What is heart failure?

Heart failure is a chronic disease of the heart in which the heart can not pump enough blood according to the requirements of body tissues. When the supply and demand of oxygen are not in a balance because of low cardiac output, the condition is known as heart failure. The most common causes of heart failure are coronary artery disease, hypertension, arteriosclerosis, myocardial infarction, hypertension, cardiomyopathy, and congenital heart problem.

Internal anatomy of heart

What is the physiology of a normal heart?

A normal heart is a strong muscular ■■■■■ within the pericardial sac (double-walled sac) having the size of a fist and located in the upper left quadrant of the human body. Physiology of heart can be explained by the process that, blood that is pumped by the heart, carries oxygen and essential nutrient to every cell of the body including the heart itself.
The heart consists of four chambers, with two upper and two lower chambers on each side. Upper chambers are known as atria (singular atrium) and the lower chambers are known as ventricles.
The process by which blood is supplied can be explained by the following steps:

  1. Blood from all over the body (de-oxygenated blood) is collected in the right atrium by veins.
  2. From the right atrium, this deoxygenated blood is sent to the right ventricle via the valves.
  3. Right ventricle contracts and blood is pumped towards the lungs for its oxygenation.
  4. Oxygenated blood from the lungs returns to the left atrium from where it is passed to the left ventricle.
  5. Left ventricle then contracts forcefully to supply the oxygen-rich blood to the whole body including the heart.
    These chambers do not contract randomly, instead, they contract and relax in a highly organized sequence.

Heart consists of four chambers, two atria, and two ventricles. These chambers contract and relaxed in an organized manner to supply the blood and oxygen to every tissue of the body.

What are the types of heart failure?

There are two types of heart failure

  1. Systolic heart failure
  2. Diastolic heart failure
  • Systolic heart failure is more common in young people. In systolic failure, there is a reduction in the force of contraction along with low ejection fraction.
  • In diastolic heart failure, heart chambers are not filled properly because of hardening and inadequate relaxation, hence the output of the heart is decreased.
  • When oxygen supply does not meet the oxygen demand, then the cells and tissues of the body try to keep the already present blood inside them, for the sake of supply to the brain and heart.
  • This results in building up of fluid (edema) causing swelling in certain body areas for example ankles and feet.

There are two types of heart failure, systolic heart failure, and diastolic heart failure. When oxygen supply and demand are not in equilibrium, it results in heart failure.

What are the stages of heart failure?

There are four stages of heart failure named A, B, C, and D. Patient once moved to stage B can’t move back to stage A. Hence heart failure is a progressive disease.

1. Stage A

  • This is the state of Pre-heart failure, which means that patient is at risk to develop heart failure. There are no structural heart disease or symptoms of heart failure.
  • Patients may have a family history of heart disease and some comorbidities that may lead to heart failure.
    Risk factors of heart failure in stage A are Hypertension, diabetes, obesity, metabolic disease, excessive use of alcohol, family history of cardiac disease, coronary artery disease, or use of medications that may cause heart failure

Treatment plan

Following the treatment plan is recommended to prevent further progression of heart failure.
• Adopting a healthy lifestyle involving exercise, regular walk, and maintaining body weight.
• Maintaining blood pressure by medication therapy and supportive treatment including low salt food.
• Taking Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or beta-blockers, in case of vascular disease, hypertension, or diabetes.
• Statins can also be an option.

2. Stage B

It is also a pre-heart failure stage but with structural heart disease. If a patient has been diagnosed with left ventricular dysfunction yet not having any symptoms of heart failure, it is considered that patient is standing at Stage B.

In this stage, the patient is having an ejection fraction of less than 40%, according to Echocardiogram (ultrasound of the heart).

Treatment plan

• All the factors mentioned in stage A treatment plan
Beta blockers are especially used if the patient has had a heart attack (if not taking in stage A)
• Additionally, spironolactone (Aldosterone antagonist) is recommended to prevent heart enlargement (Cardiomegaly) if the patients have had a heart attack along with diabetes.
• Cardiac surgery may be an option in case of a blocked coronary artery, valvular heart disease, or congenital cardiac defect.
• In some patients, there may be a need for implantable cardio-converter defibrillator (ICD).

3. Stage C

Patients that are having Stage C heart failure have previously been diagnosed with HF and may have or had signs and symptoms of heart failure. This is a more advanced stage with the following symptoms:
• Fatigue (because of inadequate oxygen supply to tissues)
• Breathlessness
• Lethargy
Edema (swelling because of fluid retention)

Treatment options

Same treatment as suggested for stage A and B

  • Treatment of other comorbidities e.g hypertension, diabetes mellitus
  • Aldosterone antagonist (to prevent fluid retention) as aldosterone acts in a way to increase blood volume.
    Ivabradine is additionally added for symptomatically treating heart-related chest pain

4. Stage D

Stage D of heart failure is associated with the symptoms that can’t be treated with medication or supportive therapy. The patient is needed to hospitalize recurrently despite all treatment measures. This is the end-stage of heart failure.

Treatment options
General treatment for patients with Stage D involves:
• Treatments options of Stages A, B, and C.
• Choosing more advanced treatment, for example:

  1. Cardiac transplantation
  2. Ionotropic drugs via the intravenous route
  3. Cardiac surgery

There are four stages of heart failure, stage A, B, C, and D. Heart failure gradually worsens and stage D is the end stage of heart failure with no effect of therapy.

Posterior view of human heart

What are the properties of cardiac physiology and pathophysiology?

There are following functional properties of the heart that if disturbed, lead to heart failure:

1. Preload

Preload is the stretching of cardiac muscles at the end of the diastole. Pressure in left atria is a determining factor of preload. The more the preload more is the blood in the heart.

Preload is generally increased in heart failure because of increased blood volume and venous pressure

. ### 2. Afterload:
Afterload is the resistance against which the heart has to contract for the ejection of blood. If there is resistance in vessels that will receive the blood, the heart has to contract more forcefully.

Afterload is increased as a result of increased vascular resistance and aortic pressure. When afterload increases, stroke volume decreases.

3. Contractility

The strength and force with which the heart contracts in the systolic phase is called contractility.
As contractility decreases in the heart, there is a reduction in the velocity of muscle shortening.

When contractility is increased by an increased influx of calcium, the heart has to work with more vigor, which is dangerous for the weakened heart.

4. Heart rate

Heart rate is the speed with which the heartbeats. It is calculated by the number of beats per minute. Heart rate is a major factor to determine cardiac output.

Cardiac output is the product of heart rate and stroke volume.

Hence decreased heart rate results in decreased cardiac output and decreased supply of blood to body tissues.
As heart rate decreases in failure and stroke volume are reduced, the sympathetic system acts to increase the heart rate and hence act as a compensatory mechanism.

Preload, afterload, contractility, and heart rate are the physiological parameters. If these parameters deviate from the normal pattern, it may lead to heart failure.

What is the treatment of heart failure?

There are seven classes of drugs that are effective in the treatment of heart failure.

1. Angiotensin-converting enzyme inhibitors (ACEIs)

They include Captopril, enalapril, lisinopril, etc.

Mode of action:

Angiotensin is a hormone that acts as a vasoconstrictive agent. Vasoconstriction can increase the workload on the heart, by increasing preload and afterload. ACEIs suppress the formation of that hormone and hence act as vasodilators. They decrease preload and afterload and compensate for the heart.

2. Angiotensin-receptor blockers

They include losartan, valsartan, telmisartan etc.
Mode of action:
Their actions result in the same effects as ACEIs except for the mechanism of suppressing angiotensin hormone levels. They block the receptor at which angiotensin acts and hence cause vasodilation.

3. Aldosterone antagonists

They include spironolactone, eplerenone. Aldosterone antagonists are diuretics and also known as water pills.

Mode of action
They act to reduce blood volume hence decreasing blood pressure and compensating weakened heart.

4. β-blockers

Beta-adrenergic blocking agents include propranolol, carvedilol, timolol, atenolol**, etc.
Mode of action:
Beta-blockers block the beta receptors in the heart. A blockade of these receptors inhibits the effect of epinephrine (a sympathetic neurotransmitter) and hence decreases blood pressure and heart rate.

5. Diuretics

Also known as water pills. They excrete excessive water from the body through the kidneys and hence decrease the blood volume and hence blood pressure and swelling of feet, ankles, etc. Important examples of diuretics are furosemide, bumetanide, and hydrochlorothiazide.

6. Vasodilators

They cause the dilation of veins leading to a decrease in cardiac preload by increasing capacitance of veins. The most important vasodilators are Nitrates.

7. Ionotropic agents

These are the drugs that increase the contractility of the heart by increasing the intracellular calcium level and hence increase the cardiac output.

1. Digitalis glycosides

  • Also known as cardiac glycosides and mostly obtained from the digitalis plant. Digitalis glycosides are chemically similar compounds that enhance the contraction of cardiac muscle and hence are used in the treatment of heart failure.
  • One of the important properties of digitalis glycosides is that they are associated with low therapeutic index i.e. there is a very small difference between a therapeutic dose and a toxic dose. The most frequently used cardiac glycoside is Digoxin.

2. β-Adrenergic agonists

β-receptors agonists, for example dopamine and dobutamine also act to improve the function of the heart by increasing contractility and vasodilatory effects. After Digoxin, the second most common agent is dobutamine.

3. Phosphodiesterase inhibitors

PDEIs such as Milrinone increase contractility of the heart by increasing intracellular levels of cyclic adenosine monophosphate (cAMP) leading to an increased influx of calcium.

In the treatment of heart failure, mainly used therapy includes ACEIs, ARBs, aldosterone antagonists, beta receptors blocking agents, certain diuretics, vasodilating agents, ionotropic agents, beta adrenergic agonists and phosphodiesterase inhibitors.

Frequently Asked Questions

1. How long can you live with heart failure?

The expected life span for the patients with heart disease is variable according to the level of disease. Some other factors like the age of the patient, genetic profile, and other comorbidities also determine how many years a heart patient can live .According to the research of the Centre for Disease Control (CDC), half of the patients with heart failure can live more than five years if they are adherent to medication and preventive measures.

2. What is the main cause of heart failure?

In most cases, several other diseases, including diabetes, arteriosclerosis, myocardial infarction, obesity, hypertension, and coronary artery defects can be a major cause of heart failure.
Family history of cardiomyopathy and congenital heart disease can also be a reason for heart failure.

3. Can depression cause a heart attack?

In the individuals that are already suffering from cardiac disease, depression can exacerbate the condition. While in the people with no previous heart problem, depression anxiety and stress can enhance the chances of developing heart disease and heart attack.

4. Is low blood pressure a symptom of heart failure?

Moderately low or extremely low blood pressure indicates that the myocardial muscles have become so weakened that the heart is unable to contract properly and pumping of blood is difficult resulting in low cardiac output. Low blood pressure and syncope is a sign of heart disease and maybe heart failure.

5. What are the signs of worsening heart failure?

The following signs and symptoms indicate the worsening heart failure:

  • Rapid and unexpected increase in body weight
  • Oedema in certain body parts i.e. feet and ankles.
  • Abdominal pain
  • Nocturnal breathlessness
  • Difficulty to walk or climb the stairs
  • Shortness of breath at rest, with no physical activity
  • Fatigue and loss of appetite
  • Wheezing and disorientation


Heart failure is a chronic, progressive disorder of the heart that occurs due to some underlying cause, for example, myocardial infarction, cardiomyopathy, hypertension, or ischemic heart disease, etc. Normal physiological parameters including preload, afterload, contractility, and cardiac output if getting disturbed, can cause heart failure. Beta-blockers, vasodilators, ACEIs, ARBs, Aldosterone antagonists, inotropic agents and diuretics are the preferred treatment for heart failure.

  1. Heart failure - Symptoms and causes - Mayo Clinic.
  2. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure
  3. Heart Failure Center - WebMD

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The term “heart failure” may be frightening. Heart failure does not mean the heart has failed or stopped working. It only means the heart of a person does not pump as well as it should.

Heart failure is a major health problem in the United States. It has affected about 5.8 million Americans. About 550,000 new cases of heart failure occur each year. It is the leading cause of hospitalization in people older than 60.

Heart failure can affect the right or left side of the heart, or both at the same time. It can be either an acute (short-term) or chronic(ongoing) condition.

In acute heart failure, the symptoms appear suddenly but go away fairly quickly. This condition often occurs after a heart attack. It may also be a result of a problem with the heart valves that control the flow of blood in the heart.

In chronic heart failure, however, symptoms are continuous and don’t improve over time. The vast majority of heart failure cases are chronic.

chronic heart failure

Heart failure and aging

Although the risk of heart failure does not change as people get older, people are more likely to have heart failure when they are older.

Heart Failure and Women

Women have equal chances to develop heart failure as men, but there are some differences:

  • Women are likely to develop heart failure later in life compared with men.
  • Women have more chances to have heart failure caused by high blood pressure and have a normal EF stress test.

If a person has a heart condition, it is important for him and his doctor to know his EF. EF can help doctor determine the best course of treatment. Measuring EF also helps healthcare team check how well treatment is working.

Types of Heart Failure

Heart failure can occur in either the left or right side of the heart. It is also possible for both sides of heart to fail at the same time.

Heart failure is also classified as diastolic heart failure or systolic heart failure.

  • Left-sided heart failure

The most common type of heart failure is left-sided heart failure.

The left ventricle of heart is located in the bottom left side of your heart. This area pumps oxygen-rich blood to the rest of
the body.

Left-sided heart failure occurs when the left ventricle does not pump efficiently. This prevents the body from getting enough oxygen-rich blood. The blood backs up into lungs instead, which causes shortness of breath and a buildup of fluid.

The lower left chamber of the heart (left ventricle) gets bigger (enlarges) and cannot squeeze (contract) hard enough to pump the right amount of oxygen-rich blood to the rest of the body.

  • Right-sided heart failure

The right ventricle of heart is responsible for pumping blood to lungs to collect oxygen. Right-sided heart failure occurs when the right side of the heart can’t perform its job effectively. It is usually triggered by left-sided heart failure. The accumulation of blood in the lungs caused by left-sided heart failure makes the right ventricle work ■■■■■■. This can stress the right side of the heart and cause it to fail.

Right-sided heart failure may also occur as a result of other conditions, such as lung disease. Right-sided heart failure is marked by swelling of the lower extremities. This swelling is caused by fluid backup in the legs, feet, and abdomen.

right-sided heart failure

Right ventricular heart failure occurs because RV fails to maintain enough blood flow through the pulmonary circulation to achieve adequate left ventricular filling.

  • Diastolic heart failure

Diastolic heart failure occurs when the heart muscle becomes stiffer than normal. The stiffness, which is usually due to heart disease, means that the heart doesn’t fill with blood easily. This is known as diastolic dysfunction. It leads to a lack of blood flow to the rest of the organs in the body.

  • Diastolic heart failure is more common in women than in men.

It means the lower left chamber of the heart (left ventricle) is not able to fill properly with blood during the diastolic phase

  • Systolic heart failure

Systolic heart failure occurs when the muscle of heart loses its ability to contract. The contractions of the heart are necessary to pump oxygen-rich blood out to the body. This problem is known as systolic dysfunction, and it usually develops when heart is weak and enlarged.
Both diastolic and systolic heart failure can occur on the left or right sides of the heart. people may have either condition on both sides of the heart.

  • Systolic heart failure is more common in men than in women.

It happens when the left ventricle of the heart can not contract completely.

systolic heart failure

Stages of Heart Failure

  • Class I

This is the period when the people are more likely to get heart failure
people don’t experience any symptoms during typical physical activity.
Heart Failure at this stage can be managed through lifestyle changes, heart medications, and monitoring.

  • Class II

people are in this stage if they never had symptoms of heart failure but they are diagnosed with systolic left ventricular dysfunction, which means the left chamber of their heart doesn’t pump well.
People are likely comfortable at rest, but normal physical activity may cause fatigue, palpitations, and shortness of breath.
Heart Failure at this stage can be managed through lifestyle changes, heart medications, and careful monitoring.

  • Class III

People are in this phase if they have systolic heart failure along with symptoms.
People are likely comfortable at rest, but there is a noticeable limitation of physical activity. Even mild exercise may cause fatigue, palpitations, or shortness of breath.
Treatment can be complicated. Talk with the doctor about what heart failure at this stage may mean for you.

  • Class IV

People are in this phase if they have systolic heart failure and advanced symptoms after they get medical care.
People are likely unable to carry on any amount of physical activity without symptoms, which are present even at rest.
There is no cure for Heart Failure at this stage, but there are still quality-of-life and palliative care options. You will want to discuss the potential benefits and risks of each with your doctor.

Heart Failure can be life-threatening. If you suspect you or someone near you has Heart Failure, seek immediate medical treatment.

stages of heart failure

Causes of Heart Failure

Heart failure is most often related to another disease or illness. Heart failure can be caused by many medical conditions that damage the heart muscle. Common conditions are:

  • Coronary artery disease (also called coronary atherosclerosis or “hardening of the arteries”). It affects the arteries that carry blood and oxygen to the heart (coronary arteries). The normal lining inside the arteries breaks down, the walls of the arteries become thick, and deposits of fat and plaque partially block the flow of blood. Over time, the arteries become very narrow or completely blocked, which causes a heart attack. The blockage keeps the heart from being able to pump enough blood to keep the organs and tissues (including heart) healthy. When arteries are blocked, people may have chest pain (angina) and other symptoms of heart disease.
  • Heart attack A heart attack happens when a coronary artery suddenly becomes blocked and blood cannot flow to all areas of the heart muscle. The heart muscle becomes permanently damaged and muscle cells may die. Normal heart muscle cells may work ■■■■■■.
  • Cardiomyopathy Cardiomyopathy is a term that describes damage to and enlargement of the heart muscle not caused by problems with the coronary arteries or blood flow. Cardiomyopathy can occur due to many causes, including viruses, alcohol or drug abuse, smoking, genetics and pregnancy (peripartum cardiomyopathy).
  • Heart defects present at birth (congenital heart disease).
  • Diabetes
  • High blood pressure (hypertension). Blood pressure is the force of blood pushing against the walls of the blood vessels (arteries). If people have high blood pressure, it means the pressure in arteries is higher than normal. When blood pressure is high, heart has to pump ■■■■■■ to move blood to the body. This can cause the left ventricle to become thick or stiff. High blood pressure can also cause coronary arteries to become narrow and lead to coronary artery disease.
  • Arrhythmia (abnormal heart rhythms, including atrial fibrillation).
  • Kidney disease
  • Obesity (being overweight).
  • Tobacco and illicit drug use.

Other conditions that may increase the risk for developing heart failure include:

  • an overactive or underactive thyroid
  • heart valve disease
  • emphysema, a disease of the lung
  • severe forms of anemia
  • ■■■
  • AIDS
  • certain cancer treatments, such as chemotherapy

The most common cause of heart failure is coronary artery disease CAD. Coronary artery disease is a disorder that causes narrowing of the arteries that supply blood and oxygen to the heart.

What are the symptoms of heart failure?

There may be times that symptoms are mild or may not have any symptoms at all. This does not mean that people no longer have heart failure. Symptoms of heart failure can range from mild to severe, and may come and go.

In general, heart failure gets worse over time. As it worsens, it may have more or different signs or symptoms. It is important to let the doctor know if you have new symptoms or if symptoms get worse.**

Common signs and symptoms of heart failure are:

  • Shortness of breath or trouble breathing. You may have trouble breathing when you exercise, or when you rest or lie flat in bed. Shortness of breath happens when fluid backs up into the lungs (congestion) or when the body isn’t getting enough oxygen-rich blood. If people wake up suddenly at night to sit up and catch their breath, the problem is severe and they need medical treatment.**
  • Feeling tired (fatigue) and leg weakness when you are active. When heart does not pump enough oxygen-rich blood to major organs and muscles, people become tired and their legs may feel weak.
  • Swelling in ankles, legs and abdomen; weight gain. When kidneys don’t filter enough blood, body holds onto extra fluid and water. Extra fluid in the body causes swelling edema and weight gain.
  • Need to urinate while resting at night. Gravity causes more blood flow to the kidneys when a person is lying down. So, a person’s kidneys make more urine and have the need to urinate.
  • Dizziness, confusion, difficulty concentrating, fainting. People may have these symptoms because their heart is not pumping enough oxygen-rich blood to the brain.
  • Rapid or irregular heartbeats palpitations When heart muscle does not pump with enough force, heart may beat faster to try to get enough oxygen-rich blood to major organs and muscles. People may also have an irregular heartbeat if heart is larger than normal (after a heart attack or due to abnormal levels of potassium in your blood).
  • A dry, hacking cough. A cough caused by heart failure is more likely to happen when a person is lying flat and have extra fluid in the lungs.
  • A full ( bloated ) or hard stomach, loss of appetite or upset stomach nausea

It is very important for everyone to manage other health conditions, such as diabetes, kidney disease, anemia, high blood pressure, thyroid disease and asthma or chronic lung disease. Some conditions have signs and symptoms that are similar to heart failure. If people have new or worsening non-urgent symptoms, tell healthcare provider.

Risk factors for heart failure?

Heart failure can happen to anyone. However, certain factors may increase risk of developing this condition.

People with diseases that damage the heart are also at an increased risk. These diseases include:

  • anemia
  • hyperthyroidism
  • hypothyroidism
  • emphysema

Certain behaviors can also increase risk of developing heart failure, including:

  • smoking
  • eating foods high in fat or cholesterol
  • living a sedentary lifestyle
  • being overweight
chest X-ray This test can provide images of the heart and the surrounding organs.
electrocardiogram Usually done in a doctor’s office, this test measures the electrical activity of the heart.
heart MRI An MRI produces images of the heart without the use of radiation.
nuclear scan A very small dose of radioactive material is injected into the body to create images of the chambers of the heart.
catheterization or coronary angiogram In this type of X-ray exam, the doctor inserts a catheter into blood vessel, usually in the groin or arm. They then guide it into the heart. This test can show how much blood is currently flowing through the heart.
stress exam During a stress exam, an EKG machine monitors heart function while a person run on a treadmill or perform another type of exercise.
Holter monitoring Electrode patches are placed on the chest and attached to a small machine called a Holter monitor for this test. The machine records the electrical activity of the heart for at least 24 to 48 hours.

Diagnosis of Heart Failure

An echocardiogram is the most useful way to diagnose heart failure. It uses sound waves to create detailed pictures of the heart, which help the doctor evaluate the damage to heart and determine the underlying causes of the condition. The doctor may use an echocardiogram along with other tests.

Your doctor may also perform a physical exam to check for physical signs of heart failure. For example, leg swelling, an irregular heartbeat, and bulging neck veins may make a doctor suspect heart failure almost immediately.

How is heart failure treated?

It depends on the severity of the condition for treating heart failure. Early treatment can improve symptoms fairly quickly, but one should still get regular testing every three to six months. The main goal of treatment is to increase the lifespan.


Early stages of heart failure may be treated with medications to help relieve from symptoms and prevent condition from getting worse. Certain medications are prescribed to:

  • improve heart’s ability to pump blood
  • reduce blood clots
  • reduce your heart rate, when necessary
  • remove excess sodium and replenish potassium levels
  • reduce cholesterol levels

Always speak with your doctor before taking new medications. Some medications are completely off-limits to people with heart failure.

Heart Surgery

Some people with heart failure will need surgery, such as coronary bypass surgery. During this surgery, surgeon will take a healthy piece of artery and attach it to the blocked coronary artery. This allows the blood to bypass the blocked, damaged artery and flow through the new one.

Doctor may also suggest an angioplasty. In this procedure, a catheter with a small balloon attached is inserted into the blocked or narrowed artery. Once the catheter reaches the damaged artery, surgeon inflates a balloon to open the artery. Surgeon may need to place a permanent stent, or wire mesh tube, into the blocked or narrowed artery. A stent permanently holds artery open and can help prevent further narrowing of the artery.

Other people with heart failure will need pacemakers to help control heart rhythms. These small devices are placed into the chest. They can slow your heart rate down when the heart is beating too quickly or increase heart rate if the heart is beating too slowly. Pacemakers are often used along with bypass surgery as well as medications.

Heart transplants are used in the final stages of heart failure, when all other treatments have failed. During a transplant, surgeon removes all or part of heart and replaces it with a healthy heart from a donor.


A healthy lifestyle may help treat heart failure and prevent the condition from developing in the first place. Losing weight and exercising regularly can significantly decrease the risk of heart failure. Reducing the amount of salt in diet can also lower risk.

Other healthy lifestyle habits include:

  • reducing alcohol intake
  • quitting smoking
  • avoiding foods high in fat
  • getting an adequate amount of sleep

Early treatment is key in preventing the most serious cases of heart failure. Call the doctor right away if you are showing signs of heart failure or if you believe you have the condition.

Frequently asked questions

  • How long can you live with heart failure?

Life expectancy with heart failure varies depending on the severity of the condition, genetics, age, and other factors. According to the Centers for Disease Control and Prevention (CDC), around one-half of all people diagnosed with heart failure will survive beyond five years.

  • What are the signs of worsening heart failure?

Warning signs of worsening heart failure are:

  • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week)

  • Extra swelling in the feet or ankles.

  • Swelling or pain in the abdomen.

  • Shortness of breath not related to exercise.

  • Discomfort or trouble breathing when lying flat.

  • Waking up short of breath.

  • Can heart failure be cured completely?

Currently, heart failure has no cure. However, treatment, such as medicines and lifestyle changes can help people who have the condition live longer and more active lives. Researchers continue to study new ways to treat heart failure and its complications.


Our treatment will depend on the type of heart failure we have and, in part, what caused it. Medications and lifestyle behaviors are part of every patient’s treatment plan. Our healthcare team will talk to us about the best treatment plan for us.

Related Articles

What is Heart failure?

Heart failure is a situation in which muscles are not able to pump blood towards the different parts of body to meet the body needs. What is heart failure? Heart failure a chronic condition and body is not able to receive proper blood supply and also the supply of oxygen is disturbed in this kind of situation. Heart failure does not mean that heart is completely lost or it will not work again, its just a disturbance in the working of the heart. When arteries of your heart become narrow and restricts blood supply then it leads to heart failure.

Normal heart vs Heart failure

What is the cause of heart failure?

Heart failure can be due to many reasons and other diseases of the body can lead to heart failure. But there are some common causes which lead to heart failure. These common causes are High blood pressure, Coronary artery diseaseand Diabetes.

These are the leading and common causes of heart failure. These disease are found mostly in aged people and people having ages above 65 years are victims of these diseases and are on risk of heart failure. According to WHO, people having more weight than their age are more easy to fall prey to heart failure. on the other hand, Men in the world have high heart failure rate than women.

Heart failure causes

What are the 4 stages of heart failure?

As we know, heart failure is a long-term disease which is sometime normal and sometimes it gets worse. It can be of chronic situation. That’s why there are stages of heart failure to recognize intensity of failure. There are 4 stages of failure and they are;

  • Stage A - Stage A is considered as pre-heart failure. IN this stage, you are at risk of developing heart failure because you have some issues like Hypertension, alcohol addiction, diabetes, metabolism syndromes because these leads to heart issues. Pre- heart failure can also be due to heart problem history of the family.

  • Stage B - In this stage, patient is diagnosed with left systolic ventricular dysfunction. It is also referred as pre-heart failure because patients have no symptoms of heart failure. In this case, patients have echocardiogram fraction of 40-45% or less.

  • Stage C - patients with C stage of heart failure have proper diagnosed heart issues and they have shown proper symptoms in the past or still having them. C stage failure patients have symptoms like shortness of breath, physical weakness and fatigue.

  • Stage D - This is the final stage of heart failure and cannot be cured with the treatment. Stage D patients have advanced symptoms and have no chances to get better. The only solution of this kind of heart failure is heart transplant and sometimes heart surgery. This stage is chronic stage of failure.

Can you recover from heart failure?

Heart failure does not mean that your heart is no more and has stopped because if heart stops then how will you live. So, heart failure is the less functioning or irregular performance of heart that can be cured when your heart muscles get well and your body’s other disease are cured. When your heart starts pumping blood regularly again then your muscles are performing, this issue can be subsided for sometime but it can appear again.


The treatment of common heart failure are the heart therapies and exercises that cure patients and remove causes that are the reason of heart failure like hypertension and diabetes can be removed by proper exercises.

But if you are suffering with chronic heart attack, then you need proper medication and if medication is not curing your issue, then you have to do heart surgery and transplant.

working of human heart

Frequently Asked Questions

Some question are asked frequently by patients suffering this disease;

How long can you live with heart failure?

People having Congestive heart failures have life duration depend upon their severity of disease, age, and health factors. According to CDC, people suffering from congestive heart failures can live beyond five years. It depends on intensity of disease and treatment factor. Some people survive their whole life with heart problems.

What foods should be avoided with congestive heart failure?

Heart diseases have link with food what you eat. So, eating healthy food and avoiding junk foods are positive steps to maintain your heart. Avoid salty food, potato chips and other oily eatables and try to drink more and more water because water maintain blood circulation level.

Can you recover from heart failure?

Heart failure in start can be cureable and heart keeps on working. Heart failure doesn’t mean that your heart goes to prevent working. It is the situation in which cardiac muscle doesn’t pump enough blood to satisfy the requirements of your body. There’s no treatment for coronary failure . Damage to your cardiac muscle may improve but heart problems remain till your life.


What is heart failure? Heart failure is a serious disease which restricts the blood flow and blood pumping function. If you are feeling start heart problems, then there is need to cure them and to take proper medical checkup. Heart failure is not too much risky, but if you are having chronic heart failure then it may lead to death.

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In human beings, mammals, animals, and birds have a heart. The heart is a muscular ■■■■■ that pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body while removing metabolic waste such as carbon dioxide to the lungs.

Human heart

What Is Heart Failure?

The term Heart failure (HF), has different names such as congestive heart failure (CHF), decompensation cordis (CCF). when the heart is powerless to pump sufficiently. The heart pumps to maintain blood flow to meet the body’s needs. Heart failure does not mean that the heart will no longer be working at all. This means the heart will be unable to work properly. Do you know about How to lower blood pressure?

Heart failure

Signs And Symptoms Of Heart Failure:

The state of heart failure is formed when cardiac output is insufficient and can not meet the body and lungs. The “congestive heart failure” is usually used, as one of the common symptoms is congestion or build-up of liquid in a person’s veins and tissues in the lungs or other parts of the body. Specifically, congestion takes the form of [water retention and swelling edema, both as peripheral edema and as pulmonary edema (causing breathing difficulty), as well as ascites(swollen abdomen).
Heart failure symptoms are divided into 3 possible symptoms:

  • Left-sided failure.

  • Right-Side Heart Failure.

  • Biventricular Failure.

Diagnostic disease

Left-sided failure:

The left side of the heart gets oxygen-rich blood from the lungs and pumps it forward to the systemic circulation the rest of the body lacking for the pulmonary circulation and Failure of the left side of the heart causes blood to back up (be congested) into the lungs, causing respiratory symptoms and fatigue due to insufficient amount of oxygenated blood. Common respiratory signs are increased rate of breathing and increased activity of breathing.

Right Side Heart Failure:

Right-sided heart failure is frequently caused by pulmonary heart disease (cor pulmonale), which is typically caused by difficulties of the pulmonary circulation or pulmonic stenosis. The physical inspection may reveal pitting peripheral edema, ascites, liver enlargement, and spleen enlargement Jugular venous pressure is oftentimes assessed as a marker of fluid status, which can be accentuated by eliciting hepatojugular reflux. If the right ventricular pressure is increased, a parasternal heave may be present, implying the compensatory increase in contraction strength.failure of the right ventricle leads to congestion of systemic capillaries. This generates excess fluid accumulation in the body. This causes swelling under the skin termed peripheral edema.

Biventricular Failure:

The dullness of the lung fields to finger percussion and reduced breath sounds at the grounds of the lung may refer to the development of a pleural effusion fluid variety between the lung and the chest wall Though it can arise in isolated left or right-sided heart failure, it is more common in [biventricular failure because pleural veins drain into both the systemic and [pulmonary venous systems. When unilateral, effusions are often right-sided.

Causes Of Heart Failure:

There we have some causes that posses heart failure:

  • A heart attack.

Attacks of heart

  • Diabetes.

Bad for Heart

  • Cardiomyopathy, a disorder of the heart muscle that causes the heart to become weak.

  • A congenital heart defect.

  • Emphysema, a disease of the lung.

  • Heart valve disease.

  • Certain types of arrhythmias, or irregular heart rhythms.

  • High blood pressure.

Blood pressure

Frequent Asked Questions(FAQs):

What is the best diet for heart failure patients?

Fresh fruits and vegetables:

They contain only small amounts of salt. Choose foods that are low in salts, such as fresh meats, poultry, fish, dry and fresh legumes, eggs, milk, and yogurt. Plain rice, pasta, and oatmeal are good low-sodium choices.

fruits good for heart

How long will you live with heart failure?

Life hopes with congestive heart failure vary depending on the severity of the condition, genetics, age, and other factors. According to the Centers for Disease Control and Prevention (CDC), about one-half of all people diagnosed with congestive heart failure will remain beyond five years. Do you know about How to get rid of hypertension?

How can I make my heart strong?

There are 7 effectual ways through which you can strengthen your heart:

What is heart failure pathophysiology?

In heart failure, the heart may not produce tissues with enough blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in ■■■■■ blockage. This condition can result from irregularities of systolic or diastolic function or, commonly, both.

What are the types of heart failure?

The following are the Types of Heart Failure:

  • Right-sided heart failure.

  • Left-sided heart failure.

  • Congestive heart failure.


The heart is a serious and important ■■■■■ of our body. The heart will flow our blood to the whole body and this is the main function of the heart. If the heart will survive failure then there are many ways to recover these issues. To cure heart disease the patient should follow the diet plans to cure his disease.

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Heart failure is a condition in which the heart muscle is weakened and is no longer able to efficiently pump blood.


The term “heart failure” does not mean that your heart has stopped pumping, but rather that your heart muscle is no longer able to efficiently or sufficiently pump blood to meet your body’s needs. As a result, you feel tired, lacking in energy, short of breath, and your body is retaining water.

The heart is a fist-sized ■■■■■ whose role as a pump allows the circulation of oxygen-enriched blood throughout the body. When the heart is healthy, each cavity contracts in a coordinated effort; the upper chambers (atria) of the heart contract first, followed by the lower chambers (ventricles). These coordinated contractions help keep blood flowing between the lungs, heart and the rest of the body. If the heart does not beat in a coordinated fashion, the body is no longer receiving enough blood to function properly.


The heart failure occurs when the heart no longer has as much force to expel blood in the arteries and it fills less blood because it is stiffened or dilated. Each contraction of the heart is therefore less efficient. Blood takes longer to pass through the arteries and tends to stagnate in the veins. It is because of this congestion of blood in the veins that it is called “congestive” heart failure.

Usually, heart failure affects one or the other of the 2 ventricles, the right or the left. In some cases, it may happen that both ventricles are affected.

  1. Left heart failure. It is the most frequent form. Fluids build up in the tissues and concentrate mainly in the lungs, causing marked breathing difficulties (shortness of breath, wheezing, etc.). Arterial hypertension that has not been treated or poorly treated for several years and coronary disorders a heart weakened by angina pectoris or infarcts are the main culprits.
  2. Right heart failure. This time, the accumulation of fluids is located mainly in the legs and ankles, causing them to swell. It is often caused by left heart failure, but can also be the result of lung diseases, such as chronic bronchitis, emphysema, or pulmonary embolism.


Usually, heart failure develops slowly after heart injury. There is no single cause, and sometimes the causes are not known.
The most common causes of heart failure are:

  1. History of heart attack (myocardial infarction)
  2. Coronary artery disease
  3. High blood pressure
  4. Heart valve disease (valve disease)
  5. Heart infection (myocarditis)
  6. Congenital heart disease
  7. Inflammation of the innermost layer of the heart (endocarditis)
  8. Diabetes (insufficient or insufficient use of insulin)

People at risk

  1. People with coronary artery disease (angina pectoris, myocardial infarction) or cardiac arrhythmia. About 40% of people who have had a myocardial infarction will have heart failure. This risk decreases when the infarction is treated well, early;
  2. People born with a congenital heart defect that affects the contractile function of either ventricle of the heart
  3. People with heart valve problems ;
  4. People with chronic lung disease

Risk factors

The most important

  1. Hypertension;
  2. Smoking;
  3. Hyperlipidemia;
  4. Diabetes.
  5. Severe anaemia;
  6. Untreated hyperthyroidism;
  7. Obesity;
  8. Sleep apnea;
  9. Physical inactivity;
  10. A diet rich in salt;
  11. Metabolic syndrome;
  12. Alcohol abuse.


Heart failure is a pathology whose worsening is progressive. At first, you may not experience any symptoms, but over time your heart will gradually lose its role as a pump and you will start to experience any or all of the following symptoms 1,2,4,5 :

  1. Chronic lack of energy
  2. Difficulty falling asleep due to problems with respiratory congestion
  3. Confusion and/or memory impairment
  4. Need to urinate more frequently at night
  5. Swelling of feet and legs
  6. Shortness of breath
  7. Swollen and painful abdomen with loss of appetite
  8. Fatty cough


In the presence of suggestive symptoms (fatigue, shortness of breath, oedema, etc.), an assessment is necessary. The medical check-up allows the doctor to confirm heart failure, assess its severity and look for the cause (sequelae of myocardial infarction, arterial hypertension (hypertension), heart valve disease, heart muscle disease.

Only your doctor can tell you if you have heart failure and tell you the stage of the pathology. Your doctor will review your medical history, including previous and current illnesses, family history, and lifestyle. As part of your physical examination, the doctor will check your heart, lungs, abdomen and legs to see if there are signs of heart failure 1 .

To rule out or confirm the diagnosis, your doctor may order one or more of the following diagnostic tests:

  1. Echocardiography
  2. Electrocardiogram (ECG)
  3. Chest x-ray
  4. Stress test
  5. Cardiac catheterization (exploration of the heart using a lead) or coronary angiography


They vary depending on the person’s state of health, age, the cause of heart failure and its severity.

Left untreated, heart failure can quickly lead to serious complications. Fluids build up in the lungs and make it difficult to breathe. The risk of arrhythmia and cardiac arrest increases. Also, if a blood clot forms in the veins, it can block the pulmonary artery pulmonary embolism, a potentially fatal problem. Finally, if left untreated, heart failure can damage the liver and kidneys, which are vital organs.


In some patients with heart failure, the lower chambers (the ventricles) of the heart do not beat at the same time, forcing the heart to work ■■■■■■ to pump blood to the whole body.

Heart failure is a progressive pathology. Your cardiologist can offer you various treatment options that may slow the progression of the disease, make your heart more efficient, and improve your quality of life. These options may include drug treatment, a change in lifestyle, the practice of physical activity and the ■■■■■■■ of a therapeutic medical device, or even a combination of these treatments. Only your cardiologist can determine the best option for you.


Your doctor may recommend lifestyle changes, such as quitting smoking, limiting salt intake, losing weight, or reducing stress levels. These changes can help alleviate some of the symptoms of heart failure and decrease fatigue in your heart.


Many medicines are used to treat heart failure. Your doctor may prescribe ACE inhibitors, beta-blockers, blood thinners, and diuretics, among others. Usually, a combination of drugs is used.


A heart device implantation called a cardiac resynchronization device may be right for you. This sends electrical impulses to the lower chambers of your heart to help them beat in a more coordinated or “synchronized” fashion. This can help in improving the pumping efficiency of the heart.


If your heart failure is caused or worsened by a weakened valve, your doctor may consider heart surgery to repair or replace the valve. If the heart failure is severe and irreversible, a heart transplant may be considered.

Talk to your doctor about treatment options that are right for you.


The first preventive measures to take are to reduce the risk factors mentioned above. These risk factors are the same as those that lead to heart problems resulting from atherosclerosis (angina pectoris and myocardial infarction). They are intimately linked to lifestyle habits: a healthy and varied diet, physical exercise, stopping smoking and, if necessary, controlling hypertension, cholesterol and diabetes. For more details on prevention, see our Cardiac Disorders fact sheet.

Periodically consult your doctor for a health check. If in doubt, the doctor may suggest an evaluation of the function of the ventricles by echocardiography.
Measures to prevent worsening or complications
As soon as the first symptoms appear, immediately consult a doctor. An early diagnosis, good medical follow-up, taking medication if necessary, but also improvements in lifestyle can slow the progression of the disease.

In addition to the factors mentioned in the basic preventive measures, take care to :

  1. maintain a healthy weight;
  2. learn to better control stress;
  3. Limit alcohol consumption;

In addition, avoid the following factors, which exacerbate the symptoms:

  1. a diet too rich in salt or fat;
  2. excessive consumption of water, juice, drinks or soups;
  3. taking medicines that cause water and salt retention (for example, anti-inflammatories).

Since infections affecting the respiratory tract aggravate symptoms of heart failure, vaccination against influenza and against pneumococcal disease is recommended.

What is heart failure?
Heart failure is a condition in which heart is unable to pump excessive blood to fulfil body need. It is due to hypertension, diabetes and obesity.

Types of heart failure

There are two types of heart failure

  1. Systolic heart failure
    It is a condition in which heart is unable to contract properly due to weakness of myocardial muscles. In this condition release of blood in the body is low.
  2. Diastolic heart failure
    It is a condition in which heart is unable to relax properly and heart chambers are not fill with adequate supply of water.

causes of heart failure

  1. Atherosclerosis
    It is a coronary artery disease which results in the break down of inner lining of arteries, walls of the arteries becomes thick. Over time arteries becomes narrow and follow of blood is disturbed which causes heart attack.

  2. Obesity
    Obesity is the mother of all diseases. It also causes heart failure. Obese people have excessive fats in their body which deposit in the veins and causes reduction in blood supply and result in heart failure.

  3. Depression
    Depression enhance the risk of heart failure in the people who are already suffering from heart problems. Those who have no heart problems may be the victims of it due to stress and hypertension.

Stages of Heart Failure

There are four stages in heart failure:

  • Stage A is known as pre- heart failure. It is due to hypertension, diabetes, and alcohol addiction. The main cause of stage A heart failure is family history of heart failure

  • Stage B is also known as pre- heart failure.It is due to left systolic ventricular disfunction with echo-diagram fraction of 40-45% or less.

  • Stage C is heart failure stage with proper symptoms like Difficult breathing, physical weakness and fatigue.

  • Stage D is chronic stage of the heart failure with no proper treatment. Patient with stage D heart failure is at the bed of death. The only solution in this stage is Heart transplant and heart surgery.

Signs of Heart failure

  • Excessive weight gain

  • Swelling in the feet and ankles

  • Pain in abdomen

  • Trouble in breathing lying flat

  • difficulty concentrating

  • Irregular heart beat

  • Dizziness

  • Loss of appetite and Dry cough

Risk factors of Heart Failure

There are certain reasons or factors that develops heart failure

  • Anemia

  • Smoking

  • Emphysema

  • Eating fatty food

  • Being over weight

  • Hyperthyroidism

Preventive measures

  • First preventive measure is to avoid the risk factors that are mentioned above.

  • It can be cured by changing lifestyle habits, eating healthy diet.

  • Certain medicines are available in the market to prevent heart-failure. In this case you have to consult a specialist.

  • Pre-Heart failure can be prevented by heart therapies.


Hence heart failure does not mean your heart is no more. It can work even though it is not well. Many risk factors can contribute to increase the risk of heart failure. In case of high risk heart failure heart transplant is the only option.

How long can you live with heart failure?

Earlier people could live with heart failure for a very short time, but nowadays people can live with heart failure for a long time only by using good medications and devices that can boost the pumping power of failure parts of the heart. with the help of these medicines, people with heart failure can live a good quality of life for a long time.

Nowadays such therapies have been identified that control symptoms and prevent death. If you have cardiac arrest once in your life, your life expectancy decreases, and each time when you face it, it will take a little bit out of you and makes you weaker.

Can you recover from heart failure?

No doubt, heart disease is serious and many cases can’t be reversed but it is preventable if you are willing to practice healthy habits. Only regular treatment can make changes in your heart failure and help you live longer. Pay attention to your body how you feel and if you are not feeling well, go for treatment before it gets worse.

After your treatment for heart failure, you received more instructions and information, follow them, feel your condition, and avoid the things that are bad for your health. Make prevention your first priority.

What does it mean if you have heart failure?

Heart failure means that your heart is unable to adequately supply blood to the different parts of the body so that all major functions of the bodywork improperly and insufficiently than normal.

Heart failure is chronic progressive and the pathophysiological state in which the heart is unable to meet the sufficient needs of the heart and lungs. Heart failure does not mean that your heart stops working.

Congestive heart failure is the same condition in which your heart pump improperly, it affects the pumping power of the heart. In this condition, fluid is buildup around the heart and cause it to pump improperly.

What are the four signs your heart quietly failing?

There are many signs of heart failure, but there are some silent signs and symptoms of heart failure that may go unnoticed earlier, and it is hazardous to ignore them because they may cause a huge amount of damage.

These silent signs of heart failure include:

1- chest pain or pressure fullness or discomfort.

2- fatigue and weakness.

3- shortness of breath.

4- nausea and cold sweat.

What is the end stage of heart failure?

In the end-stage of heart failure, you will have shortness of breath while you are lying at the bed or you are in resting condition, weakness, and swelling. These are caused by the most common hypertension, longstanding alcohol abuse, high blood pressure, coronary heart disease, idiopathic (unknown cause) such as after recovery from myocarditis, and disorders of the heart valves.

What foods cardiologists say to avoid?

In heart diseases you just need to avoid unhealthy and high cholesterol food and to increase the amount of healthy food. It is very easier to subtract than to add. You can improve your quality of life just by reducing unhealthy food from your life.

avoid salt:

to stop or reduce the sodium intake in your body you should first stop taking salt in your diet

avoid potato chips:

potato chips are high in fat and sodium that’s why a person who has heart failure should avoid these kinds of foods.

avoid wine:

your heart can not pump very well by the frequent use of alcohol. Alcohol can make heart failure worse therefore doctors recommended avoiding alcohol use.

Water intake:

if you have heart failure take a limited amount of fluid like water about 1-2litre. Drinking a lot of water can increase the fluid in your body and increases the workload on your weak heart.

white bread:

white bread has high processed grains that have no healthful effect on your body. Too much white bread contributes to obesity and heart diseases.

What foods are good for a weak heart?

Diet plays a major role in your health. Eat fruits and vegetables and take those foods which are low in sodium and fat.

Green leafy vegetables are rich in vitamin k which protect arteries and promote blood clotting and reduce blood pressure thus improve heart activities.

Strawberries, blueberries, blackberries are rich in antioxidants like anthocyanins so that they protect against oxidative stress and reduce inflammation thus reduce the risk of heart failure. Blueberries also reduce blood clotting and help the inner cells of blood vessels and control the blood pressure .

Avocados have potassium and are an excellent source of monosaturated fats which reduced the level of cholesterol. Regular intake of potassium decreases the blood pressure and can lower the risk of heart failure.

Asparagus is a source of folate which prevents the build-up of amino acid in the body that is called homocysteine. High homocysteine has been linked with the many heart linked diseases

regular eating of broccoli can lower the level of cholesterol and reducing the risk of heart disease.