What is heart failure?

Heart failure means your heart muscle does not pump as much blood as your body needs. Failure does not mean that your heart has stopped. It means that your heart is not pumping as well as it should.

Because your heart cannot pump well, your body tries to make up for it. To do this:

    * Your body holds on to salt and water. This increases the amount of blood in your bloodstream.
    * Your heart beats faster.
    * Your heart gets bigger. See a picture of an enlarged heart.

Your body has an amazing ability to make up for heart failure. It may do such a good job that you don't know you have a disease. But at some point, your body will no longer be able to keep up. Your heart gets worn out. Then fluid starts to build up in your body, and you have symptoms like feeling weak and out of breath.

This fluid buildup is called congestion. It is why some doctors call the disease congestive heart failure.

Heart failure usually gets worse over time. But treatment can slow the disease and help you feel better and live longer.
What causes heart failure?

Anything that damages your heart or affects how well it pumps can lead to heart failure. The most common causes of heart failure are:

    * Coronary artery disease (CAD).
    * Heart attack.
    * High blood pressure.

CAD and heart attack are the most common causes of heart failure in men. In women, high blood pressure is the most common cause.1

Other conditions that can lead to heart failure include:

    * Diabetes.
    * Diseases of the heart muscle (cardiomyopathies).
    * Heart valve disease.
    * Disease of the sac around the heart (pericardial disease), such as pericarditis.
    * A slow, fast, or uneven heart rhythm (arrhythmia).
    * A heart problem that you were born with (congenital heart defect).
    * Long-term alcohol abuse, which can damage your heart.

What are the symptoms?

Symptoms of heart failure start to happen when your heart cannot pump enough blood to the rest of your body. In the early stages, you may:

    * Feel tired easily.
    * Be short of breath when you exert yourself.
    * Feel like your heart is pounding or racing (palpitations).
    * Feel weak, very tired, or dizzy.

As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:

    * Feel short of breath even at rest.
    * Have swelling (edema), especially in your legs, ankles, and feet.
    * Gain weight. This may happen over just a day or two, or more slowly.
    * Cough or wheeze, especially when you lie down.
    * Need to urinate more at night.
    * Feel bloated or sick to your stomach.

If your symptoms suddenly get worse, you will need emergency care.
How is heart failure diagnosed?

Your doctor may diagnose heart failure based on your symptoms and a physical exam. But you will need tests to find the cause and type of heart failure so that you can get the right treatment. These tests may include:

    * Blood tests.
    * A chest X-ray.
    * An electrocardiogram (EKG or ECG) to check your heart’s electrical system.
    * An echocardiogram to see the size and shape of your heart and how well it is pumping.
    * Cardiac catheterization to check your heart and its blood vessels (coronary arteries).

Echocardiogram is the best and simplest way to find out if you have heart failure, what type it is, and what is causing it. Your doctor can also use it to see if your heart failure is getting worse. It can measure how much blood your heart pumps to your body. This measurement is called the ejection fraction. If your ejection fraction gets lower and you are having more symptoms, it means your heart failure is getting worse.