Heart Failure

What is heart failure?

Heart failure, also called congestive heart failure, is a condition in which the heart canít pump enough oxygenated blood to meet the needs of the body's organs. The heart keeps pumping, but not efficiently. Heart failure affects nearly five million adults in the United States.

What causes heart failure?

Heart failure can be caused by:

What are the symptoms of heart failure?

Symptoms of heart failure can vary, but may include:

  • Shortness of breath during rest, exercise, or lying flat
  • Weight gain
  • Visible swelling of the legs and ankles, and occasionally, the abdomen
  • Fatigue and weakness
  • Loss of appetite and nausea
  • Persistent cough
  • Reduced urination
The symptoms of heart failure resemble those of other medical conditions. Always consult your physician for a diagnosis.

How is heart failure diagnosed?

Stanford Hospitalís specialized team of cardiologists uses a multi-disciplinary approach to diagnosing and treating heart failure. Diagnosis by the heart failure medical team in Stanford Hospitalís Cardiomyopathy Center begins with a complete medical history and physical examination. Diagnostic tests for heart failure may include:

  • Chest x-ray -- uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs.
  • 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, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
  • B-type natriuretic peptide (BNP) testing -- a blood test that show the level of the hormone BNP. BNP is released from the ventricles (pumping chambers of the heart) in response to increased wall tension that occurs with heart failure.

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

If heart failure is caused by valvular heart disease, surgery is usually performed to repair or replace the valve. If heart failure is caused by a disease such as anemia, then the disease is treated.

Treatment of heart failure may include:

  • Controlling risk factors
    • Losing weight if overweight
    • Restricting salt and fat
    • Quitting smoking
    • Abstaining from alcohol
    • Getting proper rest
    • Controlling blood sugar if diabetic
  • Medication, such as:
    • Angiotensin converting enzyme (ACE) inhibitors to decrease the pressure inside the blood vessels, or angiotensin II receptor blockers if ACE inhibitors are not tolerated
    • Diuretics to reduce the amount of fluid in the body
    • Vasodilators to dilate the blood vessels and reduce workload on the heart
    • Digitalis to increase heart strength and control rhythm problems
    • Inotropes to increase the pumping action of the heart
    • Antiarrhythmia medications to keep the heartís rhythm regular and prevent sudden cardiac death
    • Beta-blockers to reduce the heart's tendency to beat faster by blocking specific receptors on the cells that make up the heart
    • Aldosterone blockers to block the effects of aldosterone, which causes sodium and water retention
  • 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.
  • Heart transplant