Top-Rated Care for Heart Failure Patients

What is Heart Failure?

Heart failure is a chronic (lifelong) condition where the heart is unable to pump enough oxygen-rich blood to meet your body's needs. It is defined by a combination of complaints, such as shortness of breath with exertion, fatigue, and swelling of the ankles and legs.

Heart failure is not a disease per se. It can be caused by many different problems, including heart attack, high blood pressure, viral infections or genetic predisposition, among others. Patients with heart failure can find it difficult to be active and do things like walking, climbing stairs or other daily activities. Less blood to major organs can also cause slower thinking, and impaired kidney and liver functions.

Heart failure requires timely medical attention.

Heart Failure and Ejection Fraction

You may hear the term “ejection fraction” or EF mentioned by your healthcare team. What is EF and how is it connected with heart failure? Ejection fraction is a measurement obtained when a cardiac ultrasound (or echocardiogram) is performed. It is used to describe the contracting power of your heart and represents the percentage of the amount of blood pushed out of the heart with each contraction. A normal heart, when filled with blood, is able to pump out between 55 and 65 percent of its content at each beat. If a heart is only able to pump out less than 50 percent - say 40 percent - then we say the heart's EF is 45 percent. Low EF and heart failure are not the same. In fact, some people can have heart failure with normal EF, while others have no heart failure despite having low EF.

Heart failure with reduced ejection fraction: Also known as systolic heart failure, this type of heart failure occurs when patients with EF less than 50 percent develop shortness of breath, fatigue and swelling of the legs. This type of heart failure is most commonly caused by coronary disease, but it can also occur from viral illnesses, exposure to toxic chemotherapy, illicit drug use and alcohol, genetic causes or no identifiable reason. In this condition, the heart becomes progressively larger and weaker. However, this process can sometimes be slowed down or even improved with appropriate medical interventions. This type of heart failure has been well studied, and there are many possible treatments for it. These include medications, pacemakers, heart pumps and even heart transplant.

Heart failure with preserved ejection fraction: Also known as diastolic heart failure, this type occurs when patients with EF greater than or equal to 50 percent develop symptoms of shortness of breath, fatigue and swelling of the legs. This type of heart failure is associated with different conditions, including obesity, lung disease, diabetes, obstructive sleep apnea and inactivity. Treatment of this condition is less well established, and often the most important intervention is to address the underlying cause. This can include losing weight, treating lung disease, using a CPAP mask and so on.

Symptoms of Heart Failure

With heart failure, your body has a hard time getting rid of extra salt and fluid. Most often, the fluid builds up in the legs, belly and lungs. The heart needs to work harder to pump this extra fluid, which causes you to feel tired. These are the most common symptoms of heart failure:

• Feeling short of breath or finding it hard to breathe
• Not being able to lie flat without using extra pillows
• Feeling more weak or tired
• Swelling in feet, ankles, legs, belly or veins in the neck
• Sudden weight gain
• Heart feels like it is racing, pounding or skipping a beat (called palpitations)

At first, you may feel tired and out of breath after routine activities such as climbing stairs. As fluid continues to accumulate, your symptoms get worse and you may begin to feel tired and breathless after simple activities such as getting dressed or walking across the room or while lying flat.

In addition, the fluid that builds up during heart failure can cause weight gain, frequent urination, and a cough that’s worse at night and when you're lying down. This cough may be a sign of acute pulmonary edema, a condition in which too much fluid builds up in your lungs and emergency medical treatment is required.