Heart failure


Heart failure, or congestive heart failure, is caused by specific heart diseases, such as coronary artery disease and hypertension, which causes ineffective blood pumping and filling and the weakening of the heart. When the pumping of the blood by the heart muscles is not as good as it should be, there will be a fluid buildup in the lungs due to the backing up of blood and this will cause shortness of breath.

There are many conditions that may lead to heart failure, such as coronary artery disease, high blood pressure, diabetes and obesity. Controlling and/or preventing these diseases decreases the risk of developing heart failure.

Heart failure as well as its symptoms can be controlled or treated by opting for a healthier lifestyle, including controlling your weight, exercising, choosing lower-sodium foods and managing stress. Successfully doing this can extend the lifespan of a patient as well as improve his/her quality of life.

Heart failure can be fatal or have severe symptoms, which might require a patient to receive heart surgery or use a ventricular assist device (VAD).


Heart failure can cause both acute and chronic symptoms, including:

  • Difficulty breathing or dyspnea with activity
  • Weakness and fatigue
  • Fast or irregular heartbeat
  • Swollen legs, ankles or feet
  • Abdominal swelling
  • Sudden weight gain
  • Continuous cough or wheezing with blood-mixed mucus
  • Nausea
  • Loss of appetite
  • Problems with concentration

You should consult a doctor immediately if you have signs or symptoms of heart failure, especially if you have at least one of these symptoms:

  • Tightness of the chest
  • Syncope or severe weakness
  • Heart palpitations with difficulty breathing, chest pain, or fainting
  • Suddenly starting to pant or cough with foamy, blood-mixed mucus

If the doctor finds that you have heart failure, they will try to put its symptoms under control and immediate care might also be given if your symptoms are not responding well to the current treatment and there is worsening.


Heart failure generally happens when the heart has been injured or weakened by another condition. This disease can cause the ventricles, which are mainly responsible for pumping blood in the heart, to stiffen and be unable to pump blood in sync with the cardiac beats.

Heart failure may sometimes cause the heart muscle to be injured and weakened, as well as the ventricles to enlarge. If this disease is left untreated over time, the heart will no longer be able to pump enough blood as needed to the rest of the body.

If your heart is weakened, its ejection fraction (how much blood the heart pumps in one beat) should be lower than 50%. This means less than half of your blood filling the ventricle is pumped out per beat.

However, some people might have a normal ejection fraction (over 50%) and are still at risk of heart failure. These people tend to have stiff heart muscle caused by hypertension.

As blood pumping heavily relies on the left ventricle, heart failure tends to begin in this chamber. However, heart failure can involve left ventricle, right ventricle, or both side of them.

Type of heart failure

Left-sided heart failure: symptoms include difficulty breathing due to the backup of fluid into the lungs.

Right-sided heart failure: causes your abdomen, legs and feet to swell due to the fluid buildup in the areas.

Systolic heart failure: is caused by abnormal contractions and blood pumping of the left ventricle, leading to a lower ejection fraction.

Heart failure with preserved ejection fraction: is associated with abnormal blood filling in the left ventricle as the heart chamber cannot properly relax and regulate the blood filling there.

Heart failure can be caused by any of the following factors:

  • Coronary artery disease and heart attack: caused by excessive fatty deposits in the arteries which decrease the blood flow to the heart and raise the risk of a heart attack. A complete blockage in a coronary artery can cause a sudden heart attack and injury of the heart muscles.
  • Hypertension: Too much pressure in the blood causes the heart to work harder to pump blood to the rest of the body. If this condition is left untreated, it may cause the heart muscle to be stiffened, weakened and unable to pump blood properly.
  • Faulty heart valves: Certain heart conditions, such as coronary artery disease and heart infection, can injure a heart valve and disrupt the direction of blood flow, causing the heart to work harder and weakening the heart.
  • Injury of the heart muscle: which includes some diseases, infection, genetics, excessive alcohol consumption, as well as use of or exposure to some dangerous drugs or chemicals, such as cocaine and chemotherapy.
  • Myocarditis: may cause you to suffer from heart failure in the left side of the heart. Virus infection, such as COVID-19, is the most common cause of myocarditis.
  • Congenital heart defect: might force your heart to pump blood harder due to an irregular structure of a chamber or valve, leading to heart failure.
  • Heart arrhythmia: causes the heart to beat too fast or too slow, making the organ work harder and raise the risk of cardiac failure.
  • Certain chronic disorders: including diabetes, HIV, hyperthyroidism or hypothyroidism, and an iron or protein buildup.

Acute heart failure can also be caused by any of the following factors:

  • Allergy
  • Blood clots in the lung
  • Severe infections
  • Certain kinds of medications
  • Infection with a virus

Risk factors

Heart failure can be caused by one or more factors combined. The more factors, the higher the risk you will face which includes the following:

  • Coronary artery disease: thickens the arteries and obstructs the flow of oxygen-rich blood in the heart, causing the organ to become weakened.
  • Heart attack: Coronary artery disease which occurs suddenly and injures the heart muscle, reducing its ability to pump blood.
  • Heart valve disease
  • Hypertension: which causes a high blood pressure and forces the heart to work harder.
  • Abnormal heart rhythms: These include frequent and fast beatings, which can weaken the heart muscle, leading to heart failure.
  • Congenital heart disease: This kind of disease might cause an irregular heart structure or functioning which can lead to heart failure.
  • Diabetes: The abnormal sugar level can cause hypertension and coronary artery disease.
  • Certain diabetes medications: such as rosiglitazone and pioglitazone can cause heart failure.
  • Other medications: There are also some medications that raise the risk of developing heart failure or some other heart defects. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), certain anesthesia medications and some others for treatment of hypertension, cancer, blood disease, heart arrhythmia, nervous system diseases, mental disorders, conditions associated with the lungs or the urinary tract, inflammations and infections.
  • Alcohol consumption: which causes heart muscle weakened and develop heat failure.
  • Sleep apnea: The disruption of breathing while sleeping lowers the blood-oxygen levels, and might cause the heart to beat irregularly. This can lead to the weakening of your heart.
  • Smoking or use of tobacco: raise the risk of heart failure and heart diseases.
  • Being overweight
  • Viruses: can cause injury of the heart muscle.