Understanding Heart Failure

What is heart failure?

Heart failure means that the heart's pumping power is weaker than normal. Heart failure does not mean that your heart has stopped working.

With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. Therefore, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body. This helps to keep the blood moving for a short while, but then the heart muscle walls weaken and are not able to pump as strongly. The kidneys often respond by causing the body to retain fluid (water) and sodium.

If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

What are the symptoms of heart failure?
The signs and symptoms of heart failure may be mild to severe, depending on how weak your heart is. The congestive heart failure symptoms are related to the changes that occur in your heart and body, including:

• Congested lungs (caused by fluid backing up in the lungs) -- cause shortness of breath with exercise or difficulty breathing at rest or when laying flat at night. Also cause dry, hacking cough or wheezing.
• Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs and abdomen (called edema) and weight gain. Symptoms may also include an increased need to urinate during the night.
• Less blood to your major organs and muscles causes fatigue (tiredness) and weakness when exercising. Less blood to the brain also causes dizziness or confusion.
• A feeling of fullness (bloating) in your stomach. A loss of appetite or nausea may also occur.
• Heart beating faster to pump enough blood to the body causes rapid or irregular heartbeats.

If you have heart failure or congestive heart failure, you may have one or all of these symptoms of heart failure. Sometimes, people with heart failure do not have any symptoms.

What are systolic and diastolic heart failure?
Systolic cardiac (heart) dysfunction (or systolic heart failure) occurs when the heart muscle doesn't contract with enough force, so there is not enough oxygen-rich blood to be pumped throughout the body.

Diastolic cardiac dysfunction (or diastolic heart failure) occurs when the heart contracts normally, but the ventricle doesn't relax properly so less blood can enter the heart.

A test called the ejection fraction (EF) is used measure how well your heart pumps with each beat to determine if systolic or diastolic dysfunction are present. Your doctor can discuss which condition is present in your heart.