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Heart Failure

Heart Failure and You

Heart failure is a condition in which the heart doesn't work like it's supposed to. Around 5 million people in the United States have heart failure. About 550 thousand new cases are diagnosed each year. More than 287 thousand people in the United States die each year with heart failure.1 Heart failure is the most common reason for hospitalization among people on Medicare. 2

The series of events that happen in heart failure are listed below:

  1. Weak Blood Pumping Ability - Heart Failure is a condition in which the heart muscle has become weaker than normal and doesn’t pump like it’s supposed to. The heart is unable to pump enough blood and oxygen to meet the body's needs.
  2. Swelling & Shortness of Breath - When this happens, blood that should be pumped out of the heart backs up in the lungs and other parts of the body. This is why many people with heart failure have shortness of breath or swelling in the extremities. Sometimes you may hear heart failure called CHF (congestive heart failure).
  3. Increasing Heart Damage - As the heart strains to do its’ work, the heart muscle fibers stretch and the chambers of the heart become enlarged. This further weakens the heart's ability to perform.

Heart failure usually occurs gradually over a period of time.

How Your Heart Works

The heart is divided into four chambers or sections called the right and left atrium and the right and left ventricle. These chambers are separated by valves. Valves allow the blood to move from chamber to chamber without backing up.

The right upper and lower chambers supply blood to the lungs. The left upper and lower chambers supply oxygen-rich blood to the tissues in the body.

Ejection Fraction - With each heartbeat, a normal left ventricle pumps out or "ejects" 55 - 60% of the blood it receives. This is known as the "ejection fraction". In heart failure, the heart pumps less blood with each beat, so the "ejection fraction" goes down.

Because the tissues are receiving less blood and oxygen, they are unable to perform their functions properly. Activities such as walking, climbing stairs and carrying objects become more difficult.

Heart failure, or pumping weakness, can start in the right or left chamber, or be in both.

Causes of Heart Failure

Heart failure can be caused by conditions that damage the heart or conditions that cause the heart to work harder than it should. Causes of heart failure include:

Remember, take time to enjoy your life. Stay close to family and friends who will give you support and encouragement. Taking control of your illness and following the guidelines discussed in these articles can contribute to many years of enjoyable living.

1 American Heart Association. Heart Disease and Stroke Facts, 2006 Update. Dallas, Texas: AHA, 2006.

2 Elixhauser A, Yu K, Steiner C, Bierman, AS Table 4. Most Common reasons for hospitalizations by age groups, in Hospitalization in the United States, 1997, Rockville (Md): Agency for Healthcare Research and Quality, 2000, HCUP Fact Book; AHRQ Publication No. 00–0031.

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Last Reviewed: Feb 11, 2009

Case Western Reserve University Ileana L Piña, MD
Professor, VA Quality Scholar
Louis Stokes VA Medical Center
School of Medicine
Case Western Reserve University
Ileana L Piña, MD