What is Heart Failure?

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The term heart failure sounds like the heart is no longer working at all. Actually, heart failure, sometimes called HF, means that the heart isn’t pumping as well as it should. Congestive heart failure is a type of heart failure that requires timely medical attention, although sometimes the two terms are used interchangeably.

Your body depends on the heart’s pumping action to deliver oxygen- and nutrient-rich blood to the body’s cells. With heart failure, the weakened heart can’t supply the cells with enough blood. This results in fatigue and shortness of breath, and some people experience excessive coughing. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.

Heart failure diagram

Heart Failure

Heart failure is a term used to describe a heart that cannot keep up with its workload. The body may not get the oxygen it needs.

Heart failure is a serious condition, and usually there’s no cure. But many people with heart failure lead a full, enjoyable life when the condition is managed with heart failure medications and a healthy lifestyle. It’s also helpful to have the support of family and friends who understand your condition.

How the normal heart works

The heart is a strong, muscular pump a little larger than a fist. Its job is to pump the right amount of blood to all parts of the body. This is called circulation.

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The heart has four chambers:

  • Two upper chambers called atria (when talking about just one, it’s called an atrium)
  • Two lower chambers called ventricles

The right atrium takes in oxygen-depleted blood from the rest of the body and sends it through the right ventricle to the lungs, which infuse the blood with oxygen.

Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body.

The heart pumps blood to the lungs and to all of the body’s tissues. For the heart to work properly, the four chambers must beat in an organized way. A healthy heart has more than enough pumping ability to circulate blood properly.

What is heart failure?

Heart failure is a lifelong condition in which the heart muscle can't pump enough blood to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload.

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At first the heart tries to make up for this by:

  • Enlarging. The heart stretches to contract more strongly and keep up with the body's demand to pump more blood. Over time, this causes the heart to enlarge.
  • Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
  • Pumping faster. This helps increase the heart’s output.

The body also tries to compensate in other ways:

  • The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power.
  • The kidneys retain more salt and water rather than excrete it through urine. This creates increased volume of blood, which helps to maintain blood pressure and allows the heart to pump stronger. But over time this extra volume can overtask the heart, making heart failure worse.

These temporary measures mask the problem of heart failure, but they don’t solve it. Heart failure continues and worsens until these compensating processes no longer work.

Eventually the heart and body simply can’t keep up, and the person experiences fatigue, breathing problems or other symptoms that usually prompt a trip to the doctor.

The body’s compensation mechanisms help to explain why some people might not become aware of their condition until years after their heart begins its decline. (That is a good reason to have a regular checkup with your doctor.)

Heart failure can involve the heart’s left side, right side or both sides. However, it usually affects the left side first. Read more about the types of heart failure.

Heart Failure Tools and Resources

A wealth of information to help you successfully manage heart failure.