Heart failure refers to a condition in which the heart is unable to pump blood effectively to meet the body’s needs. Although it cannot be cured, many people manage to live normal lives with appropriate treatment and lifestyle modifications.

This condition can result from the weakening or stiffening of the heart muscle or the inability of the heart to handle the body’s blood flow demands. When the heart loses pumping power, it typically leads to fatigue, swelling throughout the body, and shortness of breath.

Heart failure usually develops gradually but can present suddenly, known as acute heart failure. Sometimes, it's also called “congestive heart failure,” indicating fluid buildup in the body due to poor circulation—though not all heart failure is congestive.

Healthcare providers diagnose heart failure using a combination of physical examinations, patient history, blood tests, and imaging scans. Medications are typically prescribed to enhance heart function and delay progression.

In the United States, approximately 6.2 million people are affected. Preventative measures include maintaining a healthy diet, regular physical activity, avoiding smoking, and limiting alcohol and drug use.

Types of Heart Failure

Heart failure is classified based on the affected part of the heart and its functioning. It can involve the left ventricle, right ventricle, or both.

Heart Failure With Reduced Ejection Fraction (HFrEF)

This type occurs when the heart’s ability to contract and pump blood is reduced, leading to insufficient blood flow throughout the body.

Heart Failure With Preserved Ejection Fraction (HFpEF)

HFpEF arises when the heart muscle is too stiff to relax and fill with blood. This can lead to fluid buildup, especially in the legs, ankles, and feet.

Heart Failure With Mid-Range Ejection Fraction (HFmrEF)

HFmrEF involves a left ventricular ejection fraction between 41% and 49%, sharing traits with both HFrEF and HFpEF.

Right-Sided Heart Failure

Often resulting from left-sided heart failure, this type occurs when the right ventricle cannot effectively send oxygen-poor blood to the lungs.

Heart Failure Symptoms

Symptoms occur when the heart fails to meet the body’s circulation demands. These include:

  • Fast or irregular heartbeat

  • Abdominal swelling

  • Persistent cough

  • Fatigue

  • Nausea or reduced appetite

  • Shortness of breath

  • Swelling in the feet, ankles, or abdomen

  • Difficulty sleeping

  • Unexplained weight gain

Symptoms vary by heart failure type and severity, generally worsening over time.

What Causes Heart Failure?

Heart failure results from conditions that damage the heart or hinder its function. Common causes include coronary artery disease and high blood pressure, both of which weaken the heart muscles.

When the heart fails to pump efficiently, fluid accumulates in various body parts like the lungs, limbs, liver, and digestive organs—leading to congestive heart failure.

Risk Factors

  • Diet high in saturated fats, cholesterol, or sodium

  • Diabetes

  • Excessive alcohol consumption

  • Heart valve disorders

  • Obesity

  • Lack of physical activity

  • Previous heart attacks

  • Smoking

How Is Heart Failure Diagnosed?

Diagnosis involves evaluating symptoms such as breathlessness, difficulty walking, or trouble lying flat. Tests and assessments may include:

  • Physical examination and health history

  • Chest X-ray

  • Blood work

Diagnostic Tests

  • Coronary angiogram: Assesses blood flow via dye and X-rays

  • CCTA (CT angiography): CT scan with dye to examine narrowed arteries

  • Echocardiogram (Echo): Evaluates heart muscle function and ejection fraction

  • Electrocardiogram (EKG): Detects heart damage

  • MRI: Visualizes blood flow

  • Stress test: Assesses cardiac performance during exertion

Treatments for Heart Failure

The primary goal is to improve heart function and prevent worsening.

Medications

  • ACE inhibitors

  • Angiotensin receptor neprilysin inhibitors (ARNIs)

  • Angiotensin II receptor blockers (ARBs)

  • Beta-blockers

  • Diuretics (including potassium-sparing)

  • Sodium-glucose cotransporter-2 (SGLT-2) inhibitors

Surgical Options

  • Bypass surgery

  • Implantable defibrillator for arrhythmia

  • Left ventricular assist device (LVAD) for severe cases

  • Heart transplantation if other treatments fail

How To Prevent Heart Failure

Prevention largely depends on lifestyle changes.

  • Quit smoking: Prevents arterial damage

  • Exercise regularly: Supports heart and vascular health

  • Limit sodium: High sodium increases blood pressure and fluid retention

  • Follow a heart-healthy diet, including:

    • Fish

    • Fruits and vegetables

    • Nuts

    • Whole grains

Related Conditions

If untreated, heart failure may cause complications:

Arrhythmia

Irregular heartbeats due to weakened heart muscles.

Kidney Damage

Blood buildup in veins leading to kidneys impairs function.

Liver Damage

Reduced blood flow to the liver hinders detoxification processes.

Thromboembolism

Blood clots due to impaired circulation may lead to stroke or embolism.

Living With Heart Failure

With ongoing care, people can manage heart failure effectively. Over 50% of diagnosed patients survive beyond five years.

Coping Strategies

  • Stay connected with family and friends

  • Set achievable physical goals

  • Join support groups

  • Build a strong care network

Note: Black Americans are statistically less likely to receive advanced treatments like heart pumps or transplants due to systemic healthcare disparities. Improving access and equity remains essential.