Heart failure is the gradual loss of the heart’s ability to pump enough blood to supply the body’s needs. Sometimes this condition is called congestive heart failure, because the body retains fluid—often around the lungs (congestion) or in the legs and feet.
It was over 20 years ago, in 1997, that heart failure was singled out as an emerging epidemic.1 Heart failure is common now and becoming more common as populations age.
Heart failure affects an estimated 6.5 million American adults,2 and about 26 million worldwide.3 In fact, it remains the #1 cause of hospitalizations in among people in the U.S. insured by Medicare.4 And the global costs associated with heart failure are estimated to be $108 billion.5
Estimated Global costs associated with heart failure5
At first, the symptoms of heart failure can be subtle, and people may assume their symptoms are due to the normal aging process. Here are some of the symptoms of heart failure:
- Shortness of breath even when performing light activities
- Trouble breathing when lying down
- Frequent coughing
- Swelling of the feet, ankles, or legs (edema)
- Needing to urinate more often at night
- Swelling of the abdomen
Many conditions can cause or contribute to heart failure:
- High blood pressure
- Coronary artery disease—when fatty deposits like cholesterol block blood flow to the arteries in the heart (this can also cause a heart attack)
- Being overweight or obese
- Sleep apnea
- Family history of heart failure
- Aging, since heart failure is more common in people over age 65
Other heart conditions can also lead to heart failure.
Heart attack: A heart attack occurs when one of the arteries leading to the heart becomes blocked and cuts off blood flow. Without the oxygen that normal blood flow would provide to the heart, a small part of heart muscle starts to die. A heart attack can lead to heart failure by weakening the heart's pumping ability.
Heart valve problems: Heart valve stenosis develops when the heart valves don’t open as fully as they should, and the valve opening narrows. This causes the heart to work harder to try to pump the same amount of blood as a healthy heart. Stenosis can occur with any of the heart’s 4 valves. And without treatment, stenosis can cause heart failure.
Heart defects from birth: Many newborn infants have small holes in the walls that separate the heart into its 4 chambers. In most cases the holes close on their own soon after birth. When these holes do not close automatically, blood can flow from one chamber into another and can lead to heart problems, including heart failure. For instance, septal (heart wall) defects can occur between the atria (the heart’s top 2 chambers) or the ventricles (the heart’s bottom 2 chambers).
Cardiomyopathy, or heart muscle disease: Cardiomyopathy causes the left ventricle—which pumps blood out to the entire body—to become enlarged. In some patients cardiomyopathy might be caused by a heart attack, long-term high blood pressure, diabetes, or drinking too much alcohol over many years. In other cases the cause is never determined. As the heart pumps less effectively, heart failure can develop.
Patients with heart failure have relatively high mortality (death) rates. After being diagnosed and or hospitalized, patient survival is about 35%-50% at 5 years.1,6
Being hospitalized more than once is typical. One study found that after being in the hospital initially for heart failure treatment, nearly half of the patients (46%) were back in the hospital within 9 months.7
Because there is no cure for heart failure, treatment is critical. Even when receiving treatment, patients over time develop more symptoms that can increase in severity. In addition, the quality of life for people with heart failure is worse than it is for many heart conditions.3
However when they receive proper treatment, many patients can live with heart failure and can manage their symptoms.
Treatments for heart failure fall into several categories.
Medications: Medications can help relieve the symptoms. Common medications include ACE (angiotensin-converting enzyme) inhibitors, beta blockers, and diuretics (which rid the body of excess fluid).
Lifestyle Changes: You can make smart food and beverage choices to help the symptoms of heart failure. For instance, you should limit salty foods as well as your fluid intake. This can help prevent the heart from needing to work harder. In addition, regular exercise may not only help your heart, it may also keep you physically strong.
Devices: Some patients receive pacemaker-like devices through minimally invasive surgery (meaning that the chest is not fully opened during surgery). With cardiac resynchronization therapy, a special pacemaker device helps the heart’s two ventricles contract, or pump, at the same time. An implantable cardioverter defibrillator delivers electrical energy to the heart if a dangerous heart rhythm occurs. This device can return the heartbeat to its normal rhythm.
People who have more severe types of heart failure might receive a left ventricular assist device. This is a mechanical pump-like device that is surgically implanted. It helps the heart pump blood around the body so that heart failure doesn’t get worse. Often this device is used while a person is on the heart transplant waiting list.
Heart Transplant: A heart transplant is major surgery, but it can be an effective treatment for people with heart failure.
Talk to your doctor if you have any questions about your health.
And if you would like to learn more about heart failure, you can get accurate information from these well-regarded organizations:
American Heart Association
The American College of Cardiology
(An organization for cardiologists) Patient Website
The information provided is not intended for medical diagnosis or treatment as a substitute for professional advice. Consult with a physician or qualified healthcare provider for appropriate medical advices.
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- Roger VL. Epidemiology of heart failure. Circ Res. 2013;113(6):646-659.
- Benjamin EJ, et al. Heart Disease and Stroke Statistics— 2018 Update: a report from the American Heart Association. Circulation. 2018;137(12):e67-e492. doi: 10.1161/CIR.0000000000000558.
- Saravese G, et al. Global public health burden of heart failure. Card Fail Rev. 2017;3(1):7-11. doi: 10.15420/cfr.2016:25:2.
- Heart Failure Society of America. Learn about heart failure. www.hfsa.org/patient/learn/. Accessed September 10, 2018
- Lesyuk W, et al. Cost-of-illness studies in heart failure: a systematic review 2004–2016. BMC Cardiovasc Disorders. 2018;18:74. doi.org/10.1186/s12872-018-0815-3.
- Merck. Heart failure. https://www.merckmanuals.com/professional/cardiovascular-disorders/heart-failure/heart-failure-hf. Accessed September 10, 2018.
- O’Connor CM, et al. Causes of death and rehospitalization in patients hospitalized with worsening heart failure and reduced left ventricular ejection fraction. Am Heart J. 2010;159:841-849.e1. doi:10.1016/j.ahj.2010.02.023.