heart failure

Overview
Heart failure is a chronic condition in which the heart cannot pump blood effectively to meet the body’s needs. This can result from weakened heart muscles, stiffened heart tissue, or damage from conditions like heart attacks or high blood pressure. Blood and fluid can back up in the lungs, legs, or other parts of the body, leading to symptoms such as shortness of breath, fatigue, and swelling. Heart failure is a progressive condition that can significantly impact daily life if not managed.

Why It’s Important
Heart failure is a leading cause of hospitalization, especially in older adults, and can greatly reduce quality of life. Without proper treatment, it can lead to life-threatening complications like severe fluid buildup, organ damage, or sudden cardiac death. Early recognition, lifestyle changes, and treatment can help slow progression and improve outcomes.

Quick Facts

  • Affects about 6.5 million adults in the U.S.

  • Can develop at any age but is most common in older adults

  • Considered a chronic, progressive condition

  • Can be classified as left-sided, right-sided, or congestive heart failure, or based on ejection fraction (reduced vs. preserved)

What Happens in the Body
In heart failure, the heart muscle cannot pump blood efficiently. This leads to fluid buildup in the lungs (causing shortness of breath) and other tissues (causing swelling in legs, ankles, and abdomen). The body may attempt to compensate by increasing heart rate or constricting blood vessels, but these adaptations eventually strain the heart further.

Common Signs and Symptoms

  • Shortness of breath, especially with activity or when lying down

  • Fatigue and weakness

  • Swelling in legs, ankles, feet, or abdomen

  • Rapid or irregular heartbeat

  • Persistent cough or wheezing

  • Reduced ability to exercise or perform daily tasks

Diagnosis

  • Physical exam and medical history

  • Blood tests (BNP or NT-proBNP) to detect heart stress

  • Echocardiogram to assess heart function and ejection fraction

  • Electrocardiogram (ECG) to check rhythm

  • Chest X-ray to evaluate fluid buildup and heart size

Treatment and Management

  • Medications: ACE inhibitors, beta-blockers, diuretics, aldosterone antagonists, SGLT2 inhibitors

  • Lifestyle changes: Low-sodium diet, regular exercise, weight monitoring, quitting smoking, limiting alcohol

  • Medical devices or procedures: Pacemaker, defibrillator, or surgery (e.g., valve repair or ventricular assist device)

  • Heart failure is chronic, but proper treatment can slow progression, reduce symptoms, and improve survival

Risks and Complications

  • Severe fluid retention leading to pulmonary edema

  • Kidney or liver damage

  • Arrhythmias and sudden cardiac arrest

  • Recurrent hospitalizations

  • Reduced quality of life and mobility

Who Is at Risk

  • People with coronary artery disease or previous heart attack

  • High blood pressure

  • Diabetes or obesity

  • Heart valve disease or congenital heart defects

  • Older adults, men more than women, and those with a family history of heart disease

Related Conditions

  • Coronary artery disease

  • Hypertension

  • Atrial fibrillation

  • Chronic kidney disease

  • Sleep apnea

When to See a Doctor
Seek medical attention if you experience:

  • Sudden worsening of shortness of breath

  • Rapid weight gain from fluid retention

  • Swelling that worsens in legs or abdomen

  • Persistent fatigue or dizziness

  • Chest pain or irregular heartbeat

Last Updated: October 2, 2025