What Is Heart Failure?

Heart failure is a common and serious medical condition. Despite its misleading name, a heart with heart failure doesn't suddenly stop working. Instead, heart failure develops slowly as the heart muscle gradually weakens. The "failure" refers to the heart's inability to pump enough blood to meet the body's needs.

In a healthy heart, the chambers contract and relax in a coordinated way, or in synchrony. Think of how your hand makes a fist. The fingers open and close together.

For people with heart failure, their hearts do not pump as strongly as they should and so blood does not circulate as well as it should. In other words, pumping function declines.

Heart Failure Patient

My heart was getting weaker. I couldn’t walk a block without stopping. It got so embarrassing that I would stop and pretend that I was waiting for someone. It just got worse and worse and worse.

Sadie Edwards

With heart failure, your body generally tries to compensate for any physical problem, including reduced pumping function. Sometimes the body's responses help in the short term, but they cause even more problems over the long term. As a result, heart failure is progressive, meaning that it gets worse over time. Doctors try to slow the progression and reduce the symptoms of heart failure.

Problems Heart Failure Can Cause

Below is a partial list of the problems heart failure can cause. Each problem, in turn, causes other problems:

  • Inadequate blood flow to tissues. When blood flow to the tissues is inadequate, you may have fatigue and shortness of breath, which in turn can cause a faster heart rate.
  • Inadequate blood flow to the kidneys. If the kidneys do not receive enough blood, you may have water retention, tissue swelling, and high blood pressure. All of these problems can cause the heart to work even harder.
  • Release of hormones. If your body releases certain hormones, your blood pressure may go up, causing your heart to work harder.
  • Enlarged heart. If the heart becomes enlarged, the timing and coordination of your heartbeats may be interrupted, causing even more problems with pump function.

How common is heart failure?

Heart failure is a common health problem today:

  • 22 million people around the world1 (more than 5.5 million in the United States2) have heart failure.
  • Heart failure is one of the leading causes of hospitalization for people aged 65 and older.2
  • One out of every five people at 40 years old in the U.S. will develop heart failure in their lifetime.2

Why are more people diagnosed with heart failure today? Overall we live longer today, and heart failure mostly affects older people. Also, people who have other heart problems – such as, heart attacks – get better treatment today. They live longer, too, but they are more likely to have heart failure because of damage to their heart muscle. Thus, people with heart or blood vessel problems are more prone to heart failure. As doctors improve the care for people with heart failure, many patients can live better and longer lives.

How serious is heart failure?

Many people live for years with symptoms of heart failure. However, heart failure is a serious, progressive disease that can eventually cause or contribute to death. The symptoms of heart failure occur because the heart muscle has suffered damage and can't keep up with the body's needs. The heart's enlargement and inability to pump tend to increase with time.

Also, heart failure patients can be more prone to abnormal heart rhythms, which increase the risk of sudden death. From 1993-2003, deaths from heart failure increased 20.5%.2People with heart failure usually die of either pump failure or sudden cardiac death.

Many heart failure deaths occur suddenly. You may have heard this problem described as cardiac arrest or sudden cardiac death (SCD).

What happens when someone has a sudden death event? The electrical impulses telling the heart to contract are sent too quickly through the heart muscle. The heartbeat becomes so rapid and chaotic that blood cannot move through the heart's chambers. Blood is not pumped out to the brain and other organs. The person then passes out from lack of oxygen in the brain. If untreated, the person can die within a few minutes.

A person with heart failure is six to nine times more likely to experience sudden death than someone who does not have heart failure.2