Heart Failure in Adults

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About this topic

Heart failure is a condition where your heart does not pump well. Your heart has trouble pumping the right amount of blood throughout your body. Because of this, blood can back up in your body and your organs may not get as much blood as they need.

Heart failure is a long-term problem and can get worse over time. With the right treatment, your heart function can potentially be preserved and you can try to prevent symptoms that can make daily life more difficult.

What are the causes?

Heart failure is often caused by coronary artery disease (when there are blockages in the blood vessels that supply your heart) or a heart attack. It may also be caused by problems with the heart's valves. Other causes include a high blood pressure, abnormal heart rhythm, drinking high amounts of alcohol, a prior infection, sleep apnea, or a genetic or nutritional disorder. When your heart is weak or damaged, it has trouble pumping the right amount of blood throughout your body.

What are the main signs and symptoms?

  • Respiratory problems like:
    • Shortness of breath, with activity (such as housework, climbing stairs, walking) or if severe, at rest
    • Cough that won't go away
    • More trouble breathing at night or when you lay down flat
    • Getting up in the middle of the night feeling like you need to gasp for air
  • Extra fluid that causes:
    • Swelling of feet, ankles, legs, or belly
    • Gaining weight and you don't know why
    • Abdominal discomfort or pain in the legs
  • Loss of appetite
  • Fatigue
  • Problems sleeping like:
    • Need to sleep sitting up or on many pillows
    • Waking up often during sleep times

How does the doctor diagnose this health problem?

The doctor will take your history and will do an exam. Common tests include lab tests, a chest x-ray, electrocardiogram, an echocardiogram (an ultrasound of your heart to assess its function), or a stress test. Ultimately, if your doctor thinks that blockages in the blood vessels supplying your heart are causing your heart failure, they may order coronary angiography, which is a procedure where dye is injected into these vessels using a catheter (a thin tube) to diagnose these blockages.

How does the doctor treat this health problem?

Your doctor may suggest:

  • Diet and lifestyle changes to slow down progress of the heart failure, including a low salt and low fluid diet, and exercise
  • Drugs to help your heart work better, get rid of the extra fluid, and control your heart rate and blood pressure
  • Bypass surgery or a heart stent to open blocked vessels to the muscle of your heart
  • Devices like a heart pump
  • Heart transplant

What follow-up care is needed?

Your doctor may ask you to come back to the office to check on your progress. Be sure to keep these visits. In addition, your doctor may ask you to monitor your vitals and symptoms at home, including your blood pressure, heart rate, and weight, as well as how your breathing, activity level, and swelling are.

What lifestyle changes are needed?

  • Limit how much alcohol you drink.
  • Your doctor may ask you to limit the amount of salt in your diet. You may also be asked to limit how much fluid you drink.
  • Try to lose weight if you are overweight.
  • If you smoke, try to quit. Your doctor or nurse can help.
  • Unless your doctor tells you to limit your activities, try to be active as best as you can tolerate. Stop activity if you have symptoms like chest pain, shortness of breath, or feel dizzy.
  • Let your doctor know if you get more tired while you do an activity or you are not able to do as much activity as you did before.
  • Be careful that you take your medications as ordered by your doctor.
    • If you cannot afford your meds, talk to your doctor.
    • Talk to your doctor if you cannot tolerate your meds due to side effects.
    • Take your drugs even if you feel well.
  • Check your weight each morning and write down your weight in a notebook. This will tell you if you are building up too much fluid. Weigh in the same time each morning after you have passed urine. Weigh yourself either with clothes on or off, but do it the same way each day. Make sure your scale is on a hard surface, not on carpet. Your doctor will tell you when you should call based on how much weight you gain in a day or over a week. Take your notebook to your doctor on your next visit.

Where can I learn more?

American Heart Association


Better Health Channel


NHS Choices


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