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CIS staff members preforming a procedure on a patient with heart failure in an operating room

What is Heart Failure?

In very basic terms, heart failure occurs when the heart simply isn’t pumping as effectively as it should and is struggling to supply the body with the blood flow and oxygen it needs to survive and thrive. This often occurs as the result of conditions such as uncontrolled high blood pressure or plaque build-up that leads to narrowed arteries.

What are the Types of Heart Failure?

Right-sided Heart Failure

Heart failure, also commonly referred to as congestive heart failure, can occur on the left side of the heart, the right side, or both. Most commonly, it begins in the heart’s primary pumping chamber – the left ventricle. Each specific type of heart failure is accompanied by its own distinct characteristics.

Right-sided hear failure develops when the right ventricle struggles to deliver blood to the lungs. As blood backs up into the blood vessels, the body begins to retain fluid in the abdomen and lower body.

Left-sided Heart Failure

Left-sided heart failure is the most common form of heart failure and begins when the left ventricle cannot effectively deliver blood throughout the body. Eventually, this can lead to fluid retention throughout the body, particularly around the lungs.

Cases of left-sided heart failure can be further classified into one of two sub-types, characterized by the manner in which the ventricle is affected:

  • Systolic Heart Failure – Systolic heart failure occurs when the left ventricle is unable to contract with enough force to circulate blood properly.
  • Diastolic Heart Failure – Diastolic heart failure occurs when the heart muscle becomes stiff. Because the chamber must relax in order to fill with blood between contractions, this stiffness means that an inadequate amount of blood is available to pump out to the rest of the body.

Risk Factors Associated with Heart Failure

While there may be no way to determine with one-hundred percent certainty who will develop heart failure, we can venture a highly educated guess with incredible accuracy by taking into account the following risk factors:

  • Previous heart attack
  • Hypertension, or high blood pressure
  • Cardiomyopathy, or enlargement of the heart
  • Diabetes
  • Abnormality within the heart valves
  • Family history
  • Being overweight

If you meet any of these, there is a higher than average likelihood that you will eventually be among the 1 in 5 Americans who suffer from heart failure.

Symptoms Associated with Heart Failure

The body can provide many clues to the existence of heart failure. The most commonly noted symptoms associated with the condition include:

  • Shortness of breath (dyspnea) – This symptom occurs as fluid backs up into the lungs.
  • Persistent cough – This is also attributable to fluid in the lungs and may also present as persistent wheezing.
  • Edema – Edema is notable swelling in the body due to the accumulation of fluid. It is most commonly seen in the lower extremities and abdomen.
  • Fatigue – As the heart works harder and harder to meet the needs of the rest of the body, it is not uncommon to feel fatigue, particularly with any physical activity.
  • Increased heart rate – As the heart tries to compensate for its inability to pump as much blood, it may begin to beat faster than normal.

What are the Complications of Heart Failure?

Having an impaired heart can lead to not only cardiovascular complications, but it can negatively affect other parts of the body as well. Potential complications that can result from heart failure, include:

  • Kidney failure – As blood flow to the body decreases, the kidneys are among the organs most likely to be impacted. Reduced blood flow can result in kidney damage and even kidney failure, requiring some patients to undergo dialysis.
  • Heart valve damage – In a vicious cycle, the damage to the heart from heart failure can result in faulty valves that can no longer properly control blood as it comes in and out of the heart. In turn, the heart has an even more difficult time performing its job effectively.
  • Arrythmia– As the heart struggles to work through heart failure, it may begin to beat irregularly. A common type of arrythmia associated with heart failure is Afib, a condition which can also increase a patient’s likelihood for stroke.
  • Liver damage – As fluid begins to backup into other areas of the body, there may be added pressure on the liver. This pressure can lead to scarring which can impede the liver from doing its job effectively.
  • Lung damage – Again, this is a type of damage that results from the buildup of fluid associated with heart failure and is why shortness of breath is a common complaint among patients. There is also frequently an association between heart failure and COPD.

How is Heart Failure Diagnosed?

Heart failure is typically diagnosed through physical examination, medical history, symptoms, and diagnostic tests. Tests we may use to aid in the diagnosis of heart failure include:

  • Chest x-ray
  • Echocardiogram
  • Electrocardiogram (EKG)
  • Stress test
  • MRI
  • CT Scan
  • Coronary angiogram

How is Heart Failure Treated?

Treatment for heart failure depends on the type, severity, and patient. In many cases, initial treatment will include the use of medications to reduce fluid and ease pressure on the heart, making it easier to do its job. These medications can include diuretics, beta blockers, ACE inhibitors, and more.

For those whose heart failure has become severe, is greatly threatening their health and quality of life, or has progressed despite treatment, more invasive methods may become necessary. These can include coronary bypass, replacing or repairing damaged heart valves, implantable defibrillators, or in the most severe cases, heart transplant.

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