What Is Systolic Heart Failure?

Medically Reviewed by James Beckerman, MD, FACC on May 15, 2023
3 min read

If you have systolic heart failure, the left ventricle of your heart, which pumps most of the blood, has become weak. This may happen because it's gotten bigger. Since it's larger, the ventricle can't contract the way it should. Because of that, your heart doesn't pump with enough force to push blood throughout your body.

Heart problems or diseases can lead to heart failure. Some of the most common causes of systolic heart failure are:

High blood pressure: If you have this, your heart has to work harder to pump more blood through your body. With that extra work, your heart muscle gets thicker and doesn't work as well. Learn more about the symptoms of high blood pressure.

Coronary artery disease: The amount of blood flowing to your heart is blocked, or it's less than normal. Read more on clogged arteries and the causes of arterial plaque.

Cardiomyopathy: When your heart muscle is damaged, your heart can't pump blood as normal. Watch a video to see how your heart pumps blood.

Heart valve problems: Sometimes, valves don't open or close the way they should, or they become leaky. In those cases, the heart has to pump harder to get blood through your body. Get more information on heart valve disease symptoms and causes.

If you have systolic heart failure, you can have:

To figure out if you have heart failure, your doctor will:

  • Examine you
  • Ask about your medical history
  • Run some tests

Those tests might include:

Blood tests: Abnormal levels of important substances can show strain to organs due to heart failure. Learn about the BNP blood test to detect heart failure.

Electrocardiogram (EKG): This records the electrical activity of your heart.

Chest X-ray: It will let your doctor know if you have an enlarged heart. It can also show congestion. Find out what happens during a chest X-ray.

Echocardiogram: This uses sound waves to make a video image of your heart. Watch a video to see what happens during an echocardiogram.

Exercise test: You may hear this called a stress test. It measures how your heart responds when it has to work hard.

Heart catheterization: In this test, you get dye injected through a small tube into a blood vessel. It will show any blockages or weakened arteries. Watch a video to see what happens during heart catheterization.

There's no cure for systolic heart failure. Still, there are things that can help ease symptoms and help your heart pump better. These can include:

Lifestyle changes: Your doctor will probably suggest that you:

Medication: You may need to take one or more drugs as part of your treatment.

Common medicines for systolic heart failure are:

  • Diuretics (water pills), which help ease swelling
  • ACE inhibitors, ARB, or ARNI to widen blood vessels and lower blood pressure, making it easier for your heart to work
  • Beta-blockers to help slow heart rate and lower blood pressure
  • Mineralocorticoid receptor antagonist, a type of diuretic that gets rid of extra salt and fluid and keeps needed potassium
  • Nitrate and hydralazine, which work together to relax and open blood vessels
  • Digoxin to help the heart pump harder and ease some symptoms of heart failure
  • SGLT2 inhibitors work to keep the kidneys from reabsorbing glucose back to the blood, thereby reducing the risk of heart failure. 

Surgery and devices: In some cases, you may need surgery. Several procedures can treat heart failure. If your condition is more severe, your doctor may implant a device like a defibrillator or something called a left ventricular assist device (LVAD) in your body. Other times, a heart transplant may be the best option. Your doctor will determine the right course for you. Learn more about the LVAD for heart failure.