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Heart Failure Causes, Symptoms, and Treatments

Heart failure (HF) is a condition in which the heart cannot pump enough blood to meet your body’s needs. Although the term sounds severe, HF does not mean your heart has stopped — it just means your heart might be too weak or stiff to pump properly.

UPMC is among the nation’s leading heart failure programs. We offer standard and minimally invasive procedures to treat HF and other serious heart conditions.

Looking for Heart Failure Care? 

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  • Heart and Vascular

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On this page

  • What Is Heart Failure?
  • What Are the Symptoms of Heart Failure?
  • How Do You Diagnose Heart Failure?
  • How Do You Treat Heart Failure? 

What Is Heart Failure?

Doctors define heart failure as a condition that occurs when your heart isn’t pumping as strongly or effectively as it should be.

What are the types of heart failure?

The two most common types of heart failure are:

  • Systolic Heart Failure – when the heart becomes weak and is unable to pump effectively.
  • Diastolic Heart Failure – when the heart is too stiff or thick to relax and fill properly.

How common is heart failure?

According to the American Heart Association, more than 6 million people in the United States are living with heart failure. It's the most common reason for older adults to go to the hospital.

What are the causes of heart failure?

Heart failure is most often caused by coronary artery disease or prolonged high blood pressure.

Pulmonary hypertension — buildup of pressure in the arteries traveling from the heart to the lungs — can also cause HF.

Heart failure is more likely to happen as you age, but anyone can develop heart failure. Risk factors for developing heart failure include:

  • Coronary artery disease, which is the build-up of cholesterol in the heart’s arteries aiso known as atherosclerosis. This can lead to chest pain (angina) or a heart attack that can weaken the heart muscle.
  • A previous heart attack, which weakens the muscle tissue in the heart.
  • Prolonged high blood pressure. When the blood pressure is elevated, the heart must pump harder than normal. Over time, this can cause the heart to become too stiff or too weak to pump effectively.
  • Cardiomyopathy.
  • Abnormal heart valves.
  • Congenital heart disease.
  • Certain kinds of infections or viruses.
  • Some types of radiation or chemotherapy.
  • Chronic conditions, such as diabetes, thyroid problems, and being obese or overweight.
  • Lifestyle choices, such as alcohol and drug abuse, or smoking.

What are HF complications?

Although many people can live well and comfortably with treatment of their heart failure, some patients continue to decline despite treatment. Complications of heart failure can include:

  • Heart rhythm disorders.
  • Liver damage.
  • Kidney damage or failure.
  • Structural heart problems (heart valve disease).

How serious is HF?

HF is a serious condition that affects your heart’s ability to pump blood to your body. If left untreated, HF can result in severe symptoms, hospitalization, and even death. If you’ve been diagnosed with HF, it’s important to follow your doctor’s instructions for your care.

How can I prevent HF?

Preventing heart disease, heart damage, and chronic conditions can reduce your risk of having heart failure. To lower your blood pressure and cholesterol levels:

  • Avoid smoking.
  • Exercise.
  • Eat a diet that is rich in fruits, vegetables, and whole grains.
  • Limit alcoholic beverages.
  • Maintain a healthy weight.

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What Are the Signs and Symptoms of Heart Failure?

It can be difficult to distinguish the symptoms of heart failure from other medical conditions. Some people who have heart failure do not have any symptoms, but other people experience symptoms that range from mild to severe. Heart failure symptoms may include:

  • Awakening with shortness of breath.
  • Extreme tiredness.
  • Coughing or wheezing that won’t go away.
  • Difficulty concentrating or staying alert.
  • Lack of appetite and/or nausea.
  • Rapid or irregular heartbeat.
  • Shortness of breath with activity
  • Shortness of breath with laying down, or waking up at night with shortness of breath,
  • Sleeping with extra pillows or needing to sleep in a chair to ease breathing.
  • Sudden weight gain and bloating.
  • Swelling in your legs or abdomen.
  • Weakness or low energy

When should I see a doctor about my HF symptoms?

You should schedule an appointment with your doctor if you are experiencing symptoms of heart failure. If your symptoms are severe, visit the nearest hospital emergency room or dial 911.

If you have already been diagnosed with heart failure and develop a new symptom or your symptoms get worse, you should see your doctor as soon as possible.

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How Do You Diagnose Heart Failure?

Diagnosing HF begins with a physical exam and review of your symptoms and medical history.

What to expect during your visit

During your visit, your doctor will use a stethoscope to listen for:

  • The crackling sounds of fluid in the lungs.
  • A heart murmur indicating faulty valves.
  • A quick heartbeat.

Your doctor will also perform a physical exam, including looking at your neck veins and checking for fluid retention (edema). Your doctor may order additional tests to confirm a heart failure diagnosis.

Tests to diagnose HF

Tests your doctor may use to diagnose HF include:

  • Cardiac (heart) catheterization, which enables your doctor to see the heart's blood vessels, measure the pressures in the individual heart chambers, and measure the amount of blood your heart is pumping.
  • Cardiac magnetic resonance imaging (MRI) scan, which uses a magnetic field and radio waves to create images of your heart.
  • Chest x-ray, which can help the doctor view the structure of your heart and lungs.
  • Computerized tomography (CT) scan, which creates images of your heart.
  • Echocardiogram, which uses sound waves to create images of your heart and blood vessels.
  • Electrocardiogram (EKG), which measures the electrical activity of your heart to diagnose rhythm problems.
  • Exercise stress test, which tests your heart's electrical activity, heart rate, and blood pressure during and after exercise.

Your doctor or nurse will tell you when to expect your test results and will call you when they're available.

HF prognosis

With proper treatment, many heart failure patients can live healthy lives for years. You can play an important role in keeping yourself healthy.

How long does a person live with heart failure?

How long you live depends on your overall health, your health history, your heart failure symptoms, and how fast your condition progresses. Your doctor will discuss your prognosis and life expectancy with you.

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How Do You Treat Heart Failure?

Our team of HF experts will work with you and your family to develop a plan to help you live with heart failure. The goal of heart failure treatment is to reduce the strain on your heart while maintaining your quality of life. Your treatment plan may include:

Lifestyle changes

Your doctor will work with you to help you quit smoking, exercise, manage your weight, and adopt a heart-healthy diet to ease the workload for your heart. This may include referral to a cardiac rehabilitation program, smoking cessation program, or a nutrition or weight loss center referral.

Medicine to treat HF

Medications have been proven to reduce symptoms and complications of HF while keeping patients out of the hospital and extending life expectancy. Managing heart failure with medications is a time-tested strategy that has helped people live better lives for years.

Your doctor will prescribe a combination of medication to manage your heart failure. The group of medications used to treat heart failure is often called quadruple therapy or guideline-directed medical therapy (GDMT).

Although every medicine has potential side effects, the risks are usually not as serious as leaving HF untreated. Never stop taking medications without talking to your doctor. Your doctor may prescribe medications including:

Beta blockers

How do beta blockers work?

  • Keep stimulating hormones like epinephrine (adrenaline) and norepinephrine away from the heart's beta receptors.
  • Block the hormones to reduce the stress on the heart.

Drug names

  • Carvedilol (Coreg®)
  • Metoprolol Succinate (Toprol-XL®)
  • Bisoprolol (Zebeta)

Angiotensin Receptor-Neprilysin Inhibitor (ARNi)

How do ARNi inhibitors work?

  • Block a hormone that increases blood pressure and worsens heart failure.
  • Regulate blood pressure to improve cardiac function.

Drug name

  • Sacubitril/valsartan (Entresto)

Angiotensin converting enzyme (ACE) inhibitors

How do ACE inhibitors work?

  • Block a hormone that increases blood pressure and worsens heart failure.
  • Regulate blood pressure to improve cardiac function.

Drug names

  • Captopril (Capoten®)
  • Enalapril (Vasotec®)
  • Lisinopril (Prinivil®)

Angiotensin Receptor Blocker (ARB)

How do ARBs work?

  • Block a hormone that increases blood pressure and worsens heart failure.
  • Regulate blood pressure to improve cardiac function.

Drug names

  • Candesartan (Atacand®)
  • Irbesartan (Avapro®)
  • Losartan (Cozaar®)
  • Valsartan (Diovan)

Only one of these can be taken from the CE, ARB, and ARNi.

Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor

How do SGLT2 inhibitors work?

  • Prevents the body from holding onto extra fluid (fluid retention).
  • Increases urination.

Drug names

  • Dapagliflozin (Farxiga®)
  • Empagliflozin (Jardiance®)

Aldosterone Receptor Antagonist (MRAs)

How do MRAs work?

  • Help to prevent remodeling of the heart.
  • Helps the kidneys get rid of extra fluid.
  • Increases urination.

Drug names

  • Spironolactone (Aldactone®)
  • Eplerenone (Inspra®)

Diuretics (water pills)

How do diuretics work?

  • Increase urination to help the kidneys eliminate excess fluid from the body.
  • Often used together with a low-sodium diet.

Drug names

  • Furosemide (Lasix®)
  • Bumetanide (Bumex®)
  • Torsemide (Demadex)
  • Metolazone (Zaroxolyn)

Monitoring HF

If you are living with heart failure, your doctor will help you determine the best way to monitor your condition and reduce your chance of future hospitalizations.

Self-management skills

Doctors recommend that people with heart failure develop good self-management skills to help them manage their condition. These self-management skills include:

  • Avoiding alcohol, tobacco, and vaping.
  • Being careful not to drink too much fluid. Your doctor may ask you to restrict your fluid intake to around two liters of fluid per day.
  • Following a low-sodium diet of less than 2,000 mg or two grams for the day.
  • Participating in a cardiac rehabilitation or daily exercise program.
  • Taking your medications as prescribed. If you are having trouble with medication side effects or costs, talk to your doctor
  • Weighing yourself every morning (after you wake up and use the bathroom) and recording your weight daily, reporting any gains of more than 2-3 pounds over two days or 4-5 pounds over one week to your doctor.

CardioMEMS™ HF System

Select patients may be eligible for the CardioMEMS™ HF System. Approved by the U.S. Food and Drug Administration in 2014, the system uses a small sensor implanted in your pulmonary artery and an external electronic system to transmit information directly to your doctor's office.

With the CardioMEMS™ HF System, you take daily readings of your pulmonary artery pressure from home. The readings are delivered securely to your doctor's office through an external electronic system. These readings can help your doctor determine if your condition is getting worse before you have symptoms. Your doctor can then adjust your medication or treatment plan and help you avoid hospitalization.

Surgery for HF

If other treatments have not helped to manage your heart failure, your doctor may recommend a surgical procedure. Surgical treatment options include:

  • Coronary artery bypass graft (CABG) surgery – People with severe coronary artery disease may benefit from a CABG procedure to redirect blood flow to the heart.
  • Heart transplant – As one of the first medical centers to perform heart transplants, UPMC's experience and expertise are known the world over.
  • Heart valve intervention – In some cases, the heart valves are so weak that you may need a procedure to repair or replace the damaged valves. Our valve team consists of highly skilled interventional cardiologists and surgeons who are experts at repairing and replacing damaged valves.
  • Pacemaker or implantable cardioverter defibrillator (ICD) – In addition to medications, our specialists may refer you to an electrophysiologist (EP) to discuss whether you would benefit from a device — like a defibrillator or a pacemaker — to help regulate the heart rhythm of your damaged heart.
  • Ventricular assist devices (VADs) – In many cases, a VAD (also referred to as heart pump) is the best treatment for heart failure. VADs work mechanically to support the heart or improve the circulation of blood. They can act as a bridge to transplantation until a suitable donor organ becomes available, until the heart muscle recovers on its own, or as a long-term treatment (destination VAD) if transplant is not an option or not desired by the patient.

Palliative care

UPMC specialists offer palliative care, which helps to treat symptoms of heart failure and side effects of treatment. Our team also offers comprehensive, compassionate end-of-life care, if necessary.

How effective is treatment?

Following your doctor’s treatment plan and instructions for managing your condition can go a long way toward helping you live a healthy life with heart failure.

Can someone with heart failure recover?

The chance of recovery from HF depends on the amount of damage to your heart, the cause of your condition, your overall health, and other factors. With treatment, it is possible for your heart to recover some — or even all — of its pumping ability. However, many people with heart failure need lifelong HF treatment.

Can you improve heart failure?

It is possible to improve the symptoms of HF. The goal in treating heart failure aggressively is to have patients return to as close to their level of activity as they can. To effectively manage your condition, be sure to follow all your doctor’s treatment recommendations, get routine follow-up care, and report any changes in your health or symptoms to your doctor.

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Why Choose UPMC for HF Care?

When you choose UPMC for your heart failure treatment, you will receive expert care from a team of highly qualified heart failure specialists. Your doctors will provide you with a personalized treatment plan, access to the latest therapies, and opportunities to participate in research.

Your care will include:

  • Access to supervision and treatment wherever you are — including in the hospital, at a skilled nursing facility, in the clinic, or at home.
  • Dedicated heart failure inpatient units where you will receive specialized care.
  • A nurse navigator, who will assist you as you follow your plan of care.
  • A case manager, who will help you schedule appointments.

Learn more about HF

  • Heart Failure Guide Book (PDF)

By UPMC Editorial Staff. Last reviewed on 2024-10-01 by Jennifer Kliner, CRNP.

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