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Heart Failure

Heart failure occurs when the heart can no longer pump oxygen-rich blood to the rest of the body efficiently. Heart failure is usually a chronic condition, but it may come on suddenly.

The condition may affect only the right side or only the left side of the heart. Usually, both sides of the heart are involved.

Heart failure is present when:

  • The heart muscle cannot pump the blood out of the heart very well. This is called systolic heart failure.
  • The heart muscle is stiff and does not fill up with blood easily. This is called diastolic heart failure.

As the heart’s pumping becomes less effective, blood may back up in other areas of the body. Fluid may build up in the lungs, liver, gastrointestinal tract, and the arms and legs. This is called congestive heart failure.

The most common causes of heart failure are:

  • Coronary artery disease (CAD)
  • High blood pressure

Other heart problems that can lead heart failure include:

  • Congenital heart disease
  • Heart attack
  • Heart valves that are leaky or narrowed
  • Infection that weakens the heart muscle
  • Some types of abnormal heart rhythms

These non-cardiac diseases can also cause or contribute to heart failure:

  • Amyloidosis
  • Emphysema
  • Overactive thyroid
  • Sarcoidosis
  • Severe anemia
  • Too much iron in the body
  • Underactive thyroid

Signs & Symptoms

Common symptoms of heart failure include:

  • Cough
  • Fatigue, weakness, faintness
  • Loss of appetite
  • Need to urinate at night
  • Heart palpitations
  • Shortness of breath when you are active or after you lie down
  • Enlarged liver or abdomen


A  physician can often tell from a physical exam that a patient has congestive heart failure based on swelling in the legs and feet, and hearing fluid in the lungs with a stethoscope. Additional testing will confirm a preliminary diagnosis and can include:

  • Blood tests
  • Electrocardiogram (EKG)
  • Echocardiogram
  • Chest x-ray
  • Cardiac catheterization
  • Stress Test
  • CT Scan
  • MRI

Upon diagnosis, heart failure is staged from A to D.

  • Stage A – Patient is at high risk for heart failure but has no structural heart disease or heart failure symptoms
  • Stage B – Patient has structural heart disease but has no signs or symptoms of heart failure
  • Stage C – Patient has structural heart disease and has prior or current symptoms of heart failure
  • Stage D – Patient has advanced heart failure