The name of this condition can be a little confusing. When you have heart failure, it doesn't mean your ticker stopped beating. What's really going on is that your heart can't pump blood as well anymore.
The chambers of your heart may respond by stretching to carry more blood to pump through your body. They may become stiffer and thicker. This helps keep blood moving for a while, but in time, your heart muscle walls may get weaker.
Your kidneys react by causing your body to hold on to water and salt. Fluid may start to build up in your arms, legs, ankles, feet, lungs, or other organs.
What Causes It?
Heart failure can be brought on by many conditions that damage the heart, including:
Coronary artery disease. This is a disease of the arteries that supply blood and oxygen to your heart. It decreases blood flow to your heart muscle. If the arteries narrow or get blocked, your heart becomes starved for oxygen and nutrients and can't pump as well.
Heart attack. This may happen when a coronary artery is blocked suddenly, which stops the flow of blood to your heart muscle.
Cardiomyopathy. This is damage to your heart muscle that can be caused by artery or blood flow problems, infections, and alcohol and drug abuse. Other diseases or genetic issues can also bring it on. Make sure your doctor knows your family's health history.
Conditions that overwork the heart. These include things like high blood pressure, heart valve disease, thyroid disease, kidney disease, diabetes, or heart defects you've had since you were born.
Types of Heart Failure
Systolic heart failure. This happens when your heart muscle doesn't squeeze with enough force. When that's the case, it pumps less oxygen-rich blood through your body.
Diastolic heart failure. Your heart squeezes normally, but the ventricle -- the main pumping chamber -- doesn't relax properly. This lowers the amount of blood that can enter your heart and raises blood pressure in your lungs. When that happens, you get fluid in your lungs, legs, and belly.
Stages of Heart Failure
The American Heart Association and American College of Cardiology have put out a list of heart failure stages that helps you understand how the condition changes over time and the kinds of treatments that are used in each phase.
Stage A. This is the period when you are at risk for heart failure. You may be in this stage if you have:
- High blood pressure
- Coronary artery disease
- Metabolic syndrome
You may also be at risk if you have a history of:
- Cardiotoxic drug therapy
- Alcohol abuse
- Rheumatic fever
- Family members with cardiomyopathy
If you're in stage A, your doctor may suggest lifestyle changes and treatment such as:
- Regular exercise
- If you smoke, quit.
- Treat high blood pressure or high cholesterol.
- Stop drinking alcohol or using illegal drugs.
- Take an ACE inhibitor or an angiotensin II receptor blocker (ARB) if you've had coronary artery disease or if you have diabetes, high blood pressure, or other heart and blood vessel conditions.
- Take beta-blockers if you have high blood pressure or you've had a heart attack.
Stage B. You're in this phase if you never had symptoms of heart failure but you're diagnosed with systolic left ventricular dysfunction, which means the left chamber of your heart doesn't pump well. You may be in this group if you had or have:
- Heart attack
- Valve disease
Treatments for Stage B. Depending on your situation, your doctor may suggest treatments such as:
- ACE inhibitor or angiotensin II receptor blocker (ARB)
- Beta-blockers after a heart attack
- Aldosterone inhibitor if the symptoms continue while you are taking beta-blockers and ACE/ARB medications
- Surgery for coronary artery repair and valve repair or replacement
- Implantable cardiac defibrillator (ICD)
Stage C. You're in this phase if you have systolic heart failure along with symptoms such as:
- Shortness of breath
- Less ability to exercise
Treatments for Stage C. Your doctor may suggest treatments like these, depending on your specific condition:
- ACE inhibitors and beta-blockers
- Hydralazine/nitrate combination for some people if symptoms persist
- Diuretics (water pills) and digoxin if you continue to have symptoms
- Aldosterone inhibitor when your symptoms stay severe with other treatments
- Angiotensin receptor blocker and neprilysin inhibitors
- Biventricular pacemaker
- Implantable cardiac defibrillator (ICD)
Your doctor may also tell you to these steps:
- Eat less salt.
- Lose weight if you're overweight.
- Drink fewer fluids if necessary.
- Stop drugs that make your condition worse.
Stage D. You're in this phase if you have systolic heart failure and advanced symptoms after you get medical care.
Treatments for Stage D. Your doctor may suggest some of the treatments from stages A, B, and C. You may also talk with your doctor about some other kinds of treatments, like:
- Heart transplant
- Ventricular assist devices
- Surgery options
- Continuous infusion of intravenous inotropic drugs