Heart failure
Heart failure refers to a variety of conditions involving the inability of the heart to pump blood as well as it should. More than 4 million Americans have heart failure and at least 400,000 new cases are diagnosed each year.
Congestive heart failure is a form of heart failure in which excess fluid builds up in the body. Systolic heart failure and diastolic heart failure are the
2 categories of heart failure and symptoms vary from patient to patient. The heart does not suddenly stop, but usually becomes less efficient over a period of years.
Systolic heart failure occurs when the heart's ability to eject blood decreases. The heart does not pump with sufficient force to move enough blood into circulation. As a result, blood that normally flows from the lungs into the heart may back up and cause fluid to leak into the lungs (lung congestion).
Diastolic heart failure occurs when the heart has difficulty relaxing. If the heart muscle becomes stiff and loses its ability to relax, the heart cannot fill with blood properly. As a result, many patients experience a build up of fluid in the body, particularly in the feet, legs and ankles. Some patients may experience lung congestion.
High blood pressure, diabetes, coronary artery disease and a previous heart attack are key risk factors for developing heart failure. High cholesterol, smoking and obesity are risk factors for coronary artery disease. Some people develop heart failure from arrhythmia or heart valve disease.
Shortness of breath, fatigue, swelling in the lower limbs and persistent cough are common symptoms of heart failure. The condition can be diagnosed with a thorough physical examination and with diagnostic procedures such as electrocardiogram, echocardiogram and/or cardiac catheterization.
 Underlying
causes
Some underlying causes of heart failure can be corrected. Bypass surgery or angioplasty may help relieve symptoms caused by coronary artery disease. A pacemaker implant may be performed to provide regular electrical stimulus to the heart to treat arrhythmia. Heart valves may be replaced. However, for most patients with heart failure, there is no cure. Instead, medications and lifestyle modifications are usually prescribed to treat heart failure and prolong life.
Many of the common medications used to treat heart failure can reverse, or remodel, the damaged heart to improve its ability to pump blood to the body. In rare cases, a ventricular assist device (a small mechanical pump) may be implanted to help the damaged heart function. In some cases, heart transplant may be the only option, although a ventricular assist device sometimes makes a transplant unnecessary.
The Heart Failure Clinic is a specialty program located at Aurora St. Luke's Medical Center.
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