Heart failure

Heart failure is a chronic (long-term) condition in which your heart doesn’t pump blood as well as it should. At Atrium Health Floyd and Harbin Clinic, our heart care specialists help you learn to take better care of yourself and manage heart failure successfully.

What is heart failure?

Heart failure occurs when your heart can’t pump enough blood to meet your body’s needs. About 6.7 million adults in the U.S. have heart failure, and the number is growing.

There’s no cure for heart failure. But early diagnosis and effective treatment can help you live a healthier, more active life for longer.

Causes of heart failure

Any condition that weakens your heart muscle can lead to heart failure. Conditions that often contribute to heart failure include:

• Arrhythmias, conditions in which your heart beats too slow, too fast or irregularly
• Cardiomyopathy, a heart muscle problem that can lead to stiffening or thickness
• Congenital heart disease, heart problems that are present at birth
• Coronary artery disease, a condition that occurs when a fatty substance (plaque) builds up in your heart arteries, restricting blood flow
• Diabetes, a condition that causes high blood sugar (glucose)
• Heart valve disease, problems with your heart valves, which open and close to control blood flow
• High blood pressure, when the force of blood against your arteries is irregularly high
• Sleep apnea, a condition in which your breathing stops and starts repeatedly during sleep

Other conditions, treatments or lifestyle factors can also weaken your heart muscle, which may lead to heart failure. These include:

• Alcohol or drug misuse
• Cancer treatments such as radiation therapy or chemotherapy
• Excessive vitamin E intake
• HIV/AIDS
• Thyroid disorders

Heart failure symptoms

When your heart can’t pump blood like it’s supposed to, blood and fluid can build up in your body. This buildup can lead to various symptoms, such as:

• Cough that worsens at night and when lying down, a sign of fluid buildup in the lungs (pulmonary edema)
• Fatigue
• Frequent urination
• Shortness of breath
• Swelling in your ankles, feet, legs, abdomen or neck veins
• Weight gain for no known reason

Symptoms often worsen as your heart grows weaker. At first, you may feel tired or short of breath after routine physical activities, such as climbing stairs. Over time, you may feel out of breath after getting dressed, walking across the room or even when lying down.

Heart failure types

Doctors classify heart failure based on which part of your heart it affects. You may have:

• Left-sided heart failure: Your left lower heart chamber (ventricle) can’t contract or relax as it should. Your heart either doesn’t pump blood forcefully enough (systolic heart failure) or doesn’t fill with enough blood between beats (diastolic heart failure).
• Right-sided heart failure: This type of heart failure is usually the result of left-sided heart failure. When the left side of your heart doesn’t function properly, fluid can build up in your lungs and eventually damage the right side of your heart.
• Congestive heart failure: The rate of blood returning to your heart from throughout your body slows. Congestive heart failure requires timely medical care to prevent further complications.

Heart failure diagnosis

To diagnose heart failure, your doctor discusses your symptoms and medical and family history with you. They conduct a physical exam to:

• Check your heart for atypical sounds
• Listen to your lungs for sounds that could point to fluid build-up
• Look for swelling in your ankles, feet, legs, abdomen or neck veins

Your doctor may order tests that check how well your heart pumps blood, such as:

• Coronary angiogram to look for blockages in your heart’s arteries
• Echocardiogram to view your heart’s structure and blood flow
• Ejection fraction test to measure how much blood leaves your heart when it squeezes
• Electrocardiogram (EKG) to measure your heart’s electrical signals
• Imaging, such as a chest X-ray, CT scan or MRI to look at your heart and lungs
• Myocardial biopsy to remove a small piece of heart tissue for evaluation

Heart failure risk factors

A risk factor is anything that increases your chances of developing a condition. Risk factors for heart failure include:

• Age: Heart failure is most common in people 65 and older.
• Body weight: Excess body weight can strain your heart. It also increases your risk of conditions like heart disease and type 2 diabetes, which can lead to heart failure.
• Health history: Many heart conditions can increase your chances of developing heart failure. A history of heart attacks also increases your heart failure risk.
• Race: Black people have a higher risk of heart failure than those of other races.
• Sex: Heart failure is more common in people assigned male at birth.

Heart failure prevention

Managing your overall health is a crucial part of preventing heart failure. Whether you have a low or high risk of the condition, you can take action by:

• Avoiding illegal drugs
• Eating a heart-healthy diet with fruits, vegetables, whole grains, lean proteins and healthy fats
• Exercising regularly
• Limiting alcohol or avoiding it altogether
• Maintaining a healthy body weight
• Quitting smoking
• Treating and controlling any underlying health conditions, with your doctor’s help