Impaired ejection can cause inadequate perfusion of the body tissues with blood leading to ischemia. This manifests as water retention and swelling due to the buildup of liquid ( edema), collectively referred to as congestion. Filling dysfunction and high intracardiac pressure may result in the buildup of fluid in the veins and tissues. It develops when the heart fails properly to fill up with blood during diastole, leading to an decrease in intracardiac pressures or in ejection during systole, thereby reducing cardiac output to the rest of the body. Heart failure is not a disease but a syndrome, a combination of signs and symptoms caused by the impairment of the heart's function as a pump to support the circulatory system, at rest or during exercise. Heart failure has been known since ancient times, with the Ebers papyrus commenting on it around 1550 BCE. In the United Kingdom, the disease is the reason for 5% of emergency hospital admissions. This degree of risk of death is similar to some cancers. The risk of death is about 35% the first year after diagnosis, while by the second year the risk of death is less than 10% for those who remain alive. Overall around 2% of adults have heart failure and in those over the age of 65, this increases to 6–10%. In 2015, it affected about 40 million people globally. Heart failure often results in more drastic detrimental health effects compared to failure of other similarly complex organs such as the kidneys or liver. Heart failure is a common, costly, and potentially fatal condition, and it is the leading cause of both hospitalization and readmission amongst older adults. A ventricular assist device (for the left, right, or both ventricles), or occasionally a heart transplant may be recommended in those with severe disease that persists despite all other measures. In some moderate or severe cases, cardiac resynchronization therapy (CRT) or cardiac contractility modulation may be of benefit. Sometimes, depending on the cause, an implanted device such as a pacemaker or an implantable cardiac defibrillator may be recommended. Diuretics may also be prescribed to prevent fluid retention and its resulting shortness of breath. For those with severe disease, aldosterone antagonists, or hydralazine with a nitrate, may be used. In those with heart failure due to left ventricular dysfunction, angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, or valsartan/sacubitril along with beta blockers are recommended. In people with chronic stable mild heart failure, treatment commonly consists of lifestyle changes such as stopping smoking, physical exercise, and dietary changes, as well as medication. Treatment depends on the severity and cause. Blood tests, and chest radiography may be useful to determine the underlying cause. ĭiagnosis is based on symptoms, physical findings, and echocardiography.
Heart failure is not the same as cardiac arrest in which blood flow stops altogether due to failure of the heart to pump effectively.
Left-sided heart failure can occur with reduced ejection fraction or with a preserved ejection fraction. There are different types of heart failure: right-sided heart failure that affects the right heart, left-sided heart failure that affects the left heart, and biventricular failure that affects both sides of the heart. These cause heart failure by changing either the structure or the function of the heart, or both. Ĭommon causes of heart failure include coronary artery disease, heart attack, high blood pressure, atrial fibrillation, valvular heart disease, excessive alcohol use, infection, and cardiomyopathy. Other diseases that may have symptoms similar to heart failure include obesity, kidney failure, liver disease, anemia, and thyroid disease. The severity of the heart failure is measured by the severity of symptoms with exercise. Notably, chest pain including angina is not typically caused by heart failure, but can occur if the heart failure is caused by a heart attack. It may cause shortness of breath when exercising or while lying down, and may wake a person up at night. Symptoms commonly include shortness of breath, excessive tiredness, and leg swelling. Heart failure ( HF), also known as congestive heart failure ( CHF), is a syndrome, a group of signs and symptoms, caused by impairment of the heart's function to pump blood. Kidney failure, thyroid disease, liver disease, anemia, obesity Ĥ0 million (2015), 1–2% of adults (developed countries) Smoking, sedentary lifestyle, exposure to second-hand smoke Heart attack, high blood pressure, abnormal heart rhythm, excessive alcohol use, infection, heart damage Shortness of breath, feeling tired, leg swelling External jugular vein marked by an arrow. Congestive heart failure (CHF), congestive cardiac failure (CCF) Ī man with congestive heart failure and marked jugular venous distension.
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