Heart Failure

Congestive heart failure — or simply heart failure — is a serious heart condition affecting millions of Americans. It is usually a chronic condition brought on by weakness in the functioning heart, not a loss of functioning altogether. The term “failure,” in this case, denotes the failure of the heart’s muscular left ventricle to pump enough blood out of the heart to meet the demands of the body, causing a backup, or “congestion,” of blood in the veins and tissues.

Over time, this condition worsens. The heart beats more rapidly to compensate for its weakness, putting itself under great strain. Often the heart enlarges or “remodels” itself, stretching its walls thin and undermining itself further. Without treatment, the backup of blood and fluids in the body eventually wreaks havoc on other bodily systems and organs, resulting in death. However, by working with doctors and choosing the right treatments, patients with heart failure can improve their rate of survival and lead full lives in spite of the condition.

Heart failure can have any number of causes, but among the most common are heart attack and cardiomyopathy. A heart attack (myocardial infarction) can destroy part of the heart muscle, leaving so much tissue damaged or dead that the heart cannot function at full capacity. Cardiomyopathy, or weakening of the heart muscle, typically results from infection or disease of the heart, which leaves it unable to squeeze out enough blood with each beat.

Narrowed arteries restrict the flow of blood out of the heart, burdening the heart muscle with the task of pumping more blood through tighter passageways. Wear-and-tear on the overworked heart gradually erodes its ability to perform. Indeed, high blood pressure (hypertension), regardless of its cause, most certainly contributes to heart failure.

Infection or disease of the heart valves (valvular disease) and heart defects may also contribute to heart failure, but these are less common causes.

Because heart failure often has its root cause in another condition such as coronary artery disease or high blood pressure, the risk factors for the condition encompass the risk factors for many other cardiovascular diseases and conditions. They are the usual suspects: age; a diet high in fat, cholesterol, or sodium; lack of exercise; obesity; smoking; and abuse of alcohol. In addition, people who have suffered a heart attack are far more likely to develop heart failure than the general population.

Other events in a person’s medical history can also contribute to or cause heart failure. People who have undergone chemotherapy to treat cancer, for example, sometimes sustain heart tissue damage as a result — damage that eventually leads to heart failure.

Cardiologists can use an echocardiogram, or “echo” — an ultrasound image of the heart — to monitor the heart function of high-risk patients for signs of heart failure, even before any symptoms show up.