What is heart failure?

If you suffer from heart failure, your muscles and organs receive less oxygen and nutrients. This can make you feel dizzy and tired. Extra fluid can build up in your body, which can make you feel short of breath and cause swelling in your legs or abdomen.   

What are the different types of heart failure?  

Heart failure can occur in the left, right or both sides of the heart. Heart failure can also be grouped by an important measure known as the ejection fraction – which measures how well your heart is pumping blood, and it is used to guide treatment of heart failure. 

The ejection fraction measures the amount of blood your heart pushes in and out with each heartbeat. In a healthy heart, the ejection fraction is 50% or higher – meaning that the heart is  pumping out at least half the volume of blood that fills the chambers with each beat.  

In heart failure, you can either have a reduced rejection fraction, or a preserved ejection fraction.  

Heart failure with reduced ejection fraction (HFrEF, or systolic heart failure)  

In heart failure with reduced ejection fraction, your heart muscle is weakened and does not pump enough blood to meet the needs of your body. When your heart muscle struggles to properly pump blood to your body, fluid begins to build up in your body’s blood vessels.  

As more fluid builds up, it can leak into the space around your lungs and other areas of your body, causing shortness of breath and swelling. When your heart doesn’t pump well, your muscles and organs receive less oxygen and nutrients, which can make you feel dizzy and tired. 

Heart failure with preserved ejection fraction (HFpEF, or diastolic heart failure)   

In heart failure with preserved ejection fraction, your heart muscle can pump blood to the rest of your body, but the heart muscle does not stretch well. When your heart muscle does not stretch, the pressure inside your heart can build up. This can cause fluid to leak into the space around your lungs and other areas of your body, causing shortness of breath and swelling. 

There are other types of heart failure that cause similar symptoms, such hypertrophic obstructive cardiomyopathy and right ventricular failure. Talk to your doctor about your heart failure and what it means for your treatment and management. 

What are the causes of heart failure?  

The most common causes of heart failure are heart attack and coronary heart disease, but there are numerous other causes. Many people who have heart failure live with other long-term conditions, such as lung disease or diabetes. 

Heart failure can develop as the result of other conditions which have damaged, weakened or stiffened your heart, such as: 

• Old age 
• Chronic conditions – such as diabetes, HIV and thyroid conditions 
• Coronary heart disease and heart attack  
• Damage to the heart muscle (cardiomyopathy) – causes can include infection, alcohol abuse and certain medications 
• Faulty heart valves (heart valve disease)  
• ​Heart rhythm problems (arrhythmias)  
• Heart conditions you're born with (e.g. congenital heart disease)  
• High blood pressure (hypertension)   
• Inflammation of the heart muscle (myocarditis) 
• Pregnancy – which forces your heart to work harder than it should

Work with your professional healthcare provider to understand why you have developed heart failure and how you can manage your symptoms and live a quality life. 

What are the signs and symptoms of heart failure?  

Heart failure causes symptoms because of the reduced supply of oxygen and nutrients to your muscles and organs, and the build-up of fluid in your body (i.e. congestion). You may feel one or many of these common heart failure symptoms: 

• Bloated stomach  
• Chest pain 
• Coughing  
• Difficulty with breathing or shortness of breath, especially when doing physical activity 
• Discomfort when lying flat, due to difficulty with breathing 
• Dizziness  
• Heart pounding or racing (i.e. palpitations)  
• Loss of appetite or nausea 
• Swollen ankles or legs (i.e. oedema)  
• Tiredness 
• Waking overnight due to difficulty with breathing 
• Weakness

What should you do if your symptoms get worse?  

If your symptoms of heart failure get worse, you need to see your health care team quickly. If you see your doctor early, you may stop your heart failure symptoms from becoming worse and this could help you avoid the need for a long hospital stay. 

How can you prevent heart failure?  

The best way to prevent heart failure is to prevent coronary heart disease and heart attack. If you have had a heart attack it’s important to manage your risk factors and follow your treatment plan, including regular check-ups with your health care team. 

However, sometimes heart failure is not preventable, and you may develop symptoms because of another condition, genes or an unknown cause. Work with your health team to understand why you have developed heart failure and how you can manage your symptoms and live a quality life.  

How is heart failure diagnosed?