There are two main types of heart failure:
The causes of each type are distinct, but both types of heart failure can result in long-term effects.
The most common symptoms of heart failure include:
- exercise intolerance
- shortness of breath
- feeling weak or fatigued
- weight gain
- swelling in the abdomen, legs, or feet
Some people may also experience dizziness, which can occur from the heart failure itself or from the medications that treat it.
Over time, because the heart isn’t providing oxygen-rich blood to the organs, you can start to develop dysfunction in the kidneys, anemia, and problems with electrolyte regulation.
It’s important to take a “cocktail” of heart failure medications to minimize this risk of complications to other organs.
Heart failure is a serious condition that can increase the risk of many complications, including death.
According to the Centers for Disease Control and Prevention (CDC), heart failure was the contributing cause of 1 out of 8 deaths in the United States in 2017.
That said, the number of people dying from heart failure in the United States has gone down over time due to the use of heart failure medications.
One cause of death from heart failure could be cardiac arrhythmias, which cause the heart muscle to beat erratically.
To minimize this risk, some people who are diagnosed with heart failure get an implantable cardiac defibrillator (ICD) to shock their heart back into a normal rhythm if an arrhythmia occurs.
Another cause of death from heart failure is progressive weakening of the pumping function of the heart muscle, which leads to inadequate blood flow to organs.
Eventually, this can result in kidney and/or liver dysfunction. It can also lead to extremely reduced exercise tolerance with shortness of breath occurring with minimal exertion or even at rest.
When that happens, you’re usually evaluated for therapies like heart transplantation or a type of mechanical assistance device called a ventricular assist device (VAD).
After the diagnosis of heart failure, survival estimates are 50 percent at 5 years and 10 percent at 10 years.
These numbers have improved over time and will hopefully continue to improve with the development of better medications for heart failure.
Many people who are diagnosed with heart failure can live meaningful lives. Life expectancy with heart failure depends on a number of factors, including:
- the type and severity of heart failure
- the presence of organ dysfunction
- the levels of anemia and other markers in your blood
- your age
- the cause of heart failure
- your genetics
Compliance with and response to heart failure medications also determine life expectancy, so you can improve your life expectancy by taking the right heart failure medications as prescribed.
High-sodium foods can be especially risky for most people who are diagnosed with heart failure, as sodium can put excess stress on the heart. Foods that are high in sodium include:
- processed foods
- restaurant or takeout food
- processed meats
- frozen or canned foods and soups
- salted nuts
The American Heart Association reports that 9 out of 10 Americans consume too much sodium. For optimal heart health, you should consume no more than 1,500 milligrams (mg) of sodium per day.
But your doctor may set a different sodium target for you, depending on factors like:
- stage and class of heart failure
- kidney function
- blood pressure
If you’re also diagnosed with kidney dysfunction and are taking a diuretic medication (“water pill”), like spironolactone or eplerenone, your doctor may also recommend following a low-potassium diet.
This means limiting intake of foods like:
If you’re taking warfarin, your doctor may recommend limiting consumption of foods high in vitamin K, like kale or swiss chard.
If the heart failure is due to diabetes or coronary artery disease, your doctor may recommend limiting intake of foods high in:
Work with your doctor to determine which foods you should limit based on your individual medical history.
Heart failure is a serious condition that increases the risk of hospitalization and of dying from heart disease.
Left untreated, heart failure is likely to progress and get worse over time. It’s important to follow instructions from your doctor to minimize the risk of progression.
Heart failure progresses for several reasons:
- the underlying risk factors for heart failure (blockages in the arteries, high blood pressure, diabetes, sleep apnea) are still present
- the weakened heart beats harder and faster to keep up and releases “stress” chemicals that make it weaker over time
- habits like high-sodium intake that put further stress on the heart
For this reason, you need to:
- treat the underlying risk factors
- watch your sodium intake
- get regular exercise
- take the “cocktail” of heart failure medications your doctor prescribes in order to prevent heart failure from getting worse
The generic term “heart failure” is used for both systolic and diastolic types, but they’re significantly different in terms of their pathology.
Systolic heart failure refers to a problem with the contracting, or squeezing, of the heart muscles. As a result, the heart has trouble pumping the blood forward, causing it to back up in the lungs and the legs.
The weakening of the heart muscle also activates hormones and chemicals in the body, which can cause further:
- sodium and water retention
- fluid overload
- weakening of the heart muscle
Therapies for systolic heart failure are aimed at interrupting this reaction to help the heart hold onto fluid and get stronger over time.
Diastolic heart failure refers to a problem with relaxation and an increase in the stiffening of the heart muscle. In diastolic heart failure, the heart is stiff and causes high pressures, resulting in a backup of fluid in the lungs and the legs.
Both types of heart failure can lead to similar symptoms like:
- shortness of breath
- swelling in the legs
- fluid accumulation in the lungs
- decreased exercise tolerance
Heart failure can cause fluid retention.
Those who are diagnosed with heart failure are usually instructed to limit their daily fluid intake to 2,000 to 2,500 milliliters (mL) or 2 to 2.5 liters (L) per day. This includes all types of fluid intake, not just water.
However, too little fluid intake can increase dehydration and the risk of problems such as damage to the kidneys.
Your optimal fluid intake goal should be based on multiple factors, such as:
- the type of heart failure you have (systolic or diastolic)
- whether you take a diuretic medication
- your kidney function
- your sodium intake
- whether you’ve been hospitalized in the past for fluid retention
Based on these factors, you and your doctor can decide what your ideal fluid intake should be.
Dr. Kohli is an internationally recognized researcher and noninvasive cardiologist who specializes in preventive cardiology. She received two undergraduate Bachelor of Science degrees in biology and brain and cognitive science with a concentration in economics. She graduated with a perfect GPA, receiving the most outstanding academic record distinction. She went on to Harvard Medical School for her MD degree and again graduated at the top of her class with a magna cum laude distinction. She completed her internal medicine residency at Harvard Medical School/Brigham & Women’s Hospital in Boston.
From there, Dr. Kohli participated in a research fellowship at the Harvard Medical School’s prestigious Thrombolysis in Myocardial Infarction Study Group, a leading academic research organization. During this time, she authored several dozen publications on cardiovascular risk stratification, disease prevention, and treatment, and became a nationally recognized rising star in the world of cardiovascular research. She then completed a clinical fellowship in cardiology at the University of California, San Francisco, followed by advanced fellowship training in both cardiovascular disease prevention and echocardiography at UCSF, before returning home to Denver to practice noninvasive cardiology.