12/03/2023
Acute and chronic heart failure, explained.
By Beth Krietsch
Medically reviewed by Sharonne N. Hayes, MD
February 28, 2022
Heart failure is a serious condition, but contrary to popular belief, it doesn’t mean the heart has completely given out or stopped working. Instead, heart failure means your heart can’t pump enough blood, according to the Centers for Disease Control and Prevention. This is dangerous because blood circulation keeps your body running as it should—it keeps your organs working, helps you stay warm, nourishes your skin, supports your brain so you can think clearly, ensures you properly digest food, and so much more. Put simply: When the heart has trouble pumping blood, your whole body suffers the consequences.
Unfortunately, heart failure is fairly common. More than 6 million adults in the United States are impacted by the condition, according to a 2020 paper published in the journal Circulation1. Heart failure can become pretty complex as well, since there are numerous types and stages that characterize its symptoms. Here’s what a heart failure diagnosis entails, including which treatment options may be considered to minimize as much damage as possible to this vital organ.
Heart failure symptoms
Understandably, your body won’t feel its best when you start experiencing heart failure symptoms, which can run the gamut. You may have very few symptoms with mild heart failure, especially in its earliest stages. But if the condition progresses, your symptoms will eventually worsen as your heart becomes weaker, the NHLBI notes. The most common heart failure symptoms include:
Shortness of breath: You may have trouble breathing during physical activities, like exercise3, or just when lying down or resting, depending on the type of heart failure you have and which stage it is in.
Coughing or wheezing: This can happen if your heart doesn’t contract very forcefully, resulting in fluid buildup in your lungs.
Waking up feeling short of breath: You may have trouble sleeping through the night because of this and need to prop your head up with pillows to feel better.
Fatigue and weakness: You may feel exhausted just doing your typical daily activities. This is one of the earliest and most common heart failure symptoms4.
Fluid retention: Your feet, ankles, or legs can become swollen because blood, water, and other fluids build up due to poor circulation. Some people may notice their abdomen is swollen or they may suddenly gain weight because of fluid retention.
Rapid heart rate: Your heart might feel like it’s fluttering or racing.
Chest pain: If your heart muscle doesn’t get enough blood, then you could feel heaviness or tightness in your chest.
Bluish lips or fingers: Your skin can have a bluish tinge when you don’t get enough oxygen.
Nausea: You may feel nauseous if your digestive system doesn’t get enough blood flow.
What causes heart failure?
Heart failure has numerous causes. As we previously noted, the heart’s chronic inability to pump blood efficiently is often the result of weakness or damage caused by another cardiovascular health issue, like high blood pressure (which forces your heart to work harder) or a previous heart attack.
“Substances that are toxic to the heart such as alcohol and certain drugs, as well as chemotherapy medications, can also cause heart muscle weakness,” Dina Katz, M.D., a cardiologist at Phelps Hospital, Northwell Health, in Sleepy Hollow, New York, tells SELF.
According to the U.S. National Library of Medicine, hypertension, coronary artery disease, and diabetes are some of the most common causes of heart failure:
Hypertension, or high blood pressure, refers to the force of your blood against your artery walls. Hypertension is one of the most common causes of heart failure, especially in people assigned female at birth and in Black individuals.
Coronary artery disease is caused by plaque build-up of cholesterol and other substances in your artery walls, which prevents blood from flowing through your arteries.
Diabetes is when your blood glucose, or sugar, is too high either because you don’t have enough insulin (a hormone that regulates your blood sugar) or because your body doesn’t use insulin well. Over time, high blood sugar can also lead to high blood pressure and eventually heart disease.
Other conditions and risk factors that can lead to heart failure include the following:
Metabolic syndrome is a group of risk factors that develop in tandem and can increase your risk for heart disease, according to the NHLBI. These factors include high blood pressure, having high body fat around your waist, high blood sugar, high triglycerides (a type of fat in the blood), and low HDL (“good”) cholesterol levels.
Heart valve disease means at least one of your heart’s valves—there are four that guide the direction of blood flow—don’t fully open or close, according to the Mayo Clinic. You can be born with heart valve disease or it can be caused by another health condition.
Congenital heart defects happen when your heart chambers or valves don’t form properly before you’re even born. When this happens, your heart is forced to work harder than it should.
Peripartum cardiomyopathy is a rare type of heart failure that makes your heart weaker and larger during pregnancy, according to the Cleveland Clinic. Generally, people with high blood pressure, people who are overweight, and Black people have a higher risk of developing this form of heart failure while pregnant. Most often, people with peripartum cardiomyopathy will recover some or even all of their heart function after they give birth.
Heartbeat irregularities, or arrhythmias, occur when your heart beats too fast, too slow, or in an abnormal rhythm.
Severe viral infections, including the flu and COVID-19, can lead to inflammation of the heart muscle (medically known as myocarditis), potentially impacting its ability to pump blood5.
