Spotlight On: Heart Failure

Heart failure is a chronic, progressive condition that leads to decreased heart pumping capacity. This makes it difficult for the heart to pump enough blood to the body to meet its needs. Conditions that cause heart failure include heart disease (no, they are not the same), diabetes and high blood pressure.

Those at higher risk of developing heart failure are people over 65, those who belong to minority groups, and those who have obesity or have had a previous heart attack. Although it’s unlikely, children can develop heart failure if they are born with heart defects.

There are several types of heart failure that affect different parts of the heart:

• Failure to pump blood from the heart to the body is called left-sided heart failure. There are two types of left-sided heart failure:
  • Heart failure with reduced ejection fraction (HFrEF), which means the heart does not pump with enough force to push the blood into circulation.
  • Heart failure with preserved ejection fraction (HFpEF) is referred to as diastolic dysfunction or when the left ventricle cannot relax due to muscle stiffness. This means the heart fills with blood improperly during the rest between beats.
• Right-sided heart failure usually occurs after left-sided heart failure. When the left ventricle fails, the blood backs up and collects in the right ventricle. This increases chest pressure and causes fluid to accumulate. People with right-sided heart failure often have swelling in their arms, legs, abdomen and the veins in their neck.
• Congestive heart failure—when both sides of the heart are in distress—requires immediate medical attention. The blood flow from the left ventricle becomes impaired, causing fluid to collect in the lungs and causing difficulty breathing. People with congestive heart failure generally feel like they are drowning or that something heavy is sitting on their chest when they are lying down. Congestive heart failure can also affect the kidneys by disrupting the balance of sodium and water. Water retention causes swelling in the arms, legs and abdomen.

A number of tests can help diagnose heart failure, including:

• electrocardiogram to record the heart’s electrical activity,
• chest X-ray to determine whether the heart is enlarged or if there’s any fluid retention around it,
• blood test for markers of heart failure or heart disease, and
• echocardiography to take moving pictures that show the size and shape of the heart.

People with heart failure often need to make lifestyle modifications, such as quitting smoking, maintaining a healthy weight, following a heart healthy diet without alcohol or caffeine, and exercising, to prevent the condition from worsening.

Heart failure does not have to be a life-threatening condition. Taking steps to prevent heart failure—or to prevent heart failure from happening again—can improve your heart health.