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Am Fam Physician. 2008;77(7):967-968

See related article on heart failure.

What is heart failure?

Heart failure is one of the most common causes of heart-related illness and death in the United States. It happens when the heart can't pump enough blood through your body. The blood backs up and fluid clogs your veins, tissues, and lungs.

What causes it?

Many things can cause heart failure, such as high blood pressure, an infection, damaged valves inside the heart, or severe lung disease. It can also be caused by a blockage in the vessels that carry blood away from your heart (called coronary artery disease), especially after a heart attack.

Sometimes, your doctor can't find a cause for your heart failure. Some things may cause symptoms of heart failure or make the symptoms worse, such as being overweight, eating too much salt or drinking too much fluid, or feeling stressed. An overactive or underactive thyroid gland, a high fever, or low levels of red blood cells may also cause symptoms or make them worse.

What are the symptoms?

You may feel tired or lose your appetite. You could get short of breath, especially during exercise, and you may wake up at night because you are having trouble breathing. Your ankles and feet may swell and you may gain weight because there is too much fluid in your body.

How do I know if I have it?

Your doctor will ask about your symptoms and examine you. You may need blood and urine tests and an x-ray of your chest. Your doctor may do other tests to check the size of your heart and how it is working.

How is it treated?

Your doctor may give you medicine to ease the amount of work your heart has to do, get rid of the extra fluid in your body, and improve the way your heart pumps. He or she will also treat the problems that make your symptoms worse.

How long do the effects of heart failure last?

Even with treatment, heart failure is a serious disease. Treatment can usually help you live normally and live longer with fewer symptoms. Your doctor will still need to monitor the disease that caused your heart failure.

How can I take care of myself?

  • Get enough rest. Work fewer hours if possible.

  • Reduce stress. Stress can raise your heart rate and blood pressure. Talk to your doctor about ways to reduce stress.

  • Do not become too tired or get too short of breath.

  • Avoid doing things that make you too hot or too cold (for example, using hot tubs) because they can make your heart work harder.

  • Take your medicine on time and see your doctor regularly.

  • Check your pulse every day.

  • Weigh yourself at least every other day, at the same time of day if possible. Talk to your doctor if you gain more than three pounds in one week or if you keep gaining weight over weeks to months.

  • Learn how to take your own blood pressure or have a family member learn how to take it.

  • Try not to eat or drink too much. Follow a healthy diet plan and ask your doctor how much fluid you should drink.

  • Eat less salt, but be careful if you eat salt substitutes. Many of them have high levels of potassium. Some of the medicines used to treat heart failure raise the levels of potassium in your blood, and eating salt substitutes can raise your potassium levels even more.

  • Be aware of the symptoms of potassium loss, such as muscle cramps or weakness, feeling annoyed or impatient, and having an irregular heartbeat.

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