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Heart Failure - The Basics

What You Need to Know about Heart Failure

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Updated November 12, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Heart failure is a cardiac condition in which the heart is no longer able to function adequately to meet the body's needs. Because heart failure can be produced by many kinds of cardiac disease, it is among the most prevalent of cardiac problems. Patients with heart failure often suffer from shortness of breath and fatigue, and have difficulty with physical exertion. Their life expectancy is often significantly reduced.

Fortunately, a lot of progress is being made in the treatment of heart failure, and with aggressive therapy, both the symptoms and the risk of dying can be significantly reduced. But unfortunately, studies continue to show that many doctors fail to offer adequate treatment to their patients with heart failure. So if you have heart failure, it is very important to educate yourself about this condition and the available treatments. This way, you can help your doctor make sure you are getting the treatment you need.

The term "heart failure" itself is an imprecise one, since doctors use it to refer to several different kinds of cardiac conditions, each with its own set of causes, prognosis, and treatment. So the first step in educating yourself is to find out which specific type of heart failure you have. You can get this information from your doctor.

Types of Heart Failure

There are three general categories of heart failure -- dilated cardiomyopathy (cardiomyopathy is a term that means heart muscle disease), hypertrophic cardiomyopathy, and diastolic dysfunction. Once you know which category of heart failure you have, you can follow the links below to learn more about your condition.

Dilated cardiomyopathy is the most common variety of heart failure; most people who are told they have heart failure have dilated cardiomyopathy. Dilated cardiomyopathy is the end result of a large variety of heart diseases, especially coronary artery disease and valvular heart disease.

This type of heart failure occurs when the ventricles (the large pumping chambers of the heart) become weakened, flaccid and dilated. As a result, the pumping action of the heart becomes weak, the amount of blood pumped with each heart beat drops (or, to say it another way, the ejection fraction is reduced), and the body's organs may not receive their full quotient of blood. Pressures inside the heart increase, causing fluid to "back up" in the lungs, producing lung congestion -- a condition often called congestive heart failure. Cardiac arrhythmias -- including some life-threatening ones -- are common in patients with dilated cardiomyopathy. The outcome of a patient with dilated cardiomyopathy is strongly dependent on whether they receive the therapies that have been proven to reduce symptoms and prolong survival.

Hypertrophic cardiomyopathy is usually a genetic condition, and often runs in families. It is characterized by a thickening of the heart muscle, resulting in "stiff" ventricles. The stiffness impairs the filling of the heart, and can lead to episodes of extreme shortness of breath in some patients, especially during exercise. The thickening of the heart muscle also can cause an obstruction in the left ventricle similar to that seen with aortic stenosis. And some patients with hypertrophic cardiomyopathy have an increased risk of sudden death.

Diastolic dysfunction is similar to hypertrophic cardiomyopathy in that it is caused by a "stiffening" of the heart muscle, leading to impaired filling of the heart. But unlike hypertrophic cardiomyopathy, diastolic heart failure is often not accompanied by thickening of the heart muscle, and is not thought to be a genetic disorder. It tends to occur in older individuals, often in women, and often in people with high blood pressure. It is characterized by relatively sudden episodes of severe shortness of breath due to lung congestion.

If you have been told you have heart failure, one of the best things you can do to help yourself is to learn all you can about your condition. The links provided in this article should give you a good start.

Sources:

Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009; 119:e391.

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