Heart Failure

What is heart failure?

The name is misleading and frightens people unnecessarily. Heart failure does not mean the heart has stopped or is about to stop. It means the heart is not pumping or filling as efficiently as the body needs, so blood backs up and fluid accumulates — typically in the lungs, legs, and abdomen.

Many people live full, active lives with heart failure that is well managed. Treatment has improved substantially over the past two decades.

What are the symptoms?

• Shortness of breath with activity, or when lying flat
• Waking at night short of breath, or needing extra pillows to sleep
• Swelling in the feet, ankles, legs, or abdomen
• Fatigue and reduced ability to exercise
• Rapid weight gain over a few days, from fluid rather than fat
• Persistent cough or wheezing, sometimes worse at night

A weight gain of more than two to three pounds in a day, or five pounds in a week, often signals fluid retention and is worth reporting promptly.

Are there different types?

Yes, and the distinction guides treatment. Cardiologists describe heart failure partly by ejection fraction — the percentage of blood the left ventricle pumps out with each beat, measured on an echocardiogram.

• Reduced ejection fraction (HFrEF) — the heart muscle is weakened and pumps less forcefully than normal.
• Preserved ejection fraction (HFpEF) — the heart squeezes normally but is stiff and does not relax and fill properly. This type is common, particularly in older adults and people with high blood pressure or diabetes.

What causes heart failure?

Common causes include coronary artery disease and prior heart attack, long-standing high blood pressure, valve disease, diabetes, abnormal heart rhythms such as atrial fibrillation, and heart muscle disease. Identifying the underlying cause matters, because treating it can improve heart function.

How is heart failure managed?

Modern heart failure care combines several proven medications that, taken together, help people live longer and stay out of the hospital. Alongside medication, day-to-day management matters a great deal: monitoring weight, limiting sodium and sometimes fluid, staying as active as your condition allows, and treating contributing conditions such as sleep apnea and atrial fibrillation.

Heart failure is a condition that rewards steady follow-up. Regular visits allow medications to be adjusted before symptoms escalate, which is often what keeps a hospitalization from happening.

This page is general health information, not medical advice. It cannot replace an evaluation by a physician who knows your history. Talk with your cardiologist or primary care physician about what applies to you.