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Facts About Heart Failure

Learn more about a condition that affects millions of people.

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Heart failure is a progressive condition that affects millions of Americans. Heart failure doesn't mean that your heart actually "fails."

In simple terms, it means your heart can’t pump enough oxygen-rich blood to meet your body’s needs or can’t pump with enough force. Heart failure is often a chronic condition that develops gradually, over many years, with the heart becoming progressively less and less efficient.

In heart failure, the heart muscle is either stiff or weak and doesn't pump properly. When the heart is stiff, it can't relax enough to refill, so less blood is available to pump through your body. When your heart muscle is weak, it can't pump with enough force to circulate enough blood through your body.

The heart often tries to compensate by getting larger, developing more muscle mass and pumping faster. Your blood vessels also may narrow to keep your blood pressure up or divert blood from less important tissues and organs to make sure your heart and brain have enough. But eventually, your heart can’t keep up. As the heart weakens, certain proteins and substances, which can have a toxic effect on your heart and blood flow, might be released into your blood and worsen heart failure.

What causes heart failure?

The most common causes of heart failure are coronary artery disease, high blood pressure and diabetes. Treating these conditions can help prevent or improve heart failure.

A smaller number of people may have a disease of the heart muscle, called cardiomyopathy, or they may have heart valve disease. Others may have a heart defect from birth that affects their heartbeat or heart structure. Heart failure also may be caused by injury to the heart muscle from conditions such as alcohol abuse, cocaine or other illegal drug use, thyroid disorders, HIV/AIDS, excessive vitamin E or certain treatments for cancer. But these are less common situations.

Types of heart failure

Heart failure can involve the heart's left side, right side or both sides. However, it affects the left side more frequently.

  • Systolic heart failure occurs when the heart can’t contract normally. As a result, it doesn’t have enough force to push enough blood into circulation.
  • Diastolic heart failure occurs when the heart muscle is stiff and has trouble relaxing. If the ventricle can't relax, it can't properly fill with blood, so less blood is pumped to the body.

Who is at risk for heart failure?

Heart failure is more common if you:

  • Are 65 or older. The heart muscle can weaken with age. Some chronic diseases may lead to heart failure in older people.
  • Are African American. Compared with people of other races, you are likelier to have symptoms at an earlier age. You are likelier to go to the hospital because of it. You are also more likely to die from it.
  • Are overweight. Excess weight strains the heart. Being overweight raises your risk of heart disease and type 2 diabetes. Both can lead to heart failure.
  • Have had a heart attack.
  • Are a man.

What are the signs of heart failure?

The most common signs and symptoms of heart failure are shortness of breath or trouble breathing; fatigue (tiredness); and swelling in the ankles, feet, legs, abdomen and veins in the neck.

These symptoms stem from fluid building up in your body or lungs. The symptoms get worse as your heart weakens. Simple activities like short walks may leave you tired and out of breath.

Fluid buildup can also cause you to gain weight, urinate frequently or develop a cough that is worse at night or when you’re lying down. Shortness of breath may be a sign that you have too much fluid collecting in your lungs. That is a condition called pulmonary edema and may require emergency treatment.

Heart failure may be a progressive condition, but you can manage it by taking medications, seeing your doctor regularly and changing your lifestyle habits.

By Susan G. Warner, Contributing Writer

National Heart, Lung, and Blood Institute. What is heart failure? Accessed: November 23, 2015.
National Heart, Lung, and Blood Institute. What causes heart failure? Accessed: November 23, 2015.
American Heart Association. About heart failure. Accessed: November 23, 2015.
Centers for Disease Control and Prevention. Heart failure fact sheet. Accessed: November 23, 2015.

Last Updated: November 24, 2015