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Heart Failure: When the Heart Muscle is too Weak

The information below will help you understand what it means when the heart does not pump blood well enough, which is also known as heart failure. The described symptoms do not necessarily mean that you have significant health problems, but if the symptoms persist and you feel concerned, please contact your physician. 

Patients_Heart Failure_Test

What is Heart Failure?

Heart failure occurs when the heart muscle is weakened and does not pump blood as well as it should. Sometimes referred to as congestive heart failure, it means that the heart fails to pump enough oxygen-rich blood to meet the body’s needs. In patients with a weakened heart muscle, blood often backs up and fluid can build up in the lung, legs and other tissues throughout the body. Heart failure can persist for weeks, months or years (chronic) or can start suddenly (acute).  

What Causes Heart Failure

Heart failure often develops after other conditions have damaged or weakened the heart. These may include: 

  • Circulatory disorders such as coronary artery disease and arteriosclerosis 
  • Heart attack 
  • High blood pressure (hypertension) 
  • Abnormal heart rhythm (atrial fibrillation) 
  • Heart muscle disease or inflammation of the heart 
  • A heart valve defect 
  • Alcohol or drug abuse 
  • Other diseases and conditions including diabetes, anemia, fever and chronic obstructive pulmonary disease 

What Are the Symptoms of Heart Failure

In heart failure, the main pumping chambers of the heart (the ventricles) may become stiff and may not fill properly between beats. When the body does not receive enough oxygen-rich blood, heart failure may show through the following signs and symptoms:  

  • Shortness of breath with activity or when lying down 
  • Reduced ability to exercise 
  • Lack of energy, tiredness 
  • Fatigue 
  • Rapid or irregular heartbeat 
  • Swelling in the legs, ankle, feet and in the belly area (abdomen)  
  • Rapid weight gain (from fluid build-up) 
  • Loss of appetite 
  • Coughing and wheezing 
  • Difficulty breathing while lying down, needing to sleep in a sitting position 

Please note that while it is great to be aware of your heart health, do not attempt to self-diagnose but see a doctor if you experience one or more symptoms. 

Two elderly women working out in the park

How Is Heart Failure Diagnosed?

Your doctor can determine how well your heart is pumping by measuring how much blood is pumped out with each beat (ejection fraction). Ejection fraction is used to help classify heart failure and guide treatment. In a healthy heart, the ejection fraction is 50% or higher — meaning that more than half of the blood that fills the ventricle is pumped out with each beat. But heart failure can occur even with a normal ejection fraction when the heart muscle becomes stiff from conditions such as high blood pressure. 

An echocardiogram being performed

How Is Heart Failure Treated?

 Heart failure therapy aims to reduce the heart’s workload, increase the patient’s ability to cope with symptoms and stress, and improve their quality of life.  


Improving the Underlying Causes Leading a Healthy Lifestyle Reducing the Heart’s Workload and Improving Symptoms Increase the Patient’s Ability to Cope with Symptoms
  • treating cardiovascular diseases like coronary heart disease or a heart valve defect 
  • lowering blood pressure 
  • controlling blood sugar levels in patients with diabetes 
  • eliminating risk factors for cardiovascular disease including smoking, stress, alcohol abuse, excess weight or lack of exercise. 
  • eating healthily  
  • exercising based on your fitness level 
  • weighing yourself daily to quickly detect and treat water retention 
  • water pills to get rid of excess fluid in the lungs and body 
  • treating underlying conditions such as high blood pressure or diabetes 
  • receiving a pacemaker and resynchronization therapy  
  • receiving remote monitoring that allows to shift from heart failure detection to prediction  


Chronic heart failure is a very common disease in which symptoms appear slowly over time and gradually get worse. Acute heart failure, in contrast, develops suddenly with severe symptoms and is always a medical emergency requiring immediate action. It usually requires treatment and medication to be administered by injection. Acute heart failure may follow a heart attack, which has caused damage to the heart, or by the body being suddenly unable to compensate for chronic heart failure. 

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