What is Heart Failure?


Heart failure, also known as congestive heart failure, occurs when the heart isn’t pumping enough blood to meet the body’s needs. As a result, fluid may build up in the legs, lungs, and in other tissues throughout the body.


Heart failure can occur for several reasons. Common causes of heart failure include:

  • Coronary artery disease
  • Previous heart attack (myocardial infarction)
  • High blood pressure (hypertension)
  • Valve disease
  • Congenital heart disease (condition you are born with)
  • Cardiomyopathy (enlarged heart)
  • Endocarditis
  • Myocarditis (infection of the heart)
  • Diabetes


Heart failure symptoms aren't always obvious. Some people in the very early stages of heart failure may have no symptoms at all. Others may dismiss symptoms like fatigue or shortness of breath as signs of growing older.

Sometimes, however, heart failure symptoms are more obvious. Because of the heart's inability to efficiently pump blood and supply the organs (such as the kidneys and the brain),  a number of symptoms maybe experienced, including:

  • Shortness of breath
  • Swelling of the feet and legs
  • Lack of energy, feeling tired
  • Difficulty sleeping at night due to breathing problems
  • Swollen or tender abdomen, loss of appetite
  • Cough with "frothy" mucus or phlegm
  • Increased urination at night
  • Confusion
  • Impaired memory

Risk Factors

Some people are more likely than others to develop heart failure. No one can predict for certain who will develop it. Being aware of the risk factors and seeing a doctor for early treatment are good strategies for managing heart failure. Heart failure risk factors include:

  • High blood pressure (hypertension)
  • Heart attack (myocardial infarction)
  • Abnormal heart valves
  • Enlargement of the heart (cardiomyopathy)
  • Family history of heart disease
  • Diabetes


Only your doctor can tell if there are signs of heart failure and how far the condition has progressed. Your doctor may review your medical history, including past and present illnesses, family history, and lifestyle. As part of your physical examination, your doctor may check your heart, lungs, abdomen, and legs to see if signs of heart failure are present.

To rule out or confirm the diagnosis of heart failure, your doctor may order one or several of these diagnostic tests:

  • Echocardiogram
  • Electrocardiogram (ECG)
  • Chest x-ray
  • Exercise test (stress test)
  • Cardiac catheterisation

If you have heart failure, your doctor may also track the ejection fraction over time. Ejection fraction is the percentage of blood that is pumped out of the heart during each beat. It's a key indicator of the heart's health and doctors frequently use it to determine how well the heart is functioning as a pump.

Treatment Options


In some people with heart failure, the lower chambers of the heart don't beat at the same time, forcing the heart to work harder. A doctor may recommend cardiac resynchronisation therapy (CRT), which is an implantable heart device, like a pacemaker.

CRT may be a treatment option for some individuals with heart failure. It sends small electrical impulses to both lower chambers of the heart to correct the unsynchronised pattern. 


Your doctor may recommend lifestyle changes such as quitting smoking, limiting sodium intake, losing weight, or reducing stress levels. These changes can help relieve some of the symptoms associated with heart failure and reduce strain on the heart.


Many kinds of medications are used for treating heart failure. Your doctor may prescribe ACE inhibitors, beta-blockers, blood thinners, and diuretics, among others. 


If the heart failure is caused or made worse by a weak valve, your doctor may consider heart surgery to repair or replace the valve. If the heart failure is serious and irreversible, heart transplant surgery may be considered.

Talk to your doctor about which treatment options are right for you.