Heart failure is a chronic medical condition where the heart is unable to pump blood effectively to meet the body’s demands for oxygen and nutrients. Despite the name, heart failure does not mean the heart has stopped working completely. Instead, it signifies that the heart is weakened or too stiff to function efficiently. This inefficiency causes a cascade of effects throughout the body.

This inefficiency triggers widespread effects, including fluid accumulation in the lungs, legs, or abdomen, leading to symptoms such as shortness of breath, swelling, and fatigue. The condition can progressively worsen over time if left untreated, putting increasing strain on the heart and other vital organs. Despite its seriousness, heart failure is manageable with timely diagnosis, lifestyle changes, medications, and advanced therapies, enabling many individuals to maintain a good quality of life.

1. Left-Sided Heart Failure

The most common type, it occurs when the left ventricle doesn’t pump blood effectively to the rest of the body. This can cause fluid buildup in the lungs.

Subtypes of Left-Sided Heart Failure

• Systolic Heart Failure (HFrEF):

  The heart muscle loses its ability to contract and pump blood forcefully.

• Diastolic Heart Failure (HFpEF):

  The heart becomes stiff and can’t fill with enough blood between beats.

2. Right-Sided Heart Failure

Right-sided heart failure occurs when the right ventricle, which pumps blood to the lungs for oxygenation, becomes unable to do so effectively. This results in fluid accumulation in the lower body, including the legs, feet, and abdomen, and may also affect the liver.

Causes and Symptoms

• Causes: Often caused by left-sided heart failure, as increased pressure in the lungs can strain the right ventricle. Other causes include lung diseases such as pulmonary hypertension or chronic obstructive pulmonary disease (COPD).

• Symptoms: Symptoms include swelling (edema), fatigue, and discomfort or fullness in the abdomen due to fluid buildup.

3. Congestive Heart Failure (CHF)

The term congestive heart failure is used when fluid buildup (congestion) becomes severe, affecting multiple parts of the body, including the lungs, abdomen, and limbs. This condition may involve both sides of the heart and is often accompanied by pronounced symptoms, such as:

• Persistent shortness of breath, even at rest or during sleep.
• Swelling in the legs, feet, and abdomen.
• A feeling of fullness or bloating due to fluid retention in the abdomen.

Coronary Artery Disease (CAD)

Coronary artery disease is a leading cause of heart failure. It occurs when the arteries supplying blood to the heart become narrowed or blocked due to the buildup of fatty deposits (atherosclerosis). This reduces blood flow to the heart muscle, depriving it of oxygen and nutrients, which weakens its ability to pump efficiently. Over time, chronic oxygen deprivation leads to heart muscle damage, making CAD a significant risk factor for heart failure.

High Blood Pressure (Hypertension)

Chronic high blood pressure forces the heart to work harder than normal to pump blood throughout the body. This increased workload causes the heart muscle to thicken (hypertrophy) or stiffen, impairing its ability to fill with or pump blood effectively. Left untreated, hypertension can lead to long-term damage to the heart and is a major contributor to heart failure.

Heart Attack (Myocardial Infarction)

A heart attack occurs when blood flow to a part of the heart is completely blocked, causing damage to the heart muscle. This damage weakens the affected area, reducing the heart’s overall ability to pump blood. If a significant portion of the heart muscle is affected, the risk of developing heart failure increases dramatically.

Cardiomyopathy

Cardiomyopathy refers to diseases of the heart muscle that impair its structure or function. It can be inherited (genetic) or acquired due to factors like infections, alcohol abuse, chemotherapy, or other chronic conditions. Depending on the type, cardiomyopathy can lead to weakened, enlarged, or stiff heart muscle, all of which compromise the heart’s ability to pump blood effectively.

Valvular Heart Disease

The heart’s valves ensure that blood flows in the correct direction through the heart chambers. When these valves become damaged or malfunction (due to conditions like valve stenosis or regurgitation), they disrupt normal blood flow. This causes the heart to work harder to compensate, leading to strain and, eventually, heart failure. Valvular heart disease can arise from infections, aging, or congenital defects.