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Heart Failure: Definition, Types, Causes, Symptoms & Treatments

Dec 13, 2021

Heart Failure: Definition, Types, Causes, Symptoms & Treatments

The heart is the source of life. When it weakens and ceases to function properly, heart failure results. There are so many factors that contribute to heart failure, as well as a range of unpleasant symptoms. Learn about this condition, what causes it, its types and symptoms, and the warning signs of heart failure below. 

What is Heart Failure?

Chronic heart failure occurs when the heart is unable to pump blood effectively. It can affect either or both the left and right heart chambers. The sudden onset of heart failure symptoms that eventually disappear may cause acute heart failure in some people. In most cases, however, heart failure is a chronic condition with ongoing symptoms.

Heart failure affects both men and women, regardless of age. It's estimated that heart failure affects over 24 million people worldwide. According to the Heart Foundation, 110,000 Australians suffer from heart failure, and 179 of them are admitted to hospital every day. About eight people die of heart failure every day, which means someone dies every three hours.

Heart disease tends to worsen over time due to constant damage to heart muscle that can't be reversed. The Centers for Disease Control and Prevention (CDC) states that heart failure claims more lives than many forms of cancer combined such as leukemia, lymphoma and pancreatic cancer by age 85. 

Types of Heart Failure

Heart failure is classified into different types according to which side of the heart is affected as well as its causes. It can be divided into three categories: left-sided heart failure, right-sided heart failure and congestive heart failure.

Left-sided heart failure

This is the most common type of heart failure that occurs when there is damage or disease affecting the flow of blood from the heart to all parts of the body. It causes the heart to work harder than usual which leads to excess fluid leaking out into surrounding tissues and organs, which can cause swelling in ankles and other parts of the body. There are two types of left-sided heart failure: systolic heart failure, or heart failure with reduced ejection fraction (HFrEF), and diastolic heart failure which is heart failure with preserved ejection fraction (HFpEF).

HFrEF reduces the amount of blood pumped out of your heart each time it contracts due to reduced ejection fraction. When heart failure with reduced ejection fraction occurs, the heart muscle weakens and heart wall movement is stiffer. Heart failure with reduced ejection fraction is caused by coronary artery disease, heart attack, valvular heart disease, high blood pressure, congenital heart defects, infections, lung diseases, such as COPD or pulmonary fibrosis, anemia, kidney disease or certain drugs.

Heart failure with preserved ejection fraction (HFpEF) is caused by high blood pressure, heart valve problems, such as mitral regurgitation or aortic stenosis, coronary artery disease, heart attack, obesity, diabetes, sleep apnea and ageing. In this type of heart failure, the left ventricle has difficulty relaxing because the heart muscle is stiff, so it cannot properly fill with blood during the resting period between each beat.

Right-sided heart failure

This type of heart failure occurs when there is an overload of work for the right side of the heart due to some type of blockage or narrowing that prevents blood from easily moving into the lungs. Right-sided heart failure causes shortness of breath because blood has trouble getting oxygenated before being sent back out to all parts of the body.

Congestive heart failure

This is a long-term condition that requires constant medical care. It happens when the heart does not pump enough blood to meet the body's needs. As a result, fluid builds up in the lungs and other tissues, causing swelling, usually in the lower limbs.

What is heart failure?Source: CardioSmart

Symptoms of Heart Failure

There are a variety of symptoms associated with heart failure, which differ from person to person. However, many people with heart failure experience these common symptoms:

  • Shortness of breath during physical activity or while resting
  • Fatigue, irritability and swelling of the ankles, legs or feet
  • Heart palpitations
  • Abnormal heart rhythms
  • Chest pain
  • Swelling of the ankles, legs and feet
  • Loss of appetite
  • Sudden weight gain
  • Persistent coughing
  • Cold sweat

Causes and Risk Factors for Heart Failure

There are many causes of heart failure. However, there are certain conditions that increase the risk of heart failure, including coronary artery disease, heart attack, high blood pressure, heart valve problems, congenital heart defects, infection in the heart lining, heart muscle weakness or damage from a heart attack.

Heart failure is categorised into four stages based on severity. In stage one heart failure, a person has mild symptoms and normal heart function. In heart failure stage four, when heart failure is most severe, a person experiences shortness of breath when lying down or during physical activity.

Here below is a detailed explanation of the different stages of heart failure.

  • Stage A: Normal heart function while resting but some limitation during exercise or while performing daily activities due to outflow obstruction caused by stiff arteries and/or enlargement of the left ventricle. Symptoms may be present at this stage; however, they are not severe enough to necessitate medication therapy.
  • Stage B1: Mild restriction of the heart's ability to pump efficiently during exercise or daily activities due to heart muscle thickening or stiffening that may be caused by coronary heart disease. Symptoms are usually not present at this level of heart failure.
  • Stage B2: Mild heart failure symptoms with activity, such as fatigue and weakness, begin to appear. Medication therapy is used to treat these heart failure symptoms.
  • Stage C: Moderate heart failure symptoms become more obvious during daily activities, but generally do not interfere significantly with normal routine activities. Medication therapy becomes the main treatment for heart failure symptoms. Stage C can progress into stage D if heart function worsens.
  • Stage D: Severe heart failure symptoms that are progressive and persistent despite optimised medical, surgical, and device therapy.

Possible Treatments for Heart Failure

Treatment options vary from patient-to-patient depending upon heart function, symptoms, age and other factors. In the treatment of heart failure, the goal is to increase the heart's pumping strength and efficiency.

The usual treatment plan for heart failure may include any of the following:

  • Cardiac medications
  • Intravenous diuretics (water pills)
  • Oxygen therapy
  • Respiratory support techniques such as mechanical ventilation
  • Parenteral nutrition or feeding through a vein (intravenous feeding) or by mouth (oral feeding)
  • Nutritional supplements known as enteral nutrition 
  • Implantable devices that strengthen heart contractions

Some treatments for heart failure include angioplasty or coronary bypass surgery to open clogged heart arteries as well as medications such as ACE inhibitors to lower blood pressure and decrease strain on your heart, beta blockers to control an irregular heartbeat, anticoagulants to thin blood so it can flow more easily through narrowed or damaged heart valves, calcium channel blockers to widen heart arteries and reduce heart rate, angiotensin receptor blockers to block a hormone that causes heart vessels to constrict, and digoxin to make the heart beat more regularly.

Heart failure symptoms can also be treated by dietary changes such as increasing potassium-rich foods like bananas, avocados, baked potatoes with skin, cantaloupes or leafy greens. Potassium may help protect against heart failure symptoms caused by diuretics.

Some patients with heart failure may be candidates for palliative or end-of-life care that focusses on relieving symptoms rather than prolonging life. This type of care is most common among those who have progressed to end-stage heart disease or chronic heart failure stage. Thus, palliative care may be needed at some point during a person's lifetime if not throughout their lives with heart failure. 

Prevention Strategies for Heart Failure

Taking preventative measures can prevent heart failure from reoccurring by helping those who have had heart attacks keep their cholesterol low as well as stay at a healthy weight.

In order to prevent heart failure symptoms, you should quit smoking if you're a smoker, eat healthy and exercise regularly. Your doctor may prescribe medications to prevent blood clots.

If you suffer from any type of heart disease, or you are at risk of developing it, one way heart failure can be prevented is by eating heart healthy foods like green leafy vegetables, fresh fruits and whole grains. These foods help reduce the risk of heart disease and damage to vital organs, which leads to heart failure.

Another method for preventing heart failure involves staying active and exercising on a regular basis. Regular exercise helps control weight, lower blood pressure, increase energy levels, boost mood, promote better sleep patterns and improve cholesterol levels that are related to heart health problems.

The key to keeping your heart functioning optimally is to maintain a healthy diet and lifestyle. If you can prevent heart problems like high blood pressure, diabetes, obesity or high cholesterol before they cause heart disease, you may be able to avoid heart failure entirely. However, if your heart isn't contracting enough to distribute blood to different parts of your body, consult a heart specialist right away.

FAQs About Heart Failure

What is the most common cause of heart failure?

Heart failure occurs when the heart's pumping chamber has been affected by health issues. A previous heart attack, coronary artery disease and high blood pressure are the most common causes of heart failure.

What are the signs of worsening heart failure?

Heart failure develops in stages. You might not even realise you have the condition until you start experiencing symptoms. The signs of worsening heart failure include shortness of breath, oedema or swelling in the lower limbs, chronic cough and unexplainable weight gain.

Is heart failure painful?

Yes it is. Patients with heart failure often complain of pain. They may experience it anywhere in their body, especially if their symptoms worsen or if they are hospitalised.

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