Heart Failure & Cardiomyopathy FAQ
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What is heart failure?
Heart failure, also called congestive heart failure, is a condition in which the heart can't pump enough oxygenated blood to meet the needs of the body's organs. The heart keeps pumping, but not effectively. Heart failure affects nearly five million adults in the United States.
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What is cardiomyopathy?
Cardiomyopathy is a more specific term for any disease of the heart muscle in which the heart loses its ability to pump blood effectively. The term 'cardiomyopathy' refers to the weak condition of the heart, while heart failure refers to the symptoms resulting from that weakness of the heart. These terms are often used interchangeably, but both describe abnormal heart function.
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What causes heart failure?
Heart failure can be caused by:
• Cardiac arrhythmias (heart rhythm problems)
• Chemotherapy for cancer
• Congenital heart disease (heart disease one was born with)
• Coronary artery disease (heart attacks or narrowed blood vessels)
• Diabetes and pre-diabetes
• Drug abuse, including alcohol, cocaine or methamphetamines
• High blood pressure (hypertension)
• Infections of the heart valves and/or heart muscle
• Genetic abnormalities and diseases that affect the muscular structure of the heart (Hypertrophic Cardiomyopathy)
• Infiltrative disease (diseases that deposit abnormal proteins in the heart, such as amyloidosis and sarcoidosis)
• Metabolic disorders
• Nutritional deficiencies
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What are the symptoms of heart failure?
Some people with a weak heart don't experience any symptoms in the early stages. Without treatment, a cardiomyopathy gets worse and symptoms may include:
• Bloating
• Dizziness, lightheadedness and fainting
• Fatigue and weakness
• Irregular or rapid heartbeats
• Loss of appetite and nausea
• Persistent cough
• Reduced urination
• Shortness of breath during rest, exercise, or lying flat
• Swelling of the legs and ankles, and occasionally, the abdomen
• Weight gain
The symptoms of heart failure may vary, and often resemble those of other medical conditions. Always consult your physician for a diagnosis.
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How is heart failure diagnosed?
Stanford Hospital's specialized team of cardiologists uses a multi-disciplinary approach to diagnosing and treating heart failure. Diagnosis by the heart failure medical team in Stanford Hospital's cardiomyopathy center begins with a complete medical history and physical examination. We usually perform further diagnostic testing to confirm a diagnosis of heart failure. Diagnostic tests for heart failure may include:
• Laboratory tests: Blood work can help us determine kidney and liver function, as well as the amount of stress on the heart.
• Echocardiogram (Echo): Uses sound waves to produce images of the motion of the heart's chambers and valves
• Electrocardiogram (ECG or EKG): Records the electrical activity of the heart, detects abnormal rhythms (arrhythmias), and detects heart muscle damage.
• Cardiac Catheterization: measures pressures in the heart and blood flow through the arteries that supply the heart (coronary arteries)
Please see our patient FAQs and related services for descriptions of the tests we perform routinely.
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How is heart failure treated?
Specific treatment for heart failure will be determined by your physician based on:
• Age, overall health, and medical history
• Disease progression
• Tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Opinion or preference
• The reason for heart failureTreatment of heart failure may include:
• Controlling risk factors such as:
- Losing weight if overweight
- Restricting salt and fat
- Quitting smoking
- Abstaining from alcohol
- Getting proper rest
- Controlling blood sugar if diabetic• Medications, including:
- Beta-blockers, which by blocking specific receptors on the cells that make up the heart, protect the heart against stress, allowing it to shrink in size and gain strength
- Vasodilators, such as Angiotensin converting enzyme (ACE) inhibitors to decrease the amount of stress on the heart and allow it to recover and gain strength. Angiotensin II receptor blockers (ARB) are used if ACE inhibitors are not tolerated. We use other medications like hydralazine or nitrates if the kidney function does not allow us to use ACEI or ARB.
- Diuretics ('water pills') to reduce the amount of fluid in the body
- Digitalis to increase heart strength and control rhythm problems
- Inotropes to increase the pumping action of the heart
- Antiarrhythmic medications to keep the heart's rhythm regular and prevent sudden cardiac death
- Aldosterone blockers to block the effects of aldosterone, which causes sodium and water retention• Implantable cardioverter defibrillator, to treat and prevent fast heart rhythms
• Biventricular pacing/cardiac resynchronization therapy - a new type of pacemaker that paces both sides of the heart simultaneously to coordinate contractions and improve pumping ability
• Surgical therapy, including surgery to repair or replace the valve if heart failure is caused by valvular heart disease
• Left ventricular assist device therapy (LVAD), an implantable, battery powered pump that improves symptoms and allows patients to return to a good quality of life