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Sometimes, there is no known cause for heart failure.
| The name, “heart failure” is confusing, because the heart has not “failed,” or stopped. In heart failure, one or more chambers of the heart are “failing” to keep up with the volume of blood flowing through them. |
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How HF Affects Heart and Health
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| As the heart loses strength, not enough blood is pumped into the heart's upper chambers (atria) and out of its lower chambers (ventricles). |
| The arrows point in the direction that the ventricles pump blood out of the heart. Blood is pumped into the lungs, where it is replenished with oxygen. The left ventricle pumps the oxygen-rich blood into the aorta, the body's major artery, and throughout the body. |
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 Fluid from the blood can back up and cause "congestion" in other body tissues. This is why heart failure sometimes is called "congestive." Because of reduced blood flow to the kidneys, they produce substances called neurohormones that can lead to excess fluid and water retention. This causes swelling, or edema. Some people call it "water retention." Excess fluid may pool in the part of the heart that is failing, or in the lungs. Gradually, it spreads and pools in other tissues.
| The lungs are behind and connected to the heart. The heart and lungs work together to keep oxygen-rich blood in continual circulation. Blood is pumped into the lungs as it returns to the heart. In the lungs, blood absorbs a new supply of oxygen, and is pumped to the left ventricle. The ventricle pumps blood to the body to deliver a new supply of oxygen. The cells that make up every part of the body cannot live without oxygen. |
Heart failure may come on suddenly after a heart attack, heart valve problem or severe rise in blood pressure. In most cases, however, it is a chronic, or long-term, condition that gradually gets worse. By the time most people notice symptoms and see their doctor, their heart has been "failing," little by little, for a long time.
Heart failure may involve the left or right side of the heart, or both. Each side of the heart has two chambers: an atrium (upper) and a ventricle (lower) chamber; and each side of the heart has a unique function. Heart failure occurs when the heart's lower chambers do not receive an adequate volume of blood from the atria, or can no longer keep up with the volume of blood flowing through them.
There are two types of heart chamber problems that can lead to heart failure. These are called "systolic" and "diastolic." They may be present together or separately:
Systolic failure is the more common type, occurring in 70 percent of people with heart failure. It occurs when the heart muscle is weak and enlarged. The muscle of the left heart chamber, or ventricle, loses some of its ability to contract, or shorten. It may not have the muscle power to meet the body's need for oxygen and other nutrients. The walls of the ventricle are thin and enlarged.
Diastolic failure is when the muscle becomes stiff and loses some of its ability to relax. The affected chamber can no long properly fill with blood during the rest period between each heartbeat. The walls of the heart are thickened. The size of the left chamber may be normal or reduced.
Left-Ventricular (LV) Heart Failure
The left is the most important side of the heart for normal heart function. It usually is the first side to be affected by heart failure.
The left upper chamber, or atrium, receives oxygen-rich blood from the lungs and pumps it into the left ventricle -- the lower chamber that is the heart's largest and strongest pump. It is responsible for supplying most of the blood flow to the body.
Right-Ventricular (RV) Heart Failure
The right atrium is the chamber that receives blood after it has circulated through the body. From the atrium, blood travels to the right ventricle, which pumps it into the lungs to be replenished with oxygen. When the right side loses pumping power, blood can back up in the veins that return blood to the heart.
(RV) heart failure may occur alone, but it usually is a result of left-sided failure. When the left ventricle fails, fluid backs up through the lungs. Pressure from excess fluid can damage the heart's right side as it works to pump blood into the lungs.
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Heart Failure Is a Major Health Problem
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Estimates are that 5 million Americans have heart failure, and 550,000 new cases are diagnosed each year. HF is most common in older people, but children and young adults also can be affected.The condition is slightly more common among men than women, and it is twice as likely to affect African-Americans as whites. |
 HF causes 50,000 deaths and contributes to another 225,000 deaths in the U.S each year. |
| At 50 years of age, 1 percent of people have heart failure |
| By age 75, 5 percent of people are affected. |
| According to the National Institutes of Health, HF is the cause of nearly 1 million hospitalizations each year. |
| It is the most common reason that people who are 65 years or older are admitted to a hospital. |
Although the death rate from coronary artery disease and other heart conditions has been going down, the number of deaths from heart failure is going up. It is expected to be an even bigger problem as the population ages. |
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| Heart failure is diagnosed by physical examination, medical history, blood tests and heart tests. Some tests are used to determine how severe the condition is and decide whether an individual is at risk for other problems, such as abnormal heart rhythms that sometimes occur with heart failure. |
| An ECG test prints out a record of the heart's electrical activity. |
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When heart failure is related to conditions such as heart valve disease or high blood pressure that are diagnosed and treated in time, the problem may be resolved before it becomes severe. Even when irreversible damage has been done, there are now a number of treatments to relieve the symptoms and stop or slow down the progression of HF. Sometimes, the function of the heart also can be improved.
| Treatments - or a combination of treatments - are prescribed depending on the type, cause and severity of heart failure. Treatment may include: |
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- Lifestyle changes.
- Medications.
- Treatment of related diseases such as coronary artery disease, heart valve disease and high blood pressure that are underlying causes of HF.
- Surgery may be performed for some types of heart failure (including heart transplant in a small number of seriously ill patients).
- Implanted devices can control arrhythmias (abnormal heart rhythms) that may result from heart failure. These 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.
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| 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. This can improve the heart's pumping ability in certain groups of patients. |
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