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960,000 New Cases of Heart Failure Occur Each Year

Heart failure affects over 6.5 million Americans over the age of 20, and is expected to rise substantially by 2030.

What is heart failure?

Heart failure (congestive heart failure) does not mean your heart has ‘failed’ or stopped working. It is a condition in which your heart is not pumping blood as well as it should. The condition can be acute or chronic.

Acute heart failure is a medical emergency and needs immediate attention. Chronic heart failure develops over time and causes symptoms such as coughing, shortness of breath, and exhaustion. Your daily tasks like carrying groceries, walking, and climbing stairs can become exceedingly challenging.

Some common causes of heart failure are coronary artery disease, high blood pressure, diabetes, and obesity. Treatment typically involves a combination of lifestyle changes, and medications.

Weak heart pumping less blood out

How is heart failure diagnosed?

Cardiologists typically use a combination of medical history, physical examination and diagnostic tests in order to diagnose heart failure.

Your doctor will ask you about your symptoms, look for conditions like diabetes, coronary artery disease, or high blood pressure that might be possible causes of heart failure.

During physical examination your doctor can check your heart for murmurs that can indicate heart failure as well as your lungs for indications of fluid accumulation (lung congestion).

Additionally, your specialist could recommend a few of the following tests:

  1. Blood test

    To check for abnormalities that may harm your heart.

  2. Electrocardiogram (ECG)

    ECG captures electrical cardiac impulses and displays the frequency and duration of your heartbeats.

  3. Echocardiography (ECHO)

    ECHO uses sound waves to create visuals of your heart. This analysis is performed when heart failure is suspected and it's used to reveal the size, shape, and blood flow through your heart and heart valves.

    It shows how much blood is pushed out of the heart through the left ventricle—the primary pumping chamber—with each contraction.

    A normal ejction fraction is 53% to 70%. An ejctions fraction less than 40% indicates systolic dysfunction or heart figure with reduced ejection fraction (HFrEF), meaning your heart doesn't pump blood to your body as efficiently as it should.

  4. Chest X-ray

    Images show health of your heart and lungs.

  5. Stress test

    A cardiac test that evulates how well the heart works during exercise.

    You wear a ECG monitor while walking on a treadmill.

  6. CT scan

    A CT scan is used to produce precise images of your heart and its blood vessels.

  7. MRI

    A dye (contrast) may be used to conduct a cardiac MRI.

    It's crucial to let your doctor know if you have any renal issues since contrast can sometimes result in rare but significant problems that may arise in individuals with kidney disease.

  8. Coronary angiogram

    This procedure involves inserting a thin, flexible tube (catheter) into a blood artery, typically in the groin, and directing it to your heart arteries. A dye (contrast) is administered through the catheter to assist your specialist in identifying obstructions by making the arteries appear more clearly on an X-ray.

What are the symptoms of heart failure?

Heart Failure Symptoms
  • Shortness of breath (SOB), which may occur while exercising or during rest
  • Difficulty breathing
  • Nausea
  • Exhaustion or weakness
  • Swelling that may occur in your ankles, legs, and/or feet
  • A pulse or heartbeat that may be fast or inconsistent
  • Decreased stamina for exercise
  • A cough that may be persistent or wheezing with blood-tinged mucus that is either white or pink
  • Abdominal swelling or bloating
  • Increased weight
  • Decreased appetite
  • Having trouble focusing or being less alert

What are the different stages of heart failure?

Two classification systems

NYHA Functional Classification

The New York Heart Association Functional Classification is older, simpler and more widely used in clinical settings due to its simplicity. It consists of four stages based on patient’s self-reported symptoms.

It’s also used as a base for various drug studies, and highly significant to choices regarding drug therapy.

NYHA Functional Classification
Class I No limitations of physical activity.
Class II Slight limitation of physical activity. Comfortable at rest. Regular physical activity causes symptoms.
Class III Marked limitation of physical activity. Comfortable at rest. Less than regular physical activity causes symptoms.
Class IV Symptoms occur even at rest, discomfort with any physical activity.

ACC/AHA Stages

The American Heart Association and American College of Cardiology defined the four stages of heart failure in 2001.

It provides more a comprehensive picture of patient’s condition since it considers patient’s functional impairment as well as their symptoms.

ACC/AHA Stages
Stages Treatment
Stage A
High risk of heart failurewithout heart disease or HF symptoms
  • Exercise
  • Quit smoking
  • Treat high hyperhension, high cholesterol, and other heart disease with medication
  • Discontinue alcohol or illegal drug use
Stage B
Structural heart disease but no signs or symptoms of heart failure.
Stage C
Structural heart disease with symptoms of heart failure.
  • Hydralazine/nitrate combination for African-American patients if symptoms persist
  • Diuretics and digoxin if symptoms persist
  • Aldosterone inhibitor when symptoms remain severe with other therapies
  • Restrict dietary sodium
  • Monitor weight
  • Restrict fluids
  • Pacemaker or ICD may be recommended
Stage D
Advanced heart failure requiring specialized interventions.
  • Heart transplant
  • Ventricular assist devices
  • Surgery options
  • Continuous infusion of intravenous inotropic drugs
  • Palliative or hospice care

What are the risk factors of heart failure?

Heart failure affects both men and women equally, but men are more likely to develop it earlier in life.

If you possess more than one of the following, your likelihood of developing heart failure increases.

  • Genetics

    Your risk of heart failure is increased if your family has a history of the condition. Your heart tissue may become weaker or less flexible as a result of certain gene alterations, or mutations.

  • Aging

    Your heart might become stiff and frail as you age. The risk of heart failure is increased in individuals over the age of 65. Additionally, older individuals are more susceptible to various medical disorders that lead to heart failure.

  • Lifestyle

    Another heart failure risk factor includes bad eating habits, smoking, using cocaine or other illicit substances, drinking excessive amounts of alcohol, and not getting enough exercise.

  • African Americans

    Are more likely than individuals of other races to have heart failure, and they frequently encounter more severe instances and heart failure at a younger age.

Can heart failure be prevented?

Yes! The actions listed below can help reduce your chance of getting heart failure. Keep in mind that your chances of preventing or delaying the disease are higher the earlier you begin.

  • Choosing a heart-healthy approach. Your heart's health may be maintained by consuming heart-healthy meals (eating fruits and vegetables (4 servings a day)), working toward a healthy weight, engaging in regular physical exercise (≥ 5 days a week), stopping smoking, and managing stress.
  • Do not take illicit substances (including cocaine and amphetamine abuse), and limit or avoid drinking alcohol (limit to 1 drink a day).
  • Limit the amount of caffeine consumption (≤ 4 cups a day).
  • Manage your risk of heart failure by working with your doctor to control diseases including diabetes, high blood pressure or hypertension, and obesity.

Medication options

Heart failure treatment aims to lessen symptoms, enhance your quality of life, and try to prevent it from becoming worse (thereby reducing the chance of death and hospitalization).

To assist you in exercising safely and maintaining a heart-healthy lifestyle, your cardiologist can also suggest a program called cardiac rehabilitation. It often includes personalized exercises, knowledge, and advice on how to reduce your risk of cardiac problems, such as giving up smoking or making dietary changes..