Heart failure develops when the heart doesn't function properly. Heart failure doesn't mean that the heart has failed or stopped. People often live healthy lives by controlling this condition, which refers to one or more chambers of the heart "failing" to keep up with the volume of blood flowing through them.
Heart failure may involve the left side, the right side or both sides of the heart. Each side has two chambers — an atrium (upper chamber) and a ventricle (lower chamber). Heart failure occurs when any one of these four chambers is no longer able to keep up with the volume of blood flowing through it.
Two types of heart dysfunction can lead to heart failure, including:
The left side of the heart is crucial for normal heart function and is usually where heart failure begins. The left atrium receives oxygen-rich blood from the lungs and pumps it into the left ventricle, the heart's largest and strongest pump, which is responsible for supplying blood to the body. After it has circulated through the body, blood returns to the right atrium and then travels to the right ventricle, which pumps it into the lungs to be replenished with oxygen. When the right side loses pumping power, blood can back up in the veins attempting to return blood to the heart.
Right heart failure may occur alone but is usually a result of left-sided failure. When the left ventricle fails, fluid backs up in the lungs. In turn, pressure from excess fluid can damage the heart's right side as it works to pump blood into the lungs.
Although the death rate from coronary artery disease and other heart conditions has been declining, the number of deaths from heart failure — also called congestive heart failure — is rising and is expected to balloon as the population ages.
Heart failure usually is a chronic, or long-term, condition that gradually gets worse. By the time most people notice and see a doctor about their symptoms, the heart has been "failing," little by little, for a long time. This is a good reason to have regular health checkups. During a routine physical examination, your doctor may detect signs of heart failure long before you experience symptoms. Heart failure rarely occurs suddenly except after a major heart attack, severe heart valve problem or period of seriously high blood pressure. Heart failure can be brought on by a variety of underlying diseases and health problems.
People who experience any of the symptoms associated with heart failure, even if they are mild, should consult a doctor as soon as possible. Once a person is diagnosed, it's important to keep track of symptoms and report any sudden changes.
Typical signs of heart failure include:
These symptoms occur as the heart loses strength and the ability to pump blood throughout the body. In turn, blood can back up and cause "congestion" in other body tissues, which is why heart failure sometimes is called "congestive." In addition, excess fluid may pool in the failing portion of the heart and the lungs.
At the same time, the heart as well as other parts of the body attempt to adapt and make up for the deteriorating pumping ability. For example:
Heart grows larger — The muscle mass of the heart grows in an attempt to increase its pumping power, which works for a while. The heart chambers also enlarge and stretch so they can hold a larger volume of blood. As the heart expands, the cells controlling its contractions also grow.
Heart pumps faster — The heart speeds up in an attempt to circulate more blood throughout the body.
Blood vessels narrow — As less blood flows through the arteries and veins, blood pressure can drop to dangerously low levels. To compensate, the blood vessels become narrower, which keeps blood pressure higher, even as the heart loses power.
Blood flow is diverted — When the blood supply is no longer able to meet all of the body's needs, it is diverted away from less-crucial areas, such as the arms and legs, and given to the organs that are most important for survival, including the heart and brain. In turn, physical activity becomes more difficult as heart failure progresses.
Although the body's ability to compensate for the failing heart initially is beneficial, in the long run these adaptations contribute to the most serious cases of heart failure. For example:
Eventually, the heart and body are unable to keep up with the added stress. If patients wait until they experience obvious symptoms of heart failure before seeing a doctor, the condition already may be life-threatening. If you experience any of these symptoms, consult your doctor as soon as possible.
Treatment focuses on improving the symptoms and preventing the progression of the disease. Treatments include lifestyle and pharmacological modalities. Reversible causes of the heart failure should also be addressed: