Heart Failure


Heart failure does not mean that your heart has stopped working.  Heart failure refers to a large number of conditions that affect the structure or function of the heart, making it harder for the heart to supply sufficient blood flow to meet the body’s needs.


Heart Failure occurs when one or more of the heart’s four chambers lose the ability to maintain proper blood flow.  This can happen because the heart can’t fill well enough with blood or because the heart can’t contract strongly enough to propel the blood with enough force to maintain proper circulation. In some people, both filling and contraction problems can occur.

Most heart failure patients experience shortness of breath and fatigue. However, because heart failure worsens over time, it is considered a chronic condition and may be underway before there is any obvious indication that something is wrong.

Chronic heart failure that has been stabilized can deteriorate due to any number of factors, such as an unrelated illness or heart attack. Known as acute decompensated heart failure (ADHF), it is the leading cause of hospitalization for patients over the age of 65 and is the most costly cardiovascular disease in Western countries. 


Fluid can build up in the feet, ankles, legs and elsewhere as a result of higher pressures in the lungs, especially when the right ventricle is affected.  Blood and fluid can back into the lungs because of failure of the left ventricle.  This is called pulmonary edema and may cause coughing, breathlessness with activities, and/or breathlessness when lying down. 

Most conditions that cause heart failure affect both sides of the heart to some degree and most frequently include some impairment of left ventricular function. 


Some causes of Heart Failure Include:

Heart Valve Problems

Whether caused by disease, infection, or a defect present at birth, heart valve problems can also produce heart failure, as can irregular heartbeats (arrhythmias). Indeed, up to 40% of patients with heart failure experience a specific type of arrhythmia called atrial fibrillation and individuals with this combination of heart problems are at high risk for cardiac death.


Because it increases one’s risk of developing hypertension and coronary artery disease, Diabetes is another major contributor to the development of heart failure. In this case, gender makes a big difference in risk. According to the current American College of Cardiology (ACC) guidelines, diabetes only modestly increases the risk of heart failure for men, but it increases the relative risk of heart failure more than 3-fold among women. 

Sleep Apnea

Sleep apnea, which affects one’s breathing and reduces the amount of oxygen to the heart, does not necessarily cause heart failure but it can make it worse by increasing the heart’s workload.


The most common signs and symptoms of heart failure include:

An individual with heart failure should focus on lifestyle changes. Controlling high blood pressure and weight are critical to improving the disease.  A heart-healthy diet and increased physical activity or exercise can help. Your diet should be low in sodium, which not only stabilizes blood pressure levels but can also help reduce swelling (edema) in your legs, feet, and abdomen.

NOTE: HF-ACTION—a recent large-scale trial of patients with mild to severe heart failure symptoms—placed half of the patients into an aerobic exercise program versus the other half, who simply had usual care. Those that exercised improved the amount of activity they could perform — enhancing the ability to perform day-to-day activities — plus they reported an improved sense of well-being.

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