Heart Failure

What is Heart Failure? (From heartfailure.org)

Heart failure is a progressive disorder in which damage to the heart causes weakening of the cardiovascular system. It manifests by fluid congestion or inadequate blood flow to tissues. Heart failure progresses by underlying heart injury or inappropriate responses of the body to heart impairment.

Heart failure may result from one or the sum of many causes. It is a progressive disorder that must be managed in regard to not only the state of the heart, but the condition of the circulation, lungs, neuroendocrine system and other organs as well. Furthermore, when other conditions are present (e.g. kidney impairment, hypertension, vascular disease, or diabetes) it can be more of a problem. Finally, the impact it can have on a patient psychologically and socially are important as well.

Heart failure is a cumulative consequence of all insults to the heart over someone’s life. It is estimated that nearly 263,000 Australians have heart failure. It accounted for 43,681 hospital admissions in 2006-7 in Australia. The prevalence of heart failure approximately DOUBLES with each decade of life. As people live longer, the occurrence of heart failure rises, as well as other conditions that complicate its treatment. Even when symptoms are absent or controlled, impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent heart failure and improve outcome are known and can be applied at any stage.

What are the symptoms and signs of heart failure?

Shortness of Breath

Shortness of breath can be caused by congestion in the lungs. This congestion is known as pulmonary edema. One sign to watch out for is whether your shortness of breath is worse when you lay flat. Orthopnea is the shortness of breath which occurs when blood kept in the legs by gravity returns to the chest when you lay down. Shortness of breath can also occur at night. Shortness of breath that comes on suddenly at night is known as paroxysmal (par-ox-iz-mal) nocturnal dyspnea.


Fatigue is often attributed to getting old or being out of shape. However, if this condition persists for long periods of time, it may be the result of heart failure. Sluggishness may be the result of your organs not getting enough oxygen. You may feel as tired after getting up in the morning as you did when you went to bed. Let your doctor know if this happens on a regular basis.

Swollen Ankles or Legs

Swollen ankles or legs, known as peripheral edema, may be a result of right-sided heart failure since fluid cannot be pumped to the lungs at an efficient rate. In right-sided heart failure, fluid backs up in the veins, leaks out of capillaries and accumulates in tissues. Also, a decrease in blood flow to the kidneys can lead to an increase in fluid retention. Diuretics are often prescribed to get rid of this excess fluid and reduce the strain on the heart. In the absence of heart failure, peripheral edema may commonly be due to obesity or venous insufficiency with stretched venous valves.


Angina is chest or arm discomfort due to a blockage of the coronary arteries. Heart cells typically do not get enough oxygen when blood flow to the heart muscle is reduced. Often, angina comes on with exertion and is relieved by rest. This is because your heart may have an adequate blood supply when it is not working very hard but not when under stress. Other common causes of chest pain unrelated to the heart are chest muscle, bone or joint disease, and acid in the esophagus.

Weight Gain or Loss

Excess fluid in the body may cause an increase in weight. Similarly, when excess fluid is excreted, your weight may fall. Weight increases by about two pounds for each extra quart of fluid. You may notice that your weight has risen before you notice swelling of the ankles or extremities. Inform your doctor of changes of more than five pounds.

Causes of heart failure

Coronary Artery Disease (CAD)

This is the most common cause of heart failure in the developed world today. CAD causing obstruction to the coronary arteries prevents blood flow and, therefore, oxygen delivery to the heart. CAD is a manifestation of atherosclerosis, which can affect any artery of the body. Risk factors for CAD also include smoking, high cholesterol, hypertension, and diabetes.


This is more commonly known as high blood pressure. It is a condition that is treatable and simple to diagnose with a blood pressure cuff. Although most individuals will not have symptoms, hypertension is detected by a simple measurement with a blood pressure cuff and stethoscope. It is also a risk factor for CAD, stroke, peripheral vascular disease, or kidney impairment.

Valvular Heart Disease

A condition that occurs when the valves between the chambers of the heart are faulty, either due to birth defect or injury.


A disease of the heart muscle. This can be one of many varieties. It can arise because of genetic causes, a viral infection, or consumption of toxins (lead, alcohol, etc.). In peripartum cardiomyopathy, women who have recently given birth can develop heart muscle impairment. In many cases, the condition is called “idiopathic”, which means it has occurred of uncertain origin or cause.

In addition to those causes above, the following factors also can play a role in determining if heart failure will affect you:

  1. family history of heart failure
  2. diabetes
  3. marked obesity
  4. heavy consumption of alcohol, or drug abuse
  5. failure to take medications
  6. large salt intake in diet
  7. sustained rapid heart rhythms

Many other conditions can actually simulate heart failure symptoms – it is important to seek evaluation from a medical professional for a definitive diagnosis. Some of these are:

  1. lung impairment
  2. anemia
  3. kidney impairment
  4. pericardial disease (rare)