disease of the arteries that supply the heart muscle. The risk of developing heart failure increases if you have angina, diabetes or high blood pressure, or had a heart attack in the past.

In some cases, heart failure can occur after a viral or bacterial infection, as a result of a birth defect or because of alcohol ingestion.

Symptoms

Heart failure usually occurs gradually, but sudden episodes of 'congestion' may occur.

Symptoms of heart failure include:

• Shortness of breath with activity or when lying flat
• Swelling in the feet, legs or abdomen
• Sudden awakening at night with a feeling that you can’t catch your breath
• Fatigue, inability to do your daily activities
• Palpitations
• Dry, hacking cough
• Loss of appetite
• Nausea or vomiting

Prognosis

The severity of heart failure ranges from very mild forms to severe heart failure. Some forms of heart failure, such as those due to problems with a heart valve, are reversible. If your doctors determine that your heart failure is reversible, they will discuss this option with you.

Because many forms of heart failure are chronic illnesses, you will need to take medications the rest of your life. The best way for you to lead a full life is to take your medications as prescribed, reduce your risk factors (such as no smoking and no alcohol), engage in regular exercise and carefully monitor your weight. It is important for you to maintain regular visits with your doctor so he or she can monitor your heart failure.

Symptoms of Worsening Heart Failure

Symptoms of worsening heart failure to report to your doctor or nurse include:

• Inability to do the activities you were able to do a few days ago
• Worsening shortness of breath at rest or with activity
• Persistent cough
• Swelling of your feet, legs, abdomen or hands   
• Weight gain of 3 pounds in one day or 5 pounds in one week   
• Sudden wakening in the middle of the night feeling like you can’t catch your breath   
• Sensation that your heart is racing, or going very slowly, that lasts for several minutes