Essential Heart Failure Information
Rethinking what heart failure means to you
Understanding what heart failure is…and what it’s not
Heart failure can be a frightening and confusing diagnosis to hear from your doctor. Especially because your heart has not stopped working or failed.
You can feel reassured knowing you are not alone. In fact, there are millions of people living active lives with heart failure all around the world. Although heart failure is serious, it’s a condition you can learn to live with. Working together with your healthcare team will allow you to take an active role in managing your heart failure symptoms. Your doctor will guide you to the treatments that are right for you and discuss steps you can take to help you feel better.
You’ve taken an important first step by starting to educate yourself about heart failure. We encourage you and your caregiver to read through the information on this site and discuss it together, as well as with your healthcare team.
Heart failure is NOT the same as a heart attack
Heart attack
A heart attack occurs suddenly and unexpectedly when the arteries supplying blood to the heart are blocked and typically results in the death of part of a heart muscle.
Heart failure
Heart failure is a chronic (long-term) condition in which the heart can’t pump enough blood to meet the needs of the body. Some health conditions can lead to heart failure.
How the heart works
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Your heart is a fist-sized muscle
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It is part of the circulatory system, which is a network of blood vessels that delivers blood to the rest of your body
Your heart is responsible for pumping the right amount of blood throughout your body. This is important because your blood carries oxygen and nutrients that your organs need to work properly.
Your heart is made up of 4 separate chambers that pump blood.
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All 4 chambers work together in a continuous and coordinated effort to keep the blood moving throughout your body
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What happens when you have heart failure?
Heart failure is a condition that happens when your heart is having a hard time pumping blood to the rest of your body.
This means that your organs aren’t getting enough of the oxygen-rich blood they need to stay healthy.
There are different heart failure types
Heart failure can involve the heart’s left side, right side, or both sides. However, it usually affects the left side first. Your doctor will decide which treatments may be best for you based on the type of heart failure you have.
What is ejection fraction?
The ejection fraction (EF), measured as a percentage, helps describe how well the heart is pumping blood to the body:
‘Ejection’ refers to the amount of blood that is pumped out of the heart's main pumping chamber, the left ventricle, during each heartbeat.
‘Fraction’ refers to the fact that, even in a healthy heart, some blood always remains within this chamber after each heartbeat.
Blood pumped out during each contraction:
Normal EF = ≥ 50%
Borderline EF = 41% to 49%
Reduced EF = ≤ 40%
Seeing how well your heart is pumping out blood can help your doctor diagnose and monitor heart failure.
Your doctor may mention one of these 2 EF-related diagnoses:
Heart failure with reduced ejection fraction or HFrEF: The heart has trouble pumping out the right amount of blood, and the value for EF will be lower than normal. This can happen when the heart muscle becomes weak and stretched.
Heart failure with preserved ejection fraction or HFpEF: The heart muscle may become too stiff to relax properly. The value for EF is still in the normal range, but not enough blood is able to get into the heart, so less blood is being pumped out to the rest of the body.
Functional classes of heart failure
Doctors usually classify heart failure according to the severity of the person’s symptoms. The most commonly used classification system, the New York Heart Association (NYHA) Functional Classification, places people in 1 of 4 categories based on how much they are limited during physical activity.
Class |
Symptoms |
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I |
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation (heart feels like it is racing, fluttering, or skipping a beat), and/or dyspnoea (shortness of breath). |
II |
Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, and/or dyspnoea. |
III |
Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, and/or dyspnoea. |
IV |
Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. |
Other health conditions may lead to heart failure
The health conditions listed below can weaken the heart, leading to heart failure. Having more than one of these factors dramatically increases your risk.
Past heart attack (myocardial infarction):
When one of your arteries that supply blood to your heart gets blocked, it is called a myocardial infarction, or more commonly, a heart attack. This is dangerous because it denies oxygen and nutrients to the heart, which damages muscle tissue. Damaged heart tissue does not contract as well, making it harder for the heart to pump blood.
Heart valve problems:
Heart valve problems can result from disease, infection, or a birth defect. When the valves don't open or close completely during each heartbeat, your heart muscle works harder to keep the blood moving. If the workload becomes too great, you experience heart failure.
High blood pressure (hypertension):
When the pressure in your blood vessels is too high, your heart pumps harder than usual to keep the blood circulating. Over time, this can weaken the chambers of the heart.
Diabetes
People with diabetes often develop hypertension and atherosclerosis (a buildup of cholesterol and fatty deposits in the heart's arteries), which may contribute to heart failure.
An overactive thyroid gland (hyperthyroidism):
This condition causes the body to work faster, and the heart can be overworked trying to keep up.
Abnormal heart rhythm (arrhythmia or dysrhythmia):
An abnormal heart rhythm could mean that your heart beats too fast, too slow, or irregularly. This can be dangerous because your heart may not be able to pump enough blood to meet your body’s needs.