Heart failure can be caused by current or past medical conditions, which either damage or add extra workload to the heart. If you have (or had) more than one of these conditions your risk of heart failure is substantially increased. Your doctor should be able to tell you what may have caused your heart failure.
This section lists the different conditions that can cause or trigger heart failure, explaining what each condition is and how it can cause heart failure. Simply click on any of the conditions below to learn more.
Some of the more common causes of heart failure include:
Past heart attacks
Coronary artery disease
High blood pressure
Heart valve disease
Heart muscle disease or inflammation of the heart
Congenital heart defects
Alcohol / drug abuse
Less commonly, someone whose body is compensating well for his/her heart failure may develop symptoms if their heart is temporarily unable to keep up with their body's needs. Conditions that can trigger this type of heart failure include:
Kidney disease / poor kidney function
Abnormal heart rhythm
Overactive thyroid gland
If these triggers are treated the heart failure can often get better.
Other conditions, such as diabetes, may aggravate heart failure.
In addition people with heart failure frequently become symptomatic if they stop taking their medicines or do not follow their treatment plan properly.
For some people the cause of their heart failure is unknown, and they don't have any of the conditions listed above. If you are unsure of the cause of your heart failure you should discuss it with your doctor.
Your heart is a specialized muscle that pumps blood around your body. Blood carries oxygen and nourishment to all parts of your body and carries waste products to several organs, notably your lungs and kidneys to eliminate.
Your heart is divided into two pumps which work together. Blood coming back from the organs and tissues of your body enters the right side of your heart which then pumps it to your lungs. Your lungs remove waste carbon dioxide from the blood and recharge it with oxygen.
The oxygen-rich blood returning from your lungs enters the left side of your heart, which then pumps it to all parts of your body, including your heart muscle itself.
This process ensures that there is always enough oxygen and nourishment for your body to work efficiently.
If you have heart failure, your heart has difficulty pumping blood around your body. This can happen for many reasons - commonly because you have (or had) a medical condition which has damaged (e.g. coronary heart disease with a heart attack) or placed extra workload (e.g. high blood pressure) on your heart.
This damage or extra workload can affect the squeezing (contraction) or filling (relaxation) of your heart, and frequently both.
If your heart does not contract as it should, it will not be able to pump sufficient blood in your ventricles out of your heart. If your heart is not able to empty and relax fully, less blood will be able to enter your heart, and therefore less blood is available to pump out of your heart.
Heart failure has two main effects. Firstly, not enough blood is getting to your body, which may cause fatigue. Secondly, blood backs up waiting to enter your heart. This build up of blood causes fluid to leak out of your blood vessels and into the surrounding tissues. This leads to fluid accumulation (usually in your legs and abdomen) and congestion in your lungs.
The term "heart failure" makes it sound like the heart is no longer working at all and there’s nothing that can be done. Actually, heart failure means that the heart isn’t pumping as well as it should be. Your body depends on the heart’s pumping action to deliver oxygen- and nutrient-rich blood to the body’s cells. When the cells are nourished properly, the body can function normally. With heart failure, the weakened heart can’t supply the cells with enough blood. This results in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.
Heart failure is a serious condition, and there’s usually no cure. But many people with heart failure lead a full, enjoyable life when the condition is managed with medications and healthy lifestyle (exercise) choices. It’s also helpful to have the support of family and friends who understand your condition.
Heart failure can develop at any age but clearly becomes more common with increasing age. Around 1% of people under 65 years of age have heart failure, but 7% of 75-84 year olds have heart failure and this increases to 15% in people older than 85. It is the most common cause of hospitalisation in patients over 65 years of age.
Although it is called heart 'failure', this doesn't mean that your heart is about to stop working. It does mean that your heart is having difficulty working to meet the needs of your body (especially during activity).
Heart failure is different in every patient - the parts of the heart affected and the symptoms can vary widely. For this reason, your doctor may use several different terms for describing your heart failure.
The two main types of heart failure are chronic heart failure (long term heart failure that develops slowly over time, may dradually get worse and require long term therapy) and acute heart failure (Heart failure symptoms that develop rapidly. May be temporary due to an event such as a heart attack. May not require long term therapy)
Chronic heart failure is more common and symptoms appear slowly over time and worsen gradually.
Acute heart failure develops suddenly and symptoms are initially severe. Acute heart failure either follows a heart attack that has caused damage to an area of your heart or, more frequently, is caused by a sudden lack of ability by the body to compensate for chronic heart failure.
If you develop acute heart failure, it may be severe initially but may only last for a brief time and improve rapidly. It usually requires therapy and administration of medication by injection (intravenously).
Certain factors may cause these symptoms to worsen, such as eating high-salt foods, drinking excessive fluids, taking medications that cause salt and water to be retained or having fast heart rhythms, a cold or the flu.
Heart failure symptoms can vary widely from person to person, depending on the type of heart failure you have. Therefore, you may experience all of the symptoms described here or just a few of them.
In the early stage, you are unlikely to notice any symptoms, but if your heart failure progresses you are likely to experience symptoms,which become more severe.
The main symptoms of heart failure are caused by fluid accumulation or congestion. and poor blood flow to the body. This section will explain these symptoms and provide tips on how to improve them.
Symptoms caused by fluid accumulation or congestion include:
Shortness of breath
Shortness of breath is caused by fluid accumulation and congestion in the lungs. Wet lungs cannot exchange oxygen easily. In the early stages of heart failure you will probably only experience breathlessness after exercise, but if your heart failure progresses you may feel breathless when resting as well.
You may feel more breathless lying down because the fluid in your lungs moves with gravity, making more of your lungs wet (think of liquid in a bottle upright and then lying on its side).
If you do feel breathless at night or when lying down, try supporting yourself with pillows so you are lying in a more upright position. If you consistently feel breathless at night contact your doctor or nurse.
In addition to breathlessness, some people with heart failure develop a cough or wheezing. This is usually due to fluid accumulation in the lungs, but can also be caused by lung conditions (such as chronic obstructive pulmonary disease (COPD) and asthma).
If you have a cough or are wheezy, you should find that, as with breathlessness, supporting yourself with pillows or sitting up makes you more comfortable.
It is very common for people with heart failure to experience rapid changes in their weight. If your heart failure is causing fluid accumulation , you will gain weight. However, if your body loses this fluid (for example, after appropriate treatment), you will lose weight.
It is important to weigh yourself frequently and to tell your doctor or nurse if you notice your weight increase by more than 2 kilos (3 pounds) in 3 days. To make this easier we have provided a chart that you can download, print and use to track your weight and any changesWhen you notice weight gain on your chart, look at the pattern of weight gain and think about your lifestyle recently. Weight gain due to fluid retention is different to weight gain due to a high calorie diet. If you are unsure as to why you have gained weight, contact your doctor or nurse.
Fluid accumulation can cause swelling (oedema), particularly in the ankles. Sometimes the swelling can extend into your legs, thighs and abdomen.
Your doctor or nurse may recommend limiting how much you drink every day, in order to limit the amount of fluid that can build up in your body. He/she may also recommend that you take an extra diuretic when required. Click here for more tips on controlling your fluid intake.
Always consult your doctor or nurse before making any changes to your fluid intake.
Symptoms related to the reduced blood flow to parts of the body include:
Heart failure reduces your heart's pumping ability so less blood reaches your muscles. This lack of oxygen and nourishment cause your muscles to get tired much more quickly. Some patients find the tiredness overwhelming.
You may be able to reduce how tired you get by exercising. Moderate exercise and exercise training may help improve your symptoms. In contrast to what many people believe, exercise is considered beneficial in patients with heart failure. Exercise also reduces stress and boosts your energy levels. Click here to learn more about when to exercise and what to do.
You may also find techniques to conserve energy will help you to understand what you can do and ensure you have sufficient energy to do the things you really enjo
Heart failure causes reduced blood flow to the rest of your body. If the flow to your brain is lower than usual or your blood pressure is low, you may feel dizzy.
Dizziness in people with heart failure is often caused by their medicines. However, irregular heart beats , which often happen with heart failure, or a temporary drop in blood pressure cuased by rising from a sitting or lying position (postural hypotension) can also cause dizziness.
You should discuss any dizziness with your doctor or nurse to identify its cause
Rapid heart rate
When you have heart failure, your heart tries to compensate for its lack of pumping power by beating faster (tachycardia) in order to keep up the same flow of blood around your body.
This increased heart rate may sometimes be irregular and cause palpitations which feel like your heart is racing or throbbing. You should discuss palpitations with your doctor or nurse.
Other symptoms of heart failure include:
Loss of appetite
Fluid accumulation caused by heart failure can affect any part of your body. Some people accumulate fluid in their liver and digestive system. If this happens, it can make you feel full and/or bloated.
Therefore, you may feel less hungry. You can try eating smaller meals more frequently to stop you from feeling too full or bloated.
Need to urinate at night
When you lie down in bed at night, the fluid that has built up in your legs during the day can move back into your bloodstream and is taken to your kidneys to be eliminated as waste urine.
Going to the toilet before going to bed and limiting the amount you drink in the evening may help reduce the number of times you have to get up at night to urinate. Click here to learn more about controlling your fluid intake.
Taking your diuretic in the morning may also help
In addition to the physical symptoms of heart failure, some people can be affected by the seriousness and severity of heart failure and may experience emotional symptoms, such as
Depression and anxiety
It is very common for people with heart failure to feel depressed, uneasy or anxious.
Heart failure is a serious condition and the symptoms can leave you worn out and exasperated. In addition, breathlessness can feel constricting and make you feel uneasy and anxious. Symptoms may prevent you from participating in normal social activities, which can limit your social network. You may also depend on help from family and friends, which may make you feel that you are a burden on them.
It is important to have a positive attitude and share your concerns with your nurse or doctor. Keep taking any medicines prescribed by your doctor as these will help to ease your symptoms and make you feel more comfortable. While there is usually no cure for heart failure, there is a lot that you and your doctor can do to improve the quality of your life.
However many of these symptoms you experience, it is important to monitor them on a daily basis. If you notice something new, or a symptom suddenly gets worse, you should tell your doctor or nurse without delay.
If you suspect you have symptoms of heart failure you should talk to your doctor (normally your primary care provoder / Family Physician or Nurse Practitioner.
Your care provider will likely perform a thorough examination of your body and will ask you about your symptoms, your medical history and your lifestyle. It is important that you answer any questions as honestly and accurately as possible so that your care provider can make an accurate diagnosis and can work with you to find the best treatment.
If your care provider suspects you have heart failure he or she will probably suggest you have certain tests. These tests will help to show whether your heart is working properly and, if not, where the problem lies.
This section explains the tests your doctor may want you to have and what the test can show.The most common tests are:
Medical history and physical examination
Additional tests may be able to find out more about your heart failure or identify the cause. These include:
Lung function tests
Cardiac Magnetic Resonance Imaging (MRI)
Cardiac catheterisation and angiography
Nuclear medicines techniques
Tomography (CT scan)
As the symptoms presented to the doctor may vary widely between patients you may only receive a few of these tests, and it is very unlikely you will receive all of them. If you have any concerns regarding your tests, you should discuss them with your doctor.
Heart failure is a serious, chronic condition that tends to gradually get worse over time. Eventually it can shorten your life.
The progress of heart failure is unpredictable and different for each person. In many cases, the symptoms remain at a stable level for quite some time (months or years) before becoming worse. In some cases the severity and symptoms become gradually worse over time. Or they may progress rapidly following, for example, a new heart attack, a heart rhythm disorder or a lung infection. Such acute conditions usually respond to treatment. See below how your doctor may grade your heart failure to monitor the progression of your condition.
Your doctor will grade your heart failure when you are first diagnosed and again at later visits. There are two systems used for grading heart failure and it is likely that your doctor will use a combination of both.
New York Heart Association (NYHA) classes
This system is used to classify how severe your condition is based on your symptoms.
Contact your doctor if you experience any of the following:
Warfarin (nutrition issues)
Antiplatelets (ASA, Plavix,Ticlild)