Heart failure is what happens when your heart does not pump enough blood throughout the body. It does not mean that the heart has stopped working. Instead, it means your heart isn’t strong enough to pump blood properly, or isn’t able to fill with enough blood. This article discusses the different types of heart failure.
Overview of heart failure
In the United States, approximately 6.2 million adults suffer from heart failure. Heart failure can be acute, which means it happens quickly. Or it can develop over time as your heart weakens. This is considered chronic heart failure.
Heart failure often occurs due to another medical condition that causes heart damage, including:
Heart failure can affect other parts of the body, including the kidneys and liver. This is why it is so important to see a doctor for heart failure and manage it properly. With the right treatments, many people with heart failure can live long and fulfilling lives.
Types of heart failure
There are several anatomical types of heart failure:
You’ve probably also heard of congestive heart failure. It is not a type of heart failure; rather, it is a symptom that can occur with any of the three types listed above.
It is also possible to have more than one type of heart failure.
Left heart failure
The left side of your heart pumps blood throughout the body. With left heart failure, the left ventricle, also known as the lower left chamber, either does not pump blood as well as it normally should or cannot fill with blood properly. Left heart failure is the most common type of heart failure.
Symptoms of left heart failure
- Chest pain
- Intolerance to exercise
- Fast or irregular heartbeat
- Edema (swelling of tissues, such as the ankles or wrists)
- Shortness of breath
Diagnosis and typing
A type of measurement called an ejection fraction is used to assess how efficiently the heart is pumping blood. An ejection fraction measurement can help indicate what type of left heart failure you have:
- Systolic heart failure is used to indicate that the left ventricular muscle cannot properly pump blood. The ejection fraction is lower than normal. This is also called heart failure with reduced ejection fraction.
- Diastolic heart failure is used to indicate that the left ventricle is not filling with blood as it should during the diastolic phase. The ejection fraction is normal or close to normal. We also speak of heart failure with preserved ejection fraction. With diastolic heart failure, the left ventricle pumps well but pumps less blood than it normally would.
Knowing your ejection fraction is helpful if you have heart failure. This is what the ejection fraction numbers mean:
- An ejection fraction of 55% to 70%: The heart is pumping normally. You may have normal heart function or heart failure with preserved ejection fraction.
- An ejection fraction of 40% to 54%: The pumping capacity of the heart is slightly less than normal.
- An ejection fraction of 35% to 39%: The heart has a moderately lower pumping capacity than normal. This indicates mild heart failure with a reduced ejection fraction.
- An ejection fraction of less than 35%: The pumping capacity of the heart is much lower than normal. Very often there is moderate to severe heart failure with a reduced ejection fraction.
Although left heart failure cannot be cured, there are treatments available to help manage it. Treatments are usually tailored based on the cause of the heart failure. Treatments for left heart failure include:
- Make lifestyle changes, like getting more physical activity and eating heart-healthy food
- Reducing salt intake to help prevent or reduce fluid buildup in the body
- Take medications such as angiotensin converting enzyme (ACE) inhibitors, beta blockers, and diuretics. There are many types of medicines used for left heart failure.
- Having surgery to help repair a blocked artery or narrow or leaking heart valve
Right heart failure
Left heart failure is a common cause of right heart failure. However, other conditions can cause right heart failure, including certain lung diseases such as chronic obstructive pulmonary disease or pulmonary hypertension.
Symptoms of right heart failure
Symptoms of right heart failure are similar to those of left heart failure, although they can be more serious. These symptoms include:
- Shortness of breath even after short activity
- Swelling of the ankles and lower body as well as the abdomen, chest and thighs (also called edema)
- Swollen and painful liver
Treatments for right heart failure depend on its cause. Common treatments include:
- Surgical repair if the cause is valvular heart disease
- Use of medicines such as diuretics to help reduce edema or swelling
- Lifestyle changes such as a low fat / low sodium diet and mild aerobic exercise
- In severe cases, a heart transplant
Like left heart failure, right heart failure has no cure. However, you can use the different treatments to help manage it.
Biventricular heart failure
Heart failure most often occurs on the left side of the heart, but can then spread to the right side. Biventricular heart failure is used to describe heart failure present on both the left side and the right side of the heart.. Symptoms include fatigue, shortness of breath, and swelling. You would follow the treatments recommended by your doctor, including medications, surgery, and lifestyle changes.
What about congestive heart failure?
You may hear some healthcare professionals use the terms congestive heart failure or heart failure interchangeably. However, congestive heart failure can occur with any of the three types described above, its hallmark being the accumulation of fluid, especially in the lungs, producing pulmonary congestion.
Congestive heart failure occurs when the blood flow to the heart becomes slower than it should. This leads to a build-up of blood that returns to the heart through the veins, which usually results in swelling of the ankles, legs and sometimes other parts of the body. It is also possible for fluid to flow back into the lungs, causing breathing problems that worsen when put on.
Chronic heart failure is different from cardiac arrest, which is used to describe when the heart stops beating.
Symptoms of congestive heart failure
Sometimes congestive heart failure has no symptoms. When it does, these symptoms include:
- Irregular heartbeat
- Shortness of breath
- Swelling in the legs
Treatments for congestive heart failure include:
- Take medications like ACE inhibitors, diuretics, and vasodilators
- Having surgery to replace heart valves or open blocked arteries
- Eat a low sodium diet and avoid or limit caffeine
Doctors can monitor and treat other conditions related to congestive heart failure, including sleep apnea.
A word from Verywell
Although heart failure does not mean that the heart has stopped working completely, it is still a serious medical problem that requires medical attention and management. In addition to your doctor’s advice, you can make life changes to improve heart failure. For example, you can plan to walk regularly for physical activity and to make low sodium food choices.
If you haven’t been diagnosed with heart failure but have symptoms, such as shortness of breath, tell your doctor.
Frequently Asked Questions
What type of heart disease is most common?
Coronary artery disease is the most common type of heart disease. This can limit blood flow to the heart and increase the risk of a heart attack.
What are the stages of heart failure?
Cardiologists often use the following New York Heart Association groupings to describe heart failure:
- Class I: No symptoms and no limitation in ordinary physical activity; for example, no shortness of breath when walking or climbing stairs
- Class II: Mild symptoms such as slight shortness of breath and / or chest pain and slight limitation during ordinary activity
- Class III: Marked limitation of activity due to symptoms even during non-ordinary activity such as walking short distances; comfortable only at rest
- Class IV: severe limitations and symptoms even at rest; mainly bedridden patients
What are the warning signs of heart failure?
The warning signs of heart failure include:
- Cough and wheezing
- Shortness of breath
- Swelling around the ankles, legs and thighs
- Inability to do normal activities because you get tired easily
It is important to see a doctor to get the correct diagnosis and receive the necessary treatments.