Which specific type of heart failure is most likely to occur at the beginning of chronic HF

Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stiff.

It's sometimes called congestive heart failure, although this name is not widely used now.

Heart failure does not mean your heart has stopped working. It means it needs some support to help it work better.

It can occur at any age, but is most common in older people.

Heart failure is a long-term condition that tends to get gradually worse over time.

It cannot usually be cured, but the symptoms can often be controlled for many years.

Symptoms of heart failure

The main symptoms of heart failure are:

  • breathlessness after activity or at rest
  • feeling tired most of the time and finding exercise exhausting
  • feeling lightheaded or fainting
  • swollen ankles and legs

Some people also experience other symptoms, such as a persistent cough, a fast heart rate and dizziness.

Symptoms can develop quickly (acute heart failure) or gradually over weeks or months (chronic heart failure).

When to get medical advice

See a GP if you experience persistent or gradually worsening symptoms of heart failure.

Call 999 for an ambulance or go to your nearest A&E department as soon as possible if you have sudden or very severe symptoms.

A number of tests can be used to help check how well your heart is working, including blood tests, an ECG and an echocardiogram.

Find out more about how heart failure is diagnosed

Causes of heart failure

Heart failure is often the result of a number of problems affecting the heart at the same time.

Conditions that can lead to heart failure include:

  • coronary heart disease – where the arteries that supply blood to the heart become clogged up with fatty substances (atherosclerosis), which may cause angina or a heart attack
  • high blood pressure – this can put extra strain on the heart, which over time can lead to heart failure
  • conditions affecting the heart muscle (cardiomyopathy)
  • heart rhythm problems (arrhythmias), such as atrial fibrillation
  • damage or other problems with the heart valves
  • congenital heart disease – birth defects that affect the normal workings of the heart

Sometimes obesity, anaemia, drinking too much alcohol, an overactive thyroid or high pressure in the lungs (pulmonary hypertension) can also lead to heart failure.

Treatments for heart failure

Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.

How you're treated will depend on what is causing your heart failure.

Common treatments include:

  • lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
  • medicine – a range of medicines can help; many people need to take 2 or 3 different types
  • devices implanted in your chest – these can help control your heart rhythm
  • surgery – such as a bypass operation or a heart transplant

Treatment will usually be needed for life.

A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.

Outlook for heart failure

Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.

It can severely limit the activities you're able to do and is often eventually fatal.

But it's very difficult to tell how the condition will progress on an individual basis.

It's very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.

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Page last reviewed: 19 May 2022
Next review due: 19 May 2025

Also called: Cardiac failure, CHF, Congestive heart failure, Left-sided heart failure, Right-sided heart failure

Summary

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

  • With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
  • With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
    • Too weak to pump enough blood.
    • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

What causes heart failure?

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

  • Arrhythmia (a problem with the rate or rhythm of your heartbeat)
  • Cardiomyopathy
  • Congenital heart defects or other types of heart diseases that you are born with
  • Coronary artery disease
  • Endocarditis
  • Heart attack
  • Heart valve diseases
  • High blood pressure
  • A blood clot in your lung
  • Diabetes
  • Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
  • Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Who is more likely to develop heart failure?

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

  • You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
  • Your family health history includes relatives who have or have had heart failure.
  • You have changes in your genes that affect your heart tissue.
  • You have habits that can harm your heart, including:
    • Smoking.
    • Eating foods high in fat, cholesterol, and sodium (salt).
    • Having an inactive lifestyle.
    • Alcohol use disorder (AUD).
    • Illegal drug use.
  • You have other medical conditions that can affect your heart, including:
    • Any heart or blood vessel conditions, including high blood pressure.
    • Serious lung diseases.
    • Infection, such as HIV/AIDS or COVID-19.
    • Obesity.
    • Diabetes.
    • Sleep apnea.
    • Chronic kidney disease.
    • Anemia.
    • Iron overload disease.
    • Cancer treatments that can harm your heart, such as radiation and chemotherapy.
  • You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.

What are the symptoms of heart failure?

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

  • Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
  • Fatigue or weakness even after rest.
  • Coughing.
  • Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
  • Difficulty sleeping when lying flat.
  • Nausea and loss of appetite.
  • Swelling in the veins of your neck.
  • Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

What other problems does heart failure cause?

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

  • Breathing problems from fluid in and around your lungs (also called congestive heart failure)
  • Kidney or liver damage including cirrhosis
  • Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
  • Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
  • Pulmonary hypertension

How is heart failure diagnosed?

To find out if you have heart failure, your doctor will:

  • Ask about your medical history, including your symptoms
  • Ask about your family health history, including relatives who have had heart failure
  • Do a physical exam
  • Will likely order heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your doctor may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart failure?

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

  • Taking medicine
  • Eating less sodium and drinking less liquid to control fluid buildup
  • Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your health care provider recommends
  • Treating any conditions that may make heart failure worse

You may need heart surgery if:

  • You have a congenital heart defect or damage to your heart that can be fixed.
  • The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
    • An implantable cardioverter defibrillator.
    • A biventricular pacemaker (cardiac resynchronization therapy).
    • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
  • Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

Can heart failure be prevented?

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Start Here

  • Heart Failure (Mayo Foundation for Medical Education and Research)
  • What Is Heart Failure?
    Which specific type of heart failure is most likely to occur at the beginning of chronic HF
    (National Heart, Lung, and Blood Institute)

  • Cardiac Asthma: What Causes It? (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Diastolic Dysfunction (Texas Heart Institute) Also in Spanish
  • Heart Failure Questions to Ask Your Doctor (American Heart Association)
  • Overcoming Barriers to Shared Decision Making (American Heart Association)
  • Planning for Advanced Heart Failure (American Heart Association)
  • Pulmonary Edema (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Recognizing Advanced Heart Failure and Knowing Your Options (American Heart Association)

  • Advanced Heart Failure (American Heart Association)
  • Types of Heart Failure (American Heart Association)

  • Heart Failure Fact Sheet (Centers for Disease Control and Prevention)

  • Heart Anatomy (Texas Heart Institute) Also in Spanish
  • Heart Information Center (Texas Heart Institute) Also in Spanish
  • How the Heart Works
    Which specific type of heart failure is most likely to occur at the beginning of chronic HF
    (National Heart, Lung, and Blood Institute)
    Also in Spanish

  • Heart Failure: Unique to Older Adults (AGS Foundation for Health in Aging)

What is the most common form of initial heart failure?

Coronary artery disease is the most common form of heart disease and the most common cause of heart failure. The disease results from the buildup of fatty deposits in the arteries, which reduces blood flow and can lead to heart attack.

Which factor reflects the most common etiology of heart failure HF )?

The most frequent causes of HF with known etiology is ischemic heart disease (42.3% of all cases), followed by chronic obstructive pulmonary disease (37.0%), mitral valve disease (4.3%), aortic valve disease (3.4%), rheumatic heart disease (3.0%), myocarditis (2.6%) and endocarditis (1.4%).

Which of the following are the earliest symptoms of chronic heart failure?

5 warning signs of early heart failure.
F = Fatigue. When the heart can't pump enough oxygen-rich blood to meet the body's energy needs, a general feeling of tiredness or fatigue sets in..
A = Activity limitation. ... .
C = Congestion. ... .
E = Edema or ankle swelling. ... .
S = Shortness of breath. ... .
Image: gpointstudio/Getty Images..

What type of heart failure is HFrEF?

Heart failure with reduced ejection fraction (HFrEF), also called systolic failure: The left ventricle loses its ability to contract normally. The heart can't pump with enough force to push enough blood into circulation.