The Struggling Heart: Understanding Heart Failure

If you have heart failure (HF), you are far from alone. HF affects nearly six million people in the United States. The words “heart failure” can make it sound as though your heart has stopped working entirely, or is about to. That’s not what heart failure means, but it is a serious, chronic condition that requires careful medical attention.  

The heart is a muscle, and its main job is to pump oxygen-rich blood throughout the body. If you have HF, your heart doesn’t pump blood as efficiently as it did when you were younger, so some parts of your body don’t get enough blood and, therefore, don’t work as well as they should. In addition, blood and fluid may back up into your lungs. As a result, HF can make you feel short of breath, leave you feeling tired and cause swelling in your legs and feet.   

While heart failure usually cannot be cured, it can often be managed, through medical treatment and lifestyle changes. Many people with the condition lead full, enjoyable lives. 

Types of  Heart Failure and Its Effects 

The heart has two sides, left and right. The right side of the heart pumps oxygen-depleted or “used” blood into the lungs to gather new oxygen. The left side then sends that oxygen-rich blood into the body. The two main types of heart failure correspond to the two sides of the heart.  

In right-side heart failure, the right ventricle (right lower chamber of the heart) is not working adequately and can cause backup and fluid buildup into the large veins, liver and legs.  

In left-sided heart failure, the left ventricle (left lower chamber) can‘t properly pump blood out to the body, and blood can back up to the lungs.  

It’s possible to have right-sided and left-sided heart failure at the same time.  

Heart failure may also be classified as heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. Ejection fraction is a measurement of how much blood your heart pushes out when it beats. 

What Causes HF? 

HF can result from a number of different heart-related problems and other conditions. They include: 

• High blood pressure (also called hypertension) 
• Coronary artery disease (narrowing of your arteries due to a buildup of a waxy substance called plaque) 
• Heart valve problems (perhaps due to a heart infection or a defect) 
• Other factors that can increase your risk of HF include thyroid disease, diabetes, obesity, alcohol abuse and HIV/AIDS, as well serious infections and allergic reactions. 

Recognizing the Signs of HF 

It’s important to pay attention to how you’re feeling and be aware of possible signs of HF. If you notice more than one of the following symptoms, you should consult your doctor or health care provider: 

• Shortness of breath 
• Coughing or wheezing that doesn’t go away 
• Swelling of your feet, ankles, legs or abdomen 
• A persistent feeling of tiredness or fatigue 
• Lack of appetite or a feeling of nausea 
• Confused or impaired thinking 
• Increased heart rate 

Who Is Most Likely to Get HF? 

The number of people in the United States with HF is on the rise. It is most common among: 

• People over age 65: Heart failure is a leading cause of hospital stays for people on Medicare. 
• African Americans, who are more likely to have heart failure than people of other races.  
• Overweight people: Extra weight puts a strain on the heart. 
• Heart attack survivors: A heart attack can weaken the heart muscle. 

While heart failure usually cannot be cured, it can often be managed, through medical treatment and lifestyle changes.

How Is HF Diagnosed?

Your doctor will base your diagnosis on several things, including your medical history, a physical exam and test results. She will determine whether your heart is damaged, see how efficiently it pumps blood and rule out other things that might be causing your symptoms. Some of the most popular diagnostic tests for HF include: 

• An EKG (electrocardiogram): To reveal any abnormalities with the rhythm of your heartbeat  
• An echocardiogram: To take a close look at your heart’s structure and motion 
• A cardiac MRI: To capture still and moving pictures of your heart as it beats 
• Stress tests: To see how your heart reacts when it’s working harder than usual 
• Blood tests: To look for abnormal blood cells and infections and to check for BNP, a hormone that rises during heart failure 
• Cardiac catheterization: To look for blockages in the arteries around your heart 

How Is HF Treated? 

HF that has resulted over time from heart damage can’t be cured, but it can be managed and your symptoms can improve. The treatment will largely focus on addressing any underlying causes (such as diabetes or high blood pressure), controlling your symptoms, stopping the heart from getting worse, and improving your quality of life. Your treatment plan may include: 

• Lifestyle changes, such as healthier eating, weight loss, increased physical activity and stopping smoking 
• Medications, chosen specifically to address the type and severity of your heart failure  
• Medical procedures and surgery, which may eventually become necessary if lifestyle choices and medicines can no longer control your symptoms 
• Ongoing care, which includes regular checkups to watch for any changes in your condition 

If you’ve been diagnosed with HF, the best steps you can take are to follow your treatment plan and your doctor’s advice, including eating a healthy, low salt diet, taking your medicines as prescribed, and considering joining a support group for people like you who are living with HF. 

Source: American Heart Association; National Heart, Lung, and Blood Institute; Healthline