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Heart failure means that your heart muscle doesn't pump as much blood as your body needs. Failure doesn't mean that your heart has stopped. It means that your heart isn't 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 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 heart and body will no longer be able to keep up. Then fluid starts to build up in your lungs and other parts of your body.
This fluid buildup is called congestion. It's why some doctors call the disease congestive heart failure.
Any problem that damages your heart or affects how well it works can lead to heart failure. This includes coronary artery disease, heart attack, high blood pressure, heart valve problems, and diabetes.
Heart failure symptoms include feeling weak, light-headed, and very tired. Fluid builds up in your lungs and other parts of your body. This causes you to be short of breath and have swelling in your body.
Your doctor may diagnose heart failure based on your symptoms and a physical examination. But you will need tests, such as an echocardiogram, to find the cause and type of heart failure so that you can get the right treatment.
Heart failure is treated with medicines, a heart-healthy lifestyle, and the steps you take to check your symptoms. Treatment may also include a heart device, such as a pacemaker. Treatment can slow the disease, help you feel better, and help keep you out of the hospital. Treatment may also help you live longer.
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Any problem that damages your heart or affects how well it works can lead to heart failure. The following lists are examples of these problems.
Your risk of having heart failure is higher if you have certain risk factors. A risk factor is anything that increases your chance of having a certain problem.
Heart failure is usually caused by another health problem. So anything that increases your risk for one of those problems also increases your risk for heart failure. These problems include:
Your risk of heart failure also rises as you get older.
The best ways to help prevent heart failure are to have a heart-healthy lifestyle and manage existing health problems like high blood pressure and diabetes.
To reduce your risk for heart failure:
If you smoke, quit. Avoid second-hand smoke too. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
Eat fruits, vegetables, fish, lean meats, and whole grain foods. Choose foods that are low in saturated fat, and avoid trans fat. Limit sodium, alcohol, and sugar.
Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate to vigorous exercise a week. Walking is a good choice. You also may want to do other activities, such as running, swimming, cycling, or playing tennis or team sports.
Being active and eating healthy foods can help you stay at a healthy weight or lose weight if you need to.
Many health conditions can raise your risk for heart failure. These include heart attack, high blood pressure, and diabetes. You can help manage many health problems and stay as healthy as possible with a heart-healthy lifestyle and medicines. If you think you may have a problem with alcohol or drug use, talk to your doctor. Your doctor can help you figure out what type of treatment is best for you.
Symptoms of heart failure start to happen when your heart can't pump enough blood to the rest of your body.
In the early stages of heart failure, you may:
As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:
Sudden heart failure occurs when heart failure symptoms get worse very quickly. Your heart suddenly cannot pump as much blood as your body needs. Sudden heart failure is an emergency. You need care right away.
When you have sudden heart failure, you may have severe trouble breathing. You may cough up pink, foamy mucus. And your heart may start to beat very fast or with an uneven rhythm.
Heart failure is classified by how bad symptoms are when you are active.footnote 1 The four classes range from having few or no symptoms when active to having symptoms even when at rest.
People whose physical activity is not limited. Ordinary physical activity does not cause tiredness (fatigue), heart palpitations, trouble breathing, or chest pain. Ordinary physical activity includes activities like house cleaning, short walks, and gardening.
People who have some limitation on physical activity. They are comfortable at rest, but ordinary physical activity causes fatigue, heart palpitations, trouble breathing, or chest pain.
People who have a marked limitation on physical activity. They are comfortable at rest, but less-than-ordinary physical activity causes fatigue, heart palpitations, trouble breathing, or chest pain.
People who are unable to carry on any physical activity without symptoms. Symptoms may be present even at rest.
Heart failure is a lifelong (chronic) disease.
Treatment may be able to slow the disease and help you feel better. But heart failure tends to get worse over time. Despite this, there are many steps you can take to feel better and stay healthy longer.
Early on, your symptoms may not be too bad. As heart failure gets worse, symptoms typically get worse, and you may need to limit your activities. Heart failure can also get worse suddenly. If this happens, you need emergency care. Then, after treatment, your symptoms may go back to being stable (which means they stay the same) for a long time.
Heart failure can lead to other health problems, such as heart rhythm problems. Over time, your treatment options may change, especially as your symptoms get worse. You may want to think about what kind of care you want at the end of your life.
Heart failure stages are based on how it often progresses. Stage A means that a person is at risk for heart failure. In stage B, there are signs that the heart is not normal. Stage C means that a person has heart failure with symptoms. In stage D, a person has severe heart failure. footnote 1
To learn what to watch for, what you can do for different symptoms, and when to seek help, visit heart failure action plan.
Call 911 or other emergency services immediately if you have:
Call your doctor now if you have a pacemaker or ICD and think you have an infection near the device. Signs of an infection include:
Call your doctor soon if you have symptoms of heart failure, which include:
Call your doctor soon if:
To diagnose heart failure, your doctor will:
Your doctor will also review all the medicines you take, ask if you have heart disease in your family, and look for other risk factors, such as high blood pressure.
Your doctor will check your blood pressure and heart rate, check your weight, listen to your lung and heart sounds, check your belly and legs for swelling, and look for swelling or bulging veins in your neck.
Your doctor may diagnose heart failure from your symptoms and the physical examination. But you will have more tests to find the cause and type of heart failure so that you can get the right treatment. Tests can show how well your left lower heart chamber (left ventricle) and the valves inside your heart are working. Common tests include:
An EKG is done to find any problems with your heart rhythm. It can also show signs of damage to the heart.
A chest X-ray gives your doctor a picture of your heart, lungs, and major blood vessels.
This is an ultrasound examination of the heart. An echo can help show whether you have heart failure, what type it is, and what might be causing it.
Your doctor may order more imaging tests. These include:
This test shows how well your heart pumps blood to the rest of your body.
An MRI lets your doctor see the structure of your heart and check how well it is pumping.
Heart failure is treated with medicines, a heart-healthy lifestyle, and the steps you take to check your symptoms. Treatment may also include a heart device, such as a pacemaker. Your treatment will also depend on what you want. Everyone is different.
Your treatment depends on:
As part of your ongoing treatment, your doctor will also try to prevent or treat problems—such as fever, arrhythmia, and anemia—that can lead to sudden heart failure.
Sometimes heart failure can be fixed if another problem can be corrected, such as hyperthyroidism. But this isn't common.
Treatment can slow the disease, help you feel better, and help keep you out of the hospital. Treatment may also help you live longer.
Medicines can help your heart work better, help you feel better, and help keep you out of the hospital. Medicines may also help you live longer.
It's very important to take your medicines exactly as your doctor says.
The medicines you take will depend on the type of heart failure you have. Download heart failure medicines (PDF) and What to do with heart failure medicines if I'm sick (PDF) for more information.
You may hear that people use supplements, vitamins, or hormones, and that these natural health products might help heart failure symptoms. But there is not much evidence that they help.
Fish oil (omega-3 fatty acid) supplements may help some people who have heart failure. Fish oil supplements, taken along with heart failure medicines, may help people stay out of the hospital and live longer.footnote 1
No other supplement, vitamin, or hormone has been proven to relieve heart failure or help you live longer.footnote 1
Talk to your doctor before you take any over-the-counter medicine or natural health product. They may be used along with medical treatments for heart failure, not instead of treatment.
Emotions such as worry, sadness, or fear can be a normal part of living with heart failure. It's okay if the feelings come and go. But sometimes feelings like anxiety or depression can hang on. They can keep you from doing things to take care of your heart, like limiting salt and weighing yourself. And not doing these things may send you to the hospital.
Having healthy emotions can help you live better with heart failure. That's why your doctor may ask you about your feelings. Or maybe you and your doctor haven't talked yet about how your emotions can affect your heart. It's okay for you to bring it up with your doctor. Working together, you and your doctor can find ways to help you and your heart feel better.
Your emotions affect your physical health, so your doctor needs to hear about how you're feeling. Feelings, especially negative ones like anxiety or depression, may be hard to talk about. But your doctor can help with your emotional health just like they have been treating your heart failure. The sooner you talk to your doctor about your emotions and your options for treatment, the sooner you can start to feel better.
Here are some ideas that can help you get ready to talk to your doctor.
Take some time to think about how you're feeling. Try to picture how you deal with emotions in your daily life.
If you find it hard to think about emotions, that's okay. You could ask someone you trust and who knows you well to let you know what they may notice. Sometimes hearing another person's view can give you new insight.
It may help you to write about your feelings. To get started, try asking yourself the following questions. Write down your answers and share them with your doctor. Having specific examples will help your doctor have a better idea of how to help you.
Emotional support from friends and family can help you cope with the struggles of heart failure. But it can be hard to ask for the help and support you want or need. Remember that people may want to help, but they may not know how. Sometimes it is up to you to ask. Support can make the difference between a good day and a bad day.
Your doctors, nurses, and other health professionals can give you support. And a cardiac rehabilitation program also offers support for you and your family.
Support can also come from others who are dealing with the same things you are. Support groups can show you that you're not alone with your feelings or frustrations. They may even give you new ideas to help you cope or solve a problem. You may find that a heart failure support group helps you talk about what's going on in your life.
Your doctor may be able to tell you about the types of support and support groups that are available where you live.
Hear from others
CitationsHeidenreich PA, et al. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association. Journal of the American College of Cardiology, published online April 1, 2022. DOI: 10.1016/j.jacc.2021.12.012. Accessed April 1, 2022.
Adaptation Date: 6/15/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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