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What is heart failure?



Heart failure occurs when the heart loses its ability to pump enough blood through the body. Usually, the loss in pumping action is a symptom of an underlying heart problem, such as coronary artery disease.

The term heart failure suggests a sudden and complete stop of heart activity. But, actually, the heart does not suddenly stop. Rather, heart failure usually develops slowly, often over years, as the heart gradually loses its pumping ability and works less efficiently. Some people may not become aware of their condition until symptoms appear years after their heart began its decline.

How serious the condition is depends on how much pumping capacity the heart has lost. Nearly everyone loses some pumping capacity as he or she ages. But the loss is significantly more in heart failure and often results from a heart attack or other disease that damages the heart.

The severity of the condition determines the impact it has on a person's life. At one end of the spectrum, the mild form of heart failure may have little effect on a person's life; at the other end, severe heart failure can interfere with even simple activities and prove fatal. Between those extremes, treatment often helps people lead full lives.

But all forms of heart failure, even the mildest, are a serious health problem, which must be treated. To improve their chance of living longer, patients must take care of themselves, see their physician regularly, and closely follow treatments.

Types of heart failure
The term congestive heart failure is often used to describe all patients with heart failure. In reality, congestion (the buildup of fluid) is just one feature of the condition and does not occur in all patients. There are two main categories of heart failure although within each category, symptoms and effects may differ from patient to patient. The two categories are:

Systolic heart failure - This occurs when the heart's ability to contract decreases. The heart cannot pump with enough force to push a sufficient amount of blood into the circulation. Blood coming into the heart from the lungs may back up and cause fluid to leak into the lungs, a condition known as pulmonary congestion.

Diastolic heart failure - This occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle has become stiff, losing its ability to relax. This form may lead to fluid accumulation, especially in the feet, ankles, and legs. Some patients may have lung congestion.

Read what Dharam Pal Jain, M.D., a cardiologist with Columbia St. Mary's, advises heart failure patients.

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