Heart Failure (HF)

Heart failure (HF), previously called congestive heart failure, is a serious condition most commonly caused by weak pumping of the heart muscle. Poor heart pumping function can cause fatigue, leg swelling, and difficulty breathing, particularly with exertion. Lifestyle changes, medication, pacemakers, defibrillators and even open heart surgery can be used to treat heart failure.

Heart failure is when the heart fails to pump enough blood to the organs in the body. As blood travels from the lungs to the heart, it may back up. If fluid stays in the lungs, breathing becomes difficult. The build up of fluid is the reason for the term "congestive heart failure." A heart that is "failing" has damaged or stretched muscle. The damage can impair the electrical system in the heart. If this happens, the heartbeat may be too fast, too slow, or unsteady. Heart rhythm problems are common in people with heart failure.

Symptoms & Signs

In the early stages, people with heart failure might not be aware of any symptoms. But as it progresses, one or more of the following symptoms may begin to appear:

  • Shortness of breath (dyspnea) - A feeling of breathlessness, as if you can't get enough air, may come on during physical activity. In more advanced heart failure, shortness of breath occurs at rest or can awaken patients from sleep. Propping yourself up with extra pillows may help you breathe more easily at night.
  • Fatigue - Activities that did not feel strenuous to you before, such as walking or climbing stairs, may easily tire you out. You may even feel exhausted while resting, when you haven't been active at all.
  • Chronic coughing or wheezing - Fluid congestion (a buildup of fluid in the lungs) is common with heart failure, and is the reason why doctors often refer to it as "congestive heart failure" (CHF). This congestion can make you wheeze and cough. Some people cough up mucous or phlegm.
  • Fluid retention or swelling - Fluid also can build up in other parts of your body, such as your feet, ankles, legs, and abdomen. Swelling, or edema, is the most obvious sign of fluid buildup, but weight gain also may be a signal. This fluid buildup in the abdomen makes some people lose their appetite or feel nauseated.
  • Rapid or irregular heartbeat - Your weakened heart may try to beat faster to send more blood through your system, making you feel like your heart is racing. Or it may trigger an arrhythmia, which can cause palpitations, heart pounding, or other symptoms.
  • Confusion - The reduced blood flow to your brain may cause feelings of confusion, impaired thinking, or mental sluggishness.


Treatment of heart failure is aimed towards living longer, reducing symptoms, and improving quality of life. Treatment options include the following:

  • Diet and lifestyle changes
  • Medications
  • Treatment of underlying causes, such as clogged arteries, heart valve disease, high blood pressure, and heart rhythm problems
  • Cardiac resynchronization therapy (CRT) or other implantable cardiac devices
  • Surgery to repair structural damage
  • Heart transplantation

Risk Factors

While in some cases there is no apparent reason the heart would be weakened, some conditions can damage the heart and weaken the heart muscle. These conditions include:

  • Coronary artery disease, especially with a prior heart attack
  • High blood pressure
  • A virus
  • An arrhythmia (irregular heart rhythm)
  • Diabetes
  • Diseases of the heart muscle or valves
Last updated on November 02, 2022

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