What is heart failure?
Heart failure, also called congestive heart failure (CHF), is a condition where your heart can’t pump blood the way it should. Heart failure doesn’t mean your heart has stopped. It means your heart is stiff or weak. Because your heart isn’t working well, it may get weaker over time.
Heart failure can be different depending on which side of the heart is affected It is a chronic (long-lasting) condition, but you can treat and manage it to help control symptoms.
Common types of heart failure include:
Left-sided heart failure
When the left side of the heart can’t pump blood to the body properly, fluid may build up in the lungs.
There are two types of left-sided heart failure:
- Systolic failure: The left ventricle (lower chamber of the heart) doesn’t contract like it should, so it can’t pump enough blood. This is also called heart failure with reduced ejection (HFrEF).
- Diastolic failure: The left ventricle can’t relax like it should because the muscle is stiff, so the heart can’t fill up with blood properly between heartbeats. This is also called heart failure with preserved ejection (HFpEF).
Right-sided heart failure
When the right side of the heart can’t pump blood to the lungs properly, fluid may build up in the body's tissues. This type of heart failure may also be called right ventricular heart failure. It often happens because of left-sided heart failure.
What are symptoms and early signs of heart failure?
Early signs of heart failure may be similar to symptoms of other conditions. If you have any of these symptoms, it’s important to talk to a health care provider to figure out what’s causing them:
- Shortness of breath, which could happen when you’re lying down, resting or active
- Edema (swelling) in your legs, ankles or belly
- Fatigue (tiredness)
- Weight gain from fluid retention
- Coughing or wheezing often
- Trouble concentrating or feeling lightheaded
What causes heart failure?
Underlying health conditions and lifestyle factors can cause heart failure.
Health conditions
- Coronary artery disease or having had one or more heart attack in the past
- High blood pressure
- Diabetes
- Heart valve problems
- Cardiomyopathy, a disease that makes it harder for the heart to pump blood
- Congenital heart defects, which are heart problems you were born with
- Obesity
- Metabolic syndrome, which is when you have three or more of these conditions: high blood pressure, high blood sugar, high cholesterol, high triglycerides or too much fat at the waist
Lifestyle factors
- Smoking
- Drinking too much alcohol
- Using drugs or substances recreationally
- Not getting enough physical activity
- Eating a diet that includes a lot of unhealthy fats, refined grains, added sugar, salt and ultra-processed foods
How is heart failure diagnosed?
To diagnose heart failure, your health care provider will ask you about your medical history and symptoms. They may ask about your recent illnesses, exercise, sleeping, eating and breathing.
Your provider will perform a physical exam and will check health markers like your:
- Blood pressure
- Pulse
- Skin color
- Temperature
- Neck veins
- Breathing
- Weight
- Ankles, legs and belly, for swelling
Based on your medical history, symptoms and physical exam, they may order these imaging tests:
- Echocardiogram: Shows how well your heart is pumping and, if you have heart failure, can show what type you have
- Cardiac MRI, CT or PET scan: May help spot the cause of heart failure and can show how much heart muscle is damaged
- Chest X-ray: Shows whether your heart is bigger than it should be and whether you have fluid in your lungs, which can be a sign of heart failure
- Electrocardiogram (ECG or EKG): Shows certain electrical signals in your heart that could be markers of heart failure
Your provider may also order other tests like:
- Blood tests: Measurements of two types of peptides, B-type natriuretic peptide (BNP) and N-terminal pro B-type natriuretic peptide (NT-proBNP), help diagnose heart failure
- Stress test: Shows how the heart is functioning when it’s working hard
- Cardiac catheterization: May be needed if other tests show that you have narrowing in arteries or if other tests aren’t clear
How can heart failure be treated?
Heart failure can be treated with lifestyle changes, medication and, in some cases, medical devices.
Lifestyle changes
- Low-sodium diet: Sodium is found in salt. Too much sodium can increase your blood pressure and make heart failure symptoms like swelling and weight gain worse.
- Fluid monitoring: Restricting the amount of fluid you take in can help reduce the fluid buildup that comes from heart failure. Your provider can talk to you about the pros and cons of monitoring your fluids.
- Light exercise: If your provider says it’s OK, some forms of exercise can help with heart failure. You may need to avoid certain activities and start slowly. It might be easier for you to exercise for short periods with rest in between instead of exercising for a longer time.
Medications
Depending on the type of heart failure you have and how severe it is, your provider may recommend CHF treatment options such as:
- ACE inhibitors: To help your blood vessels relax, which can treat high blood pressure and heart failure
- Angiotensin II receptor blockers (ARBs): To help your blood vessels relax to treat heart failure and kidney disease and lower your risk of heart attack and stroke
- Beta-blockers: To help your heart beat more slowly and with less force to improve your blood flow
- Diuretics (water pills): To help your kidneys get rid of excess fluid in your body
- Aldosterone antagonists: To help your kidneys get rid of excess fluid without getting rid of potassium
- Angiotensin receptor/neprilysin inhibitors (ARNIs): A newer treatment that combines two drugs to help treat heart failure
- Sodium-glucose co-transporter 2 (SGLT-2) inhibitors: A newer treatment that may help with heart failure, type 2 diabetes and kidney disease
- Digoxin: May be used along with some other medications to treat heart failure
Medical devices
Some medical devices may help treat heart failure. They are placed inside your body with surgery:
- Pacemakers: These devices can control the heartbeat if they pick up signs of trouble
- Implantable cardioverter-defibrillators (ICDs): These devices find irregular heartbeats and help your heart beat normally.
- Cardiac-resynchronization therapy defibrillator (CRT-D): These devices send signals that tell your heart when to beat and correct dangerous heart rhythms.
- Cardiac contractility modulation (CCM): These devices help your heart work better and reduce some heart failure symptoms.
Remote hemodynamic monitoring devices like CardioMEMS are another option. These devices, which are implanted without surgery, measure changes in lung artery pressure. These measurements are sent wirelessly to your health care provider and can show if heart failure is getting worse before you spot any changes in symptoms.
Your provider can then adjust your treatment plan or medication based on your readings. Catching changes in your condition early can help you stay out of the hospital.
A combination of lifestyle changes, medication and possibly medical devices may be best for controlling your heart failure. Your provider can help you create a personalized treatment plan.
When should you seek advanced heart failure care?
You may need advanced heart failure care if:
- Your symptoms are getting worse or not improving
- You need to be hospitalized for heart failure
- You can’t tolerate standard treatments
Advanced heart failure care options include:
FAQs and related resources
What’s the difference between heart failure and a heart attack?
With heart failure, your heart health gets worse over time. Your heart muscle becomes weak or stiff so it can’t pump blood as it should. With a heart attack, your heart suddenly doesn’t get the blood it needs, usually because a blood vessel that feeds it gets blocked.
Can heart failure be reversed?
It may be possible to stop or even reverse heart failure. The earlier you start treatment for heart failure, the better your results may be.
What does “ejection fraction” mean?
Ejection fraction measures how well your heart pumps blood, as a percentage. Normal is 50% to 70% of your blood getting pumped out of your heart with every heartbeat. A lower number means your heart isn’t working as well. But you can have heart failure with a normal ejection fraction.
Learn more about:
Why choose Banner Health for heart failure care?
When you turn to Banner Health for heart failure care, you benefit from our:
- Experienced heart failure teams
- Advanced diagnostic technology
- Close coordination with specialists in mechanical circulatory support and heart transplant
- Access to cardiac rehab
- Locations throughout the Southwest with telehealth options for follow-up visits
Whole-person care, including behavioral health and nutrition, because we understand that heart failure can affect every aspect of your life
Ready to take the next step?
If you think you may have heart failure or you would like a second opinion, we’re here to help.
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