Heart failure is a condition in which the heart can't pump blood effectively to the lungs or the rest of the body. This can be because the person has developed a weakened heart muscle or because the heart muscle has thickened, making it difficult to fill the heart, backing up blood into the lungs.
With heart failure, the weakened heart pumps less blood than usual -- causing the kidneys and adrenal glands to produce chemicals that help the body to hold onto salt and water. In addition, the blood vessels constrict to try to raise the blood pressure. This makes it even harder for the heart to push blood through the arteries on the next beat.
With congestion, the legs and ankles may swell because the body is holding onto salt and water. Fluid may also collect in the lungs and interfere with the ability to breathe, especially when lying down. Left untreated, heart failure worsens and may prevent the heart from pumping enough blood to keep the person alive.
Doctors divide heart failure cases into four levels of increasing severity:
- Class I: Physical activity is unaffected, and the patient has no unusual fatigue, shortness of breath, palpitations, or pain during normal activities.
- Class II: The patient may experience mild fatigue, shortness of breath, palpitations, or pain during normal activities; slight limitations on normal activities.
- Class III: The patient experiences fatigue, shortness of breath, palpitations, or pain during normal activities; activities are dramatically limited.
- Class IV: The patient is uncomfortable even at rest. Discomfort increases with any physical activity.
Doctors also classify heart failure as the primary problem, whether it is a problem pumping the blood out due to a weakened heart (systolic dysfunction), or if the patient has problems filling the ventricle, raising pressure in the lungs (diastolic dysfunction), also called heart failure with normal ejection fraction. This second problem now accounts for almost half of the heart failure seen in this country and becomes the dominant type of heart failure in the elderly.
In some cases, medication and lifestyle changes enable patients to live nearly normal lives. Your outlook depends on how well your heart is functioning, your symptoms, and how well you respond to your treatment plan.
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